What is SIDS?
Sudden infant death syndrome (SIDS) is the leading cause of death in the United States for babies between 1 month and 1 year old.SIDS isn't any one illness or disease. Rather, it's the diagnosis given when a child under a year old dies suddenly and an exact cause can't be found after a death scene investigation, an autopsy, and a review of the child's medical history. That it can happen without warning makes SIDS particularly devastating for families.
Approximately 2,300 infants die from SIDS in the United States each year. SIDS most commonly affects babies between the ages of 1 and 4 months; 90 percent of cases involve infants younger than 6 months.
While SIDS can occur outside of cribs, it's also known as crib death because it happens most often during sleep, usually between the hours of 10 at night and 10 in the morning.
Nighttime isn't the only time that SIDS strikes, however. If your infant is in daycare, it's important to know that about 20 percent of SIDS deaths happen in childcare settings, according to a study published in the journal Pediatrics in 2000.
This is a surprisingly high number when you consider that babies spend much less time sleeping at daycare than they do at home. This statistic points out how crucial it is to make sure that everyone who cares for your baby follows safe sleeping guidelines (see "How can I lower my baby's risk of SIDS?").
What causes SIDS?
Researchers have learned a great deal about SIDS in the past three decades, but they still have no definitive answer to that question.Most experts believe that SIDS occurs when a baby has an underlying vulnerability (such as immature or abnormal functioning of the heart, breathing, or arousal) and is exposed to certain stressors (such as sleeping tummy-down or on soft bedding) during a critical period of development.
A study published in February 2010 in the Journal of the American Medical Association suggested another possible vulnerability. The researchers found that infants who died from SIDS had lower than normal levels of serotonin in the brainstem. Serotonin helps regulate breathing, heart rate, and blood pressure during sleep.
Experts are continuing to study the brain, the autonomic nervous system, infant care and sleep environments, infection and immunity, and genetics in search of answers.
Are certain babies at a higher risk for SIDS?
Although the exact cause of SIDS is unknown, some risk factors have been identified. They include:Being born prematurely or at a very low birth weight
The earlier a baby is born, the higher his risk of SIDS. Likewise, the lower his birth weight, the higher the risk.Being born to a mother under the age of 20
Teen moms are more likely than moms over 20 to have a child die of SIDS.Having a lot of siblings, especially if they are close in age
The risk of SIDS increases with each baby you have. Also, the shorter the time between a woman's pregnancies, the higher her baby's risk of SIDS.Suffering an apparent life-threatening event (ALTE)
Babies who have suffered what's called an apparent life-threatening event (stopped breathing and turned pale, blue, and limp and required resuscitation) have a higher risk of SIDS.Certain ethnic backgrounds
SIDS rates are highest for African Americans and American Indians and lowest for Asians and Hispanics. The rates of SIDS among African Americans, American Indians, and Alaska natives are more than double that of Caucasian infants.Some researchers hypothesize that a cultural preference for putting babies to sleep on their stomach puts certain groups at higher risk.
Being a boy
Boys of all ethnicities are at slightly higher risk than girls, by a ratio of 1.5 to 1.How can I lower my baby's risk of SIDS?
There's no guaranteed way to prevent SIDS, but you can greatly reduce the risk by following these recommendations from the American Academy of Pediatrics (AAP). In fact, following these safe sleep recommendations will reduce your baby's risk of all kinds of sleep-related death, including suffocation, strangulation, and entrapment.Put your baby to sleep on her back.
This is one of the most important things you can do to help protect your baby.The rate of deaths from SIDS has dropped about 50 percent since 1994, when the National Institute of Child Health and Human Development and other groups launched the Back to Sleep campaign. Make sure that every caregiver, including relatives and babysitters, knows to place your baby on her back to sleep during the first year of her life.
A baby's risk of SIDS has been found to be 1.7 to 12.9 times higher (depending on the study) if she sleeps on her tummy instead of her back. When a baby sleeps tummy-down, she's more likely to overheat, have pauses in breathing, and rebreathe the air she has just exhaled, which lacks oxygen.
