While SIDS cannot be predicted or prevented at this time, many years of research have helped identify risk factors, that when combined with an underlying biological abnormality in a susceptible infant, can increase the risk of SIDS. Reducing the presence of those risk factors can greatly lower the risk of SIDS. However, it cannot alone eliminate SIDS.
There are both modifiable and non-modifiable risk factors. Non-modifiable risk factors are factors that are beyond a parent’s control. These include:
gender (boys are almost twice at risk for SIDS than girls)
age (being between 2 and 4 months old)
season (SIDS peaks during the winter months)
being a multiple (twin, triplet or higher multiple)
being born prematurely
being born small for gestational age
being sick with a mild infection
Modifiable risk factors are factors that parents and caregivers can control, such as following safe sleep practices. Since we are not able to determine at this time which babies are at risk for SIDS and which ones are not, it is very important that anyone who cares for an infant, whether a parent, grand-parent, babysitter or friend, follows safe sleep practices and other risk reduction strategies to help lower the risk of SIDS.
What You Can Do
Back to Sleep - Always place your baby on his back to sleep for all sleeps (nap and night time) on a flat and firm surface. It is very important to place babies on their backs to sleep immediately after birth. Make sure to tell everyone who is caring for your baby that they should always place your baby on his back to sleep, as infants who normally sleep on their back are at higher risk for SIDS when placed on their tummies for the first time.
At about 5 months of age, many babies begin to roll from their backs to their tummies. Once your baby starts rolling and choosing his own sleep position, you don’t need to keep turning him over onto his back.
Your baby will need to spend supervised tummy time every day as they are born. This will help develop their neck muscles and prevent plagiocephaly (flat head). Start with short periods of time, a few times a day while your baby is awake, and increase the duration as your baby gets older and stronger.
Create a Safe Sleep Environment - The safest place for your baby to sleep is in a crib, bassinet or cradle that meets current Canadian regulations, in your room, for the first 6 months of life. The sleeping surface must be firm and flat. All you need in your baby's crib is a firm mattress with a fitted sheet. The mattress should fit the crib snugly. The crib should be free of toys, clutter, loose bedding, pillows, comforters, duvets, stuffed animals, bumper pads, positioners and other soft objects. All your baby needs to sleep is a one-piece sleeper. If a blanket is needed, use only a lightweight breathable one. You can also use a sleep sack or wearable blanket. Make sure to choose the correct size for your baby. Keep your baby warm, but not hot, and keep his head uncovered while sleeping.
Baby seats, swings, bouncers, strollers, playpens, slings and car seats are not safe substitutes for a crib.
If you are travelling, be sure to provide a safe sleep environment at all times for your baby. Playpens, adult beds and car seats are not safe alternatives for your baby to sleep in when travelling, and are not designed for unsupervised sleep.
Share your Room, Not your Bed - Place your baby to sleep in a crib next to your bed for the first 6 months of his life. Sharing a sleeping surface with your infant, also called bed sharing, increases the risk of SIDS. It also increases the risk of accidental death. Adult beds, sofas and other soft sleeping surfaces are not designed with your baby's safety in mind. Having the crib next to your bed also helps with breastfeeding during the night.
Bed sharing is especially dangerous when:
• the baby shared the sleep surface with a smoker
• there is adult bedding, duvets or pillows
• the parent is under the influence of alcohol or drugs
• the baby is sharing a sleep surface with older children or pets
• the baby is placed to sleep on a sofa, beanbag, waterbed or sagging mattress.
Provide a Smoke-Free Environment - Smoking during pregnancy and after your baby is born is one of the greatest risk factor for SIDS. Avoid both smoking and second-hand smoke during your pregnancy, and keep your baby away from tobacco smoke at all times after he is born. Make your home and your vehicle smoke-free and don’t allow anyone to smoke close to your baby or anywhere your baby spends time.
Breastfeed Your Baby - Breastfeeding is the best option for the first 6 months of life, as breast milk is the best food for your baby’s growth. Breastfeeding may continue for up to 2 years and beyond. But any amount of breastfeeding for any duration can help lower the risk of SIDS. You can bring your baby into bed to breastfeed. However, return your infant to his crib, cradle or bassinet after the feeding.
A Special Message for Canada’s Aboriginal Community
While SIDS affects all Canadians, it disproportionately affects Canada’s aboriginal community. Despite declines in SIDS rates in all Canadian communities (aboriginal and non-aboriginal), we know that young aboriginal mothers have a 6.5% higher incidence of risk for SIDS than mothers within other Canadian cultural communities. While it is not conclusively understood why this is the case, it is important to recognize this elevated risk and respond to it. Please visit the following link for additional risk reduction strategies offered through the short film “Reducing the Risk in the Circle of Life,” and risk reduction brochure “Look Up to Your Ancestors.”