Sleeping in the prone position and exposure to cigarette smoke are associated
with an increased risk of SIDS.
The SIDS rate is 0.85 SIDS deaths per 1,000 live births. There
has been a 40% decline in the SIDS rate in the last two decades. This decline
has been attributed to the 1992 recommendations.
Sleeping position
The prone (on the stomach) sleeping position is associated with the highest
risk of SIDS; the supine position is associated with the lowest risk. Changing
babies from the prone to the supine sleeping.
Cigarette smoke exposure. Maternal smoking during
pregnancy and exposing the baby after birth to cigarette smoke increases the
risk of SIDS. Mothers should not smoke during pregnancy.
Potentially hazardous sleeping environments
Approximately 30% of deaths diagnosed as SIDS-related have
been related to unsafe sleeping environments or unsafe bedding material. Soft
mattresses, soft bedding, thick blankets or comforters, pillows, bumpers and
soft crib toys are associated with a higher SIDS risk.
Because of the potential hazards of overheating, it is
recommended that for sleep, a baby should be lightly dressed and covered with a
sheet or thin blanket, and the room temperature should be such that it would be
comfortable for an adult in a short-sleeve shirt. Swaddling of infants is not
recommended.
Infant home monitoring
Infant home monitoring is only recommended for use with any infant believed
to be at risk of sudden death. This recommendation includes preterm infants
still having abnormal apnea or bradycardia, infants with one or more episodes of
severe apparent life-threatening event (ALTE) and infants with medical
conditions (eg, central hypoventilation, tracheostomy) or on respiratory support.
The risk of SIDS is increased significantly in subsequent
siblings. Home monitoring should be offered for subsequent siblings.
Home monitoring has little effect on the incidence of SIDS.
The great majority of infants dying of SIDS are apparently healthy infants who
do not meet the criteria.