Don't put your baby to sleep on her side either, since babies placed on their side can easily end up on their tummy.
Of course, by the time your baby is 5 or 6 months old, she may be able to roll over onto her tummy by herself. By this age, her risk for SIDS has started to drop, though, so do your best to get her settled on her back and then don't worry if she rolls over. Just make sure there's nothing soft in her crib that she could get her face next to that would increase the risk of SIDS or suffocation.
One problem with putting your baby on her back so much is that she may develop a flat spot on the back or side of her head. This is called positional plagiocephaly You can help prevent "flat head syndrome" by having your baby spend some supervised time on her tummy each day while she's awake.
Note: Don't use towels or a sleep positioner to try to keep your baby on her back or side. In 2010, the Food and Drug Administration (FDA) and Consumer Product Safety Commission (CPSC) issued a warning to parents to stop using sleep positioners after the suffocation deaths of 12 infants.
Choose bedding carefully.
Put your baby to sleep on a firm, flat mattress with no pillow or toys and nothing but a fitted sheet under him. (It's okay to put a thin, tight-fitting mattress pad under the sheet to protect against diaper leaks.)Several studies link soft sleeping surfaces, such as quilts, comforters, sofas, waterbeds, and beanbags to a higher risk of SIDS.(Sleeping with your baby on a couch or armchair carries a particularly high risk of SIDS and suffocation.) Even most regular adult mattresses are unsafe because they tend to be padded and covered with soft bedding.
Don't use blankets either. If you think your baby is chilly, dress him in warmer clothing such as footed pajamas or a cotton one-piece under a wearable blanket or sleep sack – a sleeveless garment that's closed along the bottom like a bag.
The AAP and SIDS prevention groups also caution against using crib bumpers. There's no evidence that bumpers prevent injuries, and they may lead to suffocation, strangulation, or entrapment. Also, without bumpers, air circulates more freely around your baby and you can see him better.
Don't use products claiming to reduce the risk of SIDS, such as sleep positioners, wedges, or special mattresses. There's no evidence that these work or that they're even safe.
Finally, don't let your baby sleep for extended periods in a car seat, stroller, swing, bouncy seat, infant carrier, or sling. This is particularly important for babies under 4 months because they can suffocate if their head rolls forward too much. If your baby falls asleep in one of these devices, transfer him to a crib or play yard as soon as is practical. When your baby is in an infant carrier or sling, make sure his nose and mouth are clear and not pressed against your body or the fabric.
Sleep in the same room as your baby.
This arrangement may lower the risk of SIDS significantly. The AAP doesn't recommend sharing a bed with your baby because it's associated with an increased risk of SIDS even with nonsmoking or breastfeeding moms. Sharing a bed is also known to lead to suffocation, strangulation, or entrapment. Instead, place your baby's crib, bassinet, or play yard in your room near your bed.Avoid overheating your baby.
To keep your baby from getting too warm while he sleeps, dress him in no more than one layer more than an adult would wear to be comfortable in that environment. Watch for signs of overheating such as sweating and damp hair.Don't cover your baby's face or head with hats or hoods. (Unless your baby is premature, he won't need the cap they give you at the hospital after the first few days.)
Get regular prenatal care.
Proper prenatal care is important in protecting your baby's health and reducing the risk of a premature birth or low birth weight (both of which are risk factors for SIDS). So make sure you keep all your prenatal appointments.Don't smoke, drink alcohol, or use illegal drugs during pregnancy.
Almost every study has identified smoking during pregnancy as a risk factor for SIDS. Drinking and using drugs have also been found to be risk factors. Of course, all three can compromise a baby's healthy development in many other ways, too.Keep your baby away from cigarette smoke.
Keep the air around your baby at home, in the car, and in all other environments free of smoke. If others insist on smoking, make sure they go outside the house to do it.Studies show that a baby's risk of SIDS rises with each additional smoker in the household, with the number of cigarettes smoked around her each day, and with the length of her exposure to cigarette smoke.
