Every year about 3,500 infants die from sleep-related issues. In 1994 doctors recommended that infants be placed on their backs to sleep. This practice reduced the rate of SIDS (sudden infant death syndrome) but in recent years the rate has leveled off. Ninety percent of SIDS occurs before the age of 6 months with a peak incidence between 1 and 4 months. For this reason the guidelines have been expanded to include total sleep environment.

New warnings include avoiding the use of soft bedding material in the infant's crib or bassinet and the dangers of placing babies on a couch or armchair to sleep. Unfortunately, some  parents think that soft bedding and bed sharing are protective, however some bedding is so soft that the babies sink into it and this is dangerous. Likewise, bed sharing may give a sense of security, that if the parent is right next to the infant they can detect if there is a problem. This sense is false. More often than not the parent becomes distracted or drowsy and is unaware of danger. 

Room sharing but not bed sharing is a good idea. The infant should sleep in the parents' room, close to their bed but on a separate surface designed for infants, ideally for the first year, but at least for the first six months. In addition to placing infants on their backs to sleep, a firm sleeping surface should be used uncluttered by soft objects. Avoiding exposure to smoke, alcohol and illicit drugs obviously is wise. Routine immunization also is obviously highly recommended. Interestingly, breast feeding alone reduces the rate of SIDS by 50 percent. Offering a pacifier after breast feeding is established is also acceptable.

Physicians do not recommend the use of home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. There is no product in existence which can prevent SIDS despite some marketing claims.

In summary, parents should remember the ABCs: Babies should sleep alone. Babies should sleep on their back. Babies should sleep in a crib or bassinet without clutter.

 

Dr. Lyle D. Smith is a doctor at Dodge City Medical Center.