Crib Death Is Real: What You Can Do to Keep Your Baby's Sleep Safe

Sudden infant death syndrome (SIDS), as the name suggests, is the unexplained death of an otherwise healthy baby during sleep. It’s also known as “crib death” and mostly occurs between 1- to 4-months-old.  

SIDS is especially terrifying because medical experts and scientists still don't know why it happens. As to how it kills infants, Dr. Philip S. Chua explains on the Cebu Doctor's University website, “Nobody knows for sure, but it appears that the baby is suddenly unable to breathe or stops breathing, resulting in respiratory arrest and ultimately cardiac arrest.” He adds, “One can suspect that the upper airway somehow suddenly becomes blocked. Why? Science does not know.” 

What we do know, however, is there are things parents can do to help prevent it. Here are the key points of latest safe sleep guidelines from the American Academy of Pediatrics (AAP). 

The full statement that lists 19 recommendations can be found here. 

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1. Put your baby down to sleep on his back. 

Lay your baby down with his back resting on his mattress and his face towards the ceiling. “The relationship between SIDS and sleep position is so strong, the Academy recommends that all infants be placed to sleep on their backs,” says the AAP. 

Dr. Chua set aside the old advice that infants are more comfortable sleeping on their stomach. “The old teaching was that the babies should sleep on their tummy. That advice was abandoned because of the observation that the prevalence of SIDS was very low among those babies who slept on their back, and higher among those who slept on their stomach.” 

“Once your baby can roll over both ways, which usually happens around 6 months, he may not stay on his back. That’s OK. It’s fine to let him choose his own sleep position once he knows how to roll over,” says WebMD. 

2. Place baby's crib in your bedroom, but avoid letting her sleep on your bed. 

The AAP recommends that your baby have a separate sleeping space from mom and dad, meaning it’s not advisable that he sleeps next to you on your bed. This is to prevent suffocation, strangulation, and entrapment. 

“Some parents think if baby is right next to them, they can tell if there is a problem...and protect the baby,” says pediatrician Dr. Rachel Y. Moon. “The safest place for the baby to sleep in is in a crib, a bassinet, or a playpen which is separate from where the parent is sleeping,” stresses Dr. Moon, the lead author of the AAP safe sleep guidelines and chair of the Task Force on SIDS. 

Have your baby sleep in your bedroom in her own crib for at least the first six months. The AAP also reminded parents not to place babies on a sofa, couch, or cushioned chair, either alone or with another person.

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3. The mattress should be firm and the bedsheet should be tight-fitting.

“Everybody thinks if [the mattress] is soft, then it can’t hurt the baby. But soft bedding is actually really a problem because it’s so soft they sink into it. People will often use pillows to ‘cushion’ the babies, and babies sink into them. …That’s very dangerous,” says Dr. Moon. 

As per the guidelines, a good mattress for babies is one that maintains its shape. It should not indent or conform to the shape of your baby’s head when he’s placed on it. “Soft mattresses, including those made from memory foam, could create a pocket (or indentation) and increase the chance of rebreathing or suffocation if the infant is placed in or rolls over to the prone position.”

4. Clear his crib — no pillows, blankets, crib bumpers, stuffed toys, etc. 

Safe sleep guidelines recommend that you keep your baby's sleeping space bare. It should only have a firm mattress and a tight-fitting bedsheet. Remove pillows, blankets, stuffed toys, bumper cribs and any other soft items. Again, it’s to prevent accidental suffocation and strangulation. 

If you’d want your baby to be warmer when he sleeps, opt for a wearable blanket. Says the AAP, “Infant sleep clothing, such as a wearable blanket, is preferable to blankets and other coverings to keep the infant warm while reducing the chance of head covering or entrapment that could result from blanket use.” 

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5. Breastfeeding and offering a pacifier may help.

If you can, breastfeed your baby for as long as possible. Its benefits may go beyond nutrition and may even help with SIDS prevention. “Any breastfeeding has been shown to be more protective against SIDS than no breastfeeding,” says guidelines. 

In a similar light, consider giving your baby a pacifier if this helps calm him down during bedtime as well. Research shows that a pacifier may also help prevent SIDS. “It does not need to be reinserted once the infant falls asleep. If the infant refuses the pacifier, he or she should not be forced to take it,” according to the AAP. “Because of the risk of strangulation, pacifiers should not be hung around the infant’s neck. Pacifiers that attach to infant clothing should not be used with sleeping infants.” 

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