Researchers are also beginning to look at the potential danger of "third-hand smoke" –that is, the chemicals that are left behind on clothing, furniture, carpets, and car upholstery when someone has been smoking nearby.
Make sure your baby gets all his vaccinations.
Evidence suggests that getting all of the vaccines on the recommended schedule may cut the risk of SIDS in half.Breastfeed if you can.
Breastfeed for at least six months, if possible. But even some breastfeeding is better than none. A large German study published in 2009 concluded that both partial breastfeeding and exclusive breastfeeding are associated with a reduction in SIDS. In fact, the researchers determined that exclusive breastfeeding until 1 month of age cut the risk of SIDS in half.Offer your baby a pacifier when you put him down to sleep.
Studies show a lower incidence of SIDS among infants who use pacifiers, although experts don't know whether there's a direct cause and effect. Because of the correlation, the AAP suggests that you give your baby a pacifier when putting him down for naps and at bedtime for the first year of life.You don't have to reinsert the pacifier if your baby drops it once he falls asleep. And there's no need to force your baby to use one if he doesn't take to it. The AAP also cautions that if you're nursing, it's best to wait to offer a pacifier until breastfeeding is well established – usually around three or four weeks after birth.
Will sharing a bed with my baby raise the risk of SIDS?
Some experts believe there are compelling reasons not to let your baby sleep in your bed during your baby's first months. For one thing, your bed surely has pillows and blankets and other soft bedding, all of which are risk factors for SIDS. It's also easier for your baby to become overheated while sharing your bed."The vast majority of studies conducted on this subject have shown that bed-sharing increases the risk of SIDS," says John Kattwinkel, past chairman of the AAP Task Force on Infant Sleep Position and Sudden Infant Death Syndrome.
Studies have shown that bed-sharing can substantially increase the risk of SIDS or suffocation in certain situations. These include:
- when the infant is under 3 months old
- bed-sharing with a smoker or if the mother smoked during pregnancy
- bed-sharing with someone who is very tired or using sedating medication or substances
- bed-sharing with anyone who is not a parent, including other children, or with more than two people
- bed-sharing on a soft surface such as a couch or waterbed or with soft bedding, including pillows and heavy covers
If you do decide to share your bed with your baby, make sure that your mattress is firm and flat and that it fits tightly against the headboard with no space around it where your baby's head could get stuck. Never co-sleep on a softer surface, such as a waterbed, couch, or armchair. Keep heavy, fluffy bedding away from your child, and even in your bed, put her to sleep on her back.
Is it okay for me to swaddle my baby?
Some researchers suggest that swaddling – the practice of wrapping a baby securely in a blanket or cloth – may help prevent SIDS because it can help a baby sleep more soundly on his back. If your baby startles while he's sleeping, his own body movements can wake him up. Swaddling can limit those movements and help a young baby feel more secure.Other SIDS experts caution that swaddling could contribute to overheating. So if you do swaddle your baby, use a thin blanket and make sure the room isn't too warm. And, of course, never put your baby on his tummy when he's swaddled.
Should I use a heart rate monitor?
Your baby's doctor may have prescribed a cardio-respiratory monitor if your baby has had a life-threatening breathing incident or severe respiratory problems. If such a monitor was prescribed for your baby, of course you should use it diligently.You may also see home sleep-monitoring systems sold by baby product retailers. These systems detect a baby's movements and alert you if movement (and presumably breathing) stops for a certain amount of time.
According to the AAP, there's no evidence these products will reduce a baby's risk of SIDS. If you use one, you'll still need to take every precaution you can to protect your baby.
Where can I get more information?
- The American SIDS Institute conducts research and offers education and round-the-clock support to pediatricians and families. Call (800) 232-7437 or (770) 426-8746, or visit the institute's website.
- The Back to Sleep Hotline, sponsored by the National Institutes of Health, offers information, support, and referrals. Call (800) 505-2742.
