Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history."[1] (Willinger et al, 1991). It's hard to believe but there are some things we, as parents and caregivers, may be able to do to help avoid SIDS by reducing some of the factors which may lead to SIDS. 

The first rule in avoiding SIDS that doctors advise is for parents and caregivers to place babies to sleep on their backs at all times.  Because babies may wake and cry more frequently when placed on their backs to sleep, parents may wonder if they are doing the right thing by not placing babies on their stomachs.  But placing baby tummy-side down may make your baby more difficult to arouse when waking--even though a baby may cry less frequently and wake up less often during sleep time.

Betty McEntire, Ph.D., of the American Institute for Sudden Infant Death Syndrome, says, "Infants are more likely to have apnea (pauses in breathing) when on their stomachs. They are also more likely to re-breathe the air they have just exhaled, which can raise their levels of carbon dioxide. The increased retention of body heat can also be dangerous for some infants. But more convincing than any other fact is that belly-sleep has up to 12.9 times the risk of death as back-sleep*."[2]

According to some statistical resources, "SIDS was responsible for 0.543 deaths per 1,000 live births in the US in 2005.[3]  While SIDS is responsible for many fewer deaths than congenital disorders and disorders related to short pregnancies, it is the main cause of death in healthy infants over one month of age. In 2009, the U.S. SIDS rate was 0.55 per 1,000 live births.

Factors that may contribute to SIDS are wide ranging and appear to include the infant's sex and age, as well as possibly ethnicity, and education and socio-economic-status of the infant's parents. There are also physiological risk factors, according to The Journal of the American Medical Association, including low birth weight, premature birth, whether a child is breastfed or not. There are some risk factors parents and caregivers can control, such as whether there is excess bedding or too soft a sleep surface, the presence of stuffed animals in the infant's crib or bed, exposure to tobacco smoke, co-sleeping with siblings or parents, even the prevalence of mold in the home which causes flu- or asthma-like symptoms in an infant. 

An infant is at the highest risk of SIDS from birth to four months of age; the risk decreases after infants attain one year of age. As parents and caregivers, paying attention to how and where babies sleep is first and foremost. Parents and caregivers should check on sleeping babies regularly and eliminate risk factors within their control. Certainly there are medical factors that parents cannot always control. Also, as conscientious caregivers, we need to do our homework when looking for daycare for infants to make sure risk factors are not present. In short, we need to be careful and watchful of our precious infants at all times.