What is SIDS and is my baby at risk?

Sudden infant death syndrome (SIDS), or “cot death,” is a scary thought for parents, but you can reduce your baby’s risk. A paediatrician explains how. 

Sudden infant death syndrome (SIDS) is when a baby dies suddenly and unexpectedly. While it's commonly referred to as “cot death”, it has nothing to do with whether the baby is sleeping in a cot. It’s also not caused by one specific thing.

“SIDS is the term we use for babies who die unexpectedly and there’s no clear cause of death at autopsy,” explains Dr Andrew Ferreirinha, a paediatrician at Mediclinic Kloof. However, he adds that things that can cause a baby to die suddenly and unexpectedly include:

• Infections
• Accidental injury
• Accidental suffocation.

“There are a range of other conditions that can cause a baby to get severely ill, such as heart or lung conditions, seizures, metabolic disorders, and endocrine (hormone) conditions,” says Dr Ferreirinha. “This is why being seen by a paediatrician at birth and six weeks is important as some of these will be detected on examination.”

How common is SIDS?

As scary as SIDS is, it is not common, and the number of cases is actually decreasing. “The rate of SIDS has gone down since the early '90s when the Back-to-Sleep campaign started, which recommended putting babies to sleep on their backs,” explains Dr Ferreirinha.

SIDS risk factors

Babies are most at risk for SIDS between the ages of two and four months, says Dr Ferreirinha. He lists these risk factors:

• Sleeping on stomach or side – babies must always be put down to sleep on their backs.
• Bed sharing – especially if you fall asleep with the baby on a small surface like a couch. Falling asleep with the baby in bed after drinking alcohol or taking medicine that affects awareness significantly increases the risk.
• Soft mattresses – as well as loose bedding, such as blankets or duvets that cover the baby’s head and neck.
• Smoking – if the mom smokes, the baby’s risk of SIDS is higher.
• Premature birth – babies born prematurely or who had a complicated stay in the NICU have a higher risk of SIDS.
• Poor growth – may suggest health issues that affect the baby’s ability to handle risks like low oxygen during sleep.
• Overheating – check the baby is not getting too hot.
• Missing vaccinations – non-immunised infants are at higher risk of SIDS.

How to avoid SIDS

While you can’t eliminate the risk of SIDS entirely, there are many ways to greatly reduce the risk, says Dr Ferreirinha. “The most important way to prevent SIDS is placing your baby down on their back to sleep. This has been shown to be much safer than side sleeping or sleeping on their stomachs. It may be counterintuitive, but sleeping on their backs reduces the risk of choking on regurgitated milk.”

He also suggests using a firm mattress instead of a very soft one and making sure your baby’s head isn’t covered by a blanket or duvet. Avoid putting items with cords, ribbons, or ties in your baby’s cot, and don’t let them sleep in car seats or prams.

In the early days, he recommends keeping your baby close. “Room sharing (not bed sharing) has been shown to reduce the risk of SIDS, so we recommend that you have your baby’s cot in your room for the first few months.”

Breastfeeding and routine vaccinations have also been shown to reduce the incidence of SIDS.

Don’t rely on a monitor

Importantly, Dr Ferreirinha warns that home monitors tracking breathing, heart rate, and oxygen levels do not reduce the risk of SIDS. “The recommendation is that these devices be used for babies that require home monitoring for specific reasons,” he says.

Remember, SIDS is rare, and many of the risk factors are things you can control.