- The CJ Foundation for SIDS is the largest nongovernmental funder of SIDS-related programs in the United States. Visit the foundation's website for news about SIDS, a look at ongoing research, and updates on fundraisers and events around the country.
- First Candle (formerly SIDS Alliance) provides information and supports research aimed at preventing SIDS and stillbirth. It also offers grief counseling to those affected by the death of a baby.
- The National SIDS/Infant Death Resource Center provides information sheets, annotated bibliographies, and referral services to parents, caregivers, and researchers.
ABOUT SID LEAFLET PDF
Sleep Position: Why Back is Best
The
American Academy of Pediatrics recommends that healthy infants be
placed on their backs for sleep, as this is the safest position for an
infant to sleep. Putting your baby to sleep on his back decreases his
chance of sudden infant death syndrome (SIDS), which is responsible for
more infant deaths in the United States than any other cause during the
first year of life (beyond the newborn period). The exact reason for
this finding is not certain, but it may be related to findings that
suggest that an infant who sleeps on her stomach gets less oxygen or
gets rid of carbon dioxide less because she is “rebreathing” the air
from a small pocket of bedding pulled up around the nose.
In addition, recent findings suggest that certain regions of the brain may be underdeveloped in babies who die from SIDS. When these sleeping babies encounter a situation challenging to their well-being, they may fail to wake up to remove themselves from danger. Since it is impossible to identify which babies may not arouse normally, and because the relationship between SIDS and sleep position is so strong, the Academy recommends that all infants be placed to sleep on their backs. Some doctors once thought that sleeping on the side might be a reasonable alternative to back positioning, but recent evidence has shown that side sleeping also should be avoided for safety reasons. (Please note that there are a few exceptions to this recommendation, including babies with certain medical conditions, which your pediatrician can discuss with you.)
This recommendation of putting the baby down on her back applies to infants throughout the first year of life. However, it is particularly important during the first six months, when the incidence of SIDS is the highest.
Even when you are sure your baby is lying on her back when going to sleep, it is also important to avoid placing her on soft, porous surfaces such as pillows, quilts, comforters, sheepskins, or bean bags—even soft materials used for stuffed toys—which may block her airway if she burrows her face in them. Also avoid having her sleep on waterbeds, sofas, or soft mattresses. A firm crib mattress covered by a sheet is the safest bedding. Keep all soft toys and stuffed animals out of your child’s crib throughout infancy. Keep the temperature in your baby’s room comfortable and do not place her near air-conditioning or heating vents, open windows, or other sources of drafts. Use sleep clothing (such as a one-piece sleeper) with no other covering, as an alternative to blankets. For an extra layer, a wearable blanket sleeper or sleepsack is a safe alternative.
Pacifiers also may help reduce the risk of SIDS. However, if your baby doesn’t want the pacifier or if it falls out of her mouth, don’t force it. If you are breastfeeding, wait until breastfeeding is well established, usually around three or four weeks of age, before using a pacifier. While sleeping on the back is important, your baby also should spend some time on her stomach when she is awake and being observed. This will help to develop her shoulder muscles and her head control, and avoid the development of flat spots on the back of her head.
As she gets older and her stomach grows, your baby will be able to go longer between feedings. In fact, you’ll be encouraged to know that more than 90 percent of babies sleep through the night (six to eight hours without waking) by three months. Most infants are able to last this long between feedings when they reach 12 or 13 pounds (5.44–5.89 kg), so if yours is a very large baby, she may begin sleeping through the night even earlier than three months. As encouraging as this sounds, don’t expect the sleep struggle to end all at once. Most children swing back and forth, sleeping beautifully for a few weeks, or even months, then returning abruptly to a late-night wake-up schedule. This may have to do with growth spurts increasing the need for food, or, later, it may be related to teething or developmental changes.
