Infant Safety and SIDS

Sudden Infant Death Syndrome, also known as SIDS, is a frightening threat for many new parents. When infants pass away suddenly and without explanation, it can create anxiety and fear in the hearts of other parents and caregivers who desperately want to take every measure to protect their little ones from harm. 

Although the root cause still isn't known, brand new research has made SIDS a little easier to understand as new studies have pointed to a certain enzyme that may play a role in why some infants succumb to SIDS and others do not.

Each year in the U.S., SIDS is responsible for thousands of infant deaths, most occurring before 6 months of age. The how's and why's of SIDS deaths still remain unclear, but new research recently published in eBioMedicine has brought some new information to light about how biology affects sudden infant death.

A potential biomarker has been identified

The new study published in eBioMedicine in May of 2022 showed that compared to other babies, infants that died of SIDS tended to have lower levels of butyrylcholinesterase, an enzyme that is responsible for arousal from sleep.

This doesn't necessarily mean that low levels of this particular enzyme directly causes SIDS, but there appears to be some sort of connection between the low levels of the enzyme causing a dysfunction in the area of a baby's brain that deals with sleep arousal.

Infant sleep and creating a safe sleep environment should be at the forefront of parental concern about SIDS and other sleep related infant deaths.

Sleep and SIDS are closely connected

Sudden Unexpected Infant Death (SUID), a category that includes SIDS, is the leading cause of death in infants. The American Academy of Pediatrics (AAP) has conducted significant research on how to keep babies safe, especially during sleep. 

Thousands of infants die each year due to sleep-related deaths. The death rates did decrease in the 1990s as safe sleep practices changed.

The introduction of safe sleep practices has dramatically reduced the number of SIDS cases in this country each year. Despite this, many infants continue to die without any real cause or connection, which can be terrifying to new parents.

The guilt of feeling negligent or that they didn't do all they could to protect their baby from death is crushing for parents and caregivers who desperately want to keep their babies safe. When considering using any baby products, it is important to consider your baby's risk, avoiding products that claim to reduce your baby's risk of SIDS with no real scientific evidence to back those claims.

The American Academy of Pediatrics recommends keeping babies safe at night by:

• Putting them to sleep on their backs. Infants should be placed on their backs to sleep for the first year. Many parents report that their baby sleeps better on their belly, but this is not as safe as sleeping on their back. Babies that roll might move to their belly during the night, which is safe because their brains and bodies are mature enough to regulate their breathing. It is important to make sure a baby can fall asleep on his back, but once he can roll over, it's fine to allow for change in position.

• Using a firm sleep surface. Use a firm sleep surface for your infant. Keep soft bedding and mattresses out of the nursery until your little one is older. Soft, padded bedding can increase the risk of suffocation. Keep your baby out of your bed, as the caregiver's sleep area is not ideal for sharing with an infant. Your little one should always sleep in a crib or bassinet designed to keep infants safe. Babies need to sleep on a firm mattress to prevent SIDS.

• Sharing a room with your baby. The American Academy of Pediatrics recommends room sharing for your baby's first 6-12 months. Room sharing can help prevent SIDS and other sleep-related deaths because parents and caregivers can be closer to their baby to tend to their needs throughout the night. Babies that sleep close to their caregivers are also shown to have better breathing and temperature regulation. Room sharing for 1 year can feel like a daunting task, so do what works for your family. Help reduce the risk of SIDS by room sharing (not to be confused with bed sharing).

  Sharing a room with your little one can also make breastfeeding easier for both mothers and babies. It can also be helpful when your baby's pacifier falls out of the crib or bassinet, and you can easily give it back to them.

• Avoiding bed sharing with your baby. Do not place your baby in bed with you during the night. Sleeping in bed with exhausted parents or on a soft mattress surrounded by pillows and blankets is not a safe space for infants. Babies should always sleep in a crib or bassinet.

• Avoiding soft bedding. Soft, loose bedding needs to be kept out of your baby's sleep area because it increases the risk of SIDS. Use a properly sized fitted sheet over your baby's mattress and do not use soft objects, blankets, pillows, stuffed toys, or bumper pads around your baby in the crib.

• A pacifier is safe to use, and has also been shown to reduce the risk of SIDS. Not all babies enjoy using a pacifier, but be sure to introduce one early on to see how your baby tolerates it.

• Keeping the sleep environment at an ideal temperature. Babies are not able to regulate body temperature well, so keep your baby's sleep space at an ideal temperature of around 70 degrees Fahrenheit. Use an air conditioner, ceiling fan, or portable fan to help cool your baby's bedroom on warm nights.

• Don't overdress your baby at night. Do not use loose blankets in the crib. Your baby can use a wearable blanket that allows for movement while keeping them warm. Loose blankets can get stuck and block baby's face, making it difficult for them to breathe. 

Parents and caregivers can also reduce the risk of SIDS through other measures.

The AAP also states that parents can reduce their baby’s SIDS risk by avoiding exposure to smoke, choosing to breastfeed, keeping up with routine immunizations, and encouraging your baby to use a pacifier.

Skin to skin time between parents and caregivers and their little ones has also been shown to be beneficial in reducing the risk of SIDS. The American Academy of Pediatrics also urges parents to avoid sleeping on couches, chairs, and other raised surfaces with their baby.

Tummy time is also helpful for allowing your baby to practice the skills he'll need to move his head and body safely during the night, which can help regulate breathing and keep your baby safe from sleep-related injuries and death. If your baby doesn't like tummy time, use a small pillow or rolled-up receiving blanket under her shoulders to help prop her up.

Your baby's sleep space matters.

Babies need to be placed to sleep in a crib or bassinet for naps and at night, with no exceptions. Swings, car seats, and rockers are not ideal or safe sleep environments for infants. A baby's sleep area is an important factor in reducing the risk of SIDS.

The safe sleep campaign urges parents to put their baby to sleep on her back, on a firm mattress, in a safe space.

Through simple adjustments, parents and caregivers can keep their babies safe.

Sudden Infant Death Syndrome (SIDS) and other sleep-related infant deaths can be frightening for parents, but putting your baby to sleep in a safe environment can greatly reduce the risk of injury and/or death. Safe sleep is something all new parents need to learn about, and your health care provider can give you information on how to create the ideal sleep environment for your little one.