From time to time, you will need to help your baby fall asleep or go back to sleep. Especially as a newborn, she probably will doze off most easily if given gentle continuous stimulation. Some infants are helped by rocking, walking, patting on the back, or by a pacifier in the mouth. For others, music from a radio or a CD player can be very soothing if played at moderate volume. Certain stimulation, however, is irritating to any baby—for example, ringing telephones, barking dogs, and roaring vacuum cleaners.
There is no reason to restrict your baby’s sleeping to her crib. If, for any reason, you want her closer to you while she sleeps, use her bassinet as a temporary crib and move it around the house with you.
Based on an evaluation of current sudden infant death syndrome (SIDS) data, the American Academy of Pediatrics recommends that healthy infants, when being put down to sleep, be placed on their backs. Despite common beliefs, there is no evidence that choking is more frequent among infants lying on their backs (the supine position) when compared to other positions, nor is there evidence that sleeping on the back is harmful to healthy babies. In some circumstances, there are still good reasons for placing certain infants on their stomachs for sleep. Discuss your individual circumstances with your pediatrician.
Since 1992, when the American Academy of Pediatrics began recommending this sleep position the annual SIDS rate has declined more than 50 percent.
In addition, recent findings suggest that certain regions of the brain may be underdeveloped in babies who die from SIDS. When these sleeping babies encounter a situation challenging to their well-being, they may fail to wake up to remove themselves from danger. Since it is impossible to identify which babies may not arouse normally, and because the relationship between SIDS and sleep position is so strong, the Academy recommends that all infants be placed to sleep on their backs. Some doctors once thought that sleeping on the side might be a reasonable alternative to back positioning, but recent evidence has shown that side sleeping also should be avoided for safety reasons. (Please note that there are a few exceptions to this recommendation, including babies with certain medical conditions, which your pediatrician can discuss with you.)
This recommendation of putting the baby down on her back applies to infants throughout the first year of life. However, it is particularly important during the first six months, when the incidence of SIDS is the highest.
Even when you are sure your baby is lying on her back when going to sleep, it is also important to avoid placing her on soft, porous surfaces such as pillows, quilts, comforters, sheepskins, or bean bags—even soft materials used for stuffed toys—which may block her airway if she burrows her face in them. Also avoid having her sleep on waterbeds, sofas, or soft mattresses. A firm crib mattress covered by a sheet is the safest bedding. Keep all soft toys and stuffed animals out of your child’s crib throughout infancy. Keep the temperature in your baby’s room comfortable and do not place her near air-conditioning or heating vents, open windows, or other sources of drafts. Use sleep clothing (such as a one-piece sleeper) with no other covering, as an alternative to blankets. For an extra layer, a wearable blanket sleeper or sleepsack is a safe alternative.
Pacifiers also may help reduce the risk of SIDS. However, if your baby doesn’t want the pacifier or if it falls out of her mouth, don’t force it. If you are breastfeeding, wait until breastfeeding is well established, usually around three or four weeks of age, before using a pacifier. While sleeping on the back is important, your baby also should spend some time on her stomach when she is awake and being observed. This will help to develop her shoulder muscles and her head control, and avoid the development of flat spots on the back of her head.
As she gets older and her stomach grows, your baby will be able to go longer between feedings. In fact, you’ll be encouraged to know that more than 90 percent of babies sleep through the night (six to eight hours without waking) by three months. Most infants are able to last this long between feedings when they reach 12 or 13 pounds (5.44–5.89 kg), so if yours is a very large baby, she may begin sleeping through the night even earlier than three months. As encouraging as this sounds, don’t expect the sleep struggle to end all at once. Most children swing back and forth, sleeping beautifully for a few weeks, or even months, then returning abruptly to a late-night wake-up schedule. This may have to do with growth spurts increasing the need for food, or, later, it may be related to teething or developmental changes.
From time to time, you will need to help your baby fall asleep or go back to sleep. Especially as a newborn, she probably will doze off most easily if given gentle continuous stimulation. Some infants are helped by rocking, walking, patting on the back, or by a pacifier in the mouth. For others, music from a radio or a CD player can be very soothing if played at moderate volume. Certain stimulation, however, is irritating to any baby—for example, ringing telephones, barking dogs, and roaring vacuum cleaners.
There is no reason to restrict your baby’s sleeping to her crib. If, for any reason, you want her closer to you while she sleeps, use her bassinet as a temporary crib and move it around the house with you.
Based on an evaluation of current sudden infant death syndrome (SIDS) data, the American Academy of Pediatrics recommends that healthy infants, when being put down to sleep, be placed on their backs. Despite common beliefs, there is no evidence that choking is more frequent among infants lying on their backs (the supine position) when compared to other positions, nor is there evidence that sleeping on the back is harmful to healthy babies. In some circumstances, there are still good reasons for placing certain infants on their stomachs for sleep. Discuss your individual circumstances with your pediatrician.
Since 1992, when the American Academy of Pediatrics began recommending this sleep position the annual SIDS rate has declined more than 50 percent.
Myth I, "Supine sleeping has greatly reduced the incidence of SIDS since 1992.": FALSE. The absolute incidence of SIDS prior to the Back to Sleep Campaign was already dropping in the US, from 1.511 per 1000 in 1979 to 1.301 per 1000 in 1991 (cdc.gov).
SIDS deaths in the U.S. decreased from 4,895 in 1992 to 2,247 in 2004 (source). But, during a similar time period, 1989 to 2004, SIDS being listed as the cause of death for sudden infant death (SID) decreased from 80% to 55% (source). According to Dr. John Kattwinkel, chairman of the Center for Disease Control (CDC) Special Task Force on SIDS "A lot of us are concerned that the rate (of SIDS) isn't decreasing significantly, but that a lot of it is just code shifting†(source).
Myth 2, "There is a regulated, standard, routine procedure for determining an infant death as SIDS. I can be confident that the statistics match actual SIDS deaths.": FALSE. Deaths that are determined to be SIDS deaths are as variable as the doctor or coroner determining the cause of death. There is currently no legislation (law) regulating the national standards for investigation (source). The Scripps review of 40,000 infant deaths going back to 1992 revealed that the quality of infant death investigations, the level of training for coroners, and the amount of oversight and review vary enormously across the country. In many cases, professional bias — both for and against a diagnosis of SIDS — trumps medical evidence (source). President Obama and the CDC are only just (as of this year, 2009) beginning to make legislation to standardize these investigations.
Myth 3, "Supine sleeping, prevents SIDS.": FALSE. No one thing prevents SIDS. It is a mysterious occurrence that the medical world only has theories about. It seems to be an environmental incident, closely related to the infant's home environment, environmental exposures, pre and antenatal care, among other factors. This is Wikipedia's list of possible SIDS causes.
Myth 4, "Because I know that supine sleeping prevents SIDS, it must be safe to place my baby to sleep this way." Not entirely false, not entirely true. There are several current completed and working studies that indicate that supine sleeping may be dangerous.
Dr. Rafael Pelayo from Stanford University and a number of other pediatric sleep researchers in the U.S. have stated that they believe that the American Academy of Pediatrics' recommendations regarding cosleeping and pacifier use may have unintended consequences. They have stated that the SIDS prevention strategy of the American Academy of Pediatrics which keeps infants at a low arousal threshold and reduces the time in quiet sleep may be unhealthy for children. They state that slow wave sleep is the most restorative form of sleep and limiting this sleep in the first 12 months of life may have unintended consequences to both the sleep and the infant (source).
According to a 1998 study by British researchers that compared back sleeping infants to stomach sleeping infants there were developmental differences at 6 months of age between the two groups. At 6 months of age the stomach sleeping infants had higher gross motor scores, social skills scores, and total development skills scores than the back sleeping infants. The differences were apparent at the 5% statistical significant level. But, at 18 months the differences were no longer apparent. The researchers deemed the lower development scores of back sleeping infants at 6 months of age to be transient and stated that they do not believe the back sleeping recommendations should be changed (source). Other scientists have stated that the conclusion that the negative effects of back sleep at 18 months of age is transient is based upon very little evidence and that no long-term randomized trials have been completed (source; This source, by the Scientific World publication offers a challenge to the Back to Sleep Campaign (BTSC) from two perspectives: (1) the questionable validity of SIDS mortality and risk statistics, and (2) the BTSC as human experimentation rather than as confirmed preventive therapy).
Other side effects of the back sleeping position include increased rates of shoulder retraction, positional plagiocephaly (flattened back of the head) and positional torticollis (source). A research study on children with plagiocephaly found that 26% had mild to severe psychomotor delay. This study also showed that 10% of infants with plagiocephaly had mild to severe mental development delay (source). Because of the delays caused by back sleep some medical professionals have suggested that the "normal" ages at which children had previously attained developmental milestones should be pushed back. This would enable medical professionals to consider children who previously were considered developmentally delayed as "normal" (Stevens P, "The Flip Side of Back to Sleep", The O&P Edge.)
Additional studies have reported that the following negative conditions are associated with the back sleep position: increase in sleep apnea, decrease in sleep duration, strabismus, social skills delays, deformational plagiocephaly, and temporomandibular jaw difficulties (source). Other studies have reported that the prone position prevents subluxation of the hips, increases psychomotor development, prevents scoliosis, lessens the risk of gastroesophageal reflux, decreases infant screaming periods, causes less fatigue in infants, and increases the relief of infant colic (source). In addition, prior to the “Back to Sleep†campaign many babies self-treated their own torticollis by turning their heads from one side to the other while sleeping in the prone position (Graham J, Gomez M, Halberg A, Earl D, Kreuzman J, Cui J, Guo X. Management of Deformational Plagiocephaly: Repositioning Versus Orthotic Therapy. The Journal of Pediatrics. 2005;10.016:258-22).
Since 1998 there have been several studies published which report that infants placed to sleep in the supine position lag in motor skills, social skills, and cognitive ability development when compared to infants who sleep in the prone position (source, source). In a 1998 article entitled “Effects of Sleep Position on Infant Motor Development.†by Davis, Moon, Sachs, and Ottolini, the authors state “We found that sleep position significantly impacts early motor development.†The prone (stomach) sleeping infants in this study slept an average of 225.2 hours (8.3%) more in their first 6 months of life than the supine (back) sleeping infants (source).
Back-sleeping significantly reduces the amount of slow wave sleep that infants engage in and it is theorized that infants that have the brain-stem defect are at increased risk of being unable to arouse from SWS (also called deep sleep) and therefore have an increased risk of SIDS due to their decreased ability to arouse from SWS (Kattwinkel J, Hauck F.R., Moon R.Y., Malloy M and Willinger M Infant Death Syndrome: In Reply, Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden\Pediatrics 2006;117;994-996). (Basically they're saying that if the infant has this defect, then they are at risk. Healthy infants are not apparently at risk for not arousing from SWS, and prenatal factors are what affect the development of the brainstem). SWS is vitally important to development and growth, and studies indicate that supine-positioned infants are being deprived of it, thereby aiding in cognitive and psychomotor delay.
Many of the studies and articles cited are available to be read online and I strongly suggest that if you are concerned that you read them. To me, there is no question: the risks of SIDS is hugely outweighed by the crushing evidence that back sleeping is unhealthy for children and causes several kinds of developmental delays. My purpose for this post is to help to inform, as the BTSC is so powerful and pervasive. Children are at risk for SIDS no matter what their sleep position; it is not prone sleeping that causes this condition. Hopefully in the future the true causes for SIDS will be discovered, SIDS investigations will be well-regulated, and no parent will have to suffer. It is unnacceptable to me that the basic message of the BTSC is "if you put your baby to sleep on his back, he will not die of SIDS". It's ridiculous, and I think the whistle needs to be blown.
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