Preventing SIDS: New Thinking

It's every new parent's worst nightmare: crib death, the silent killer also known as Sudden Infant Death Syndrome, or SIDS, for short. The term describes an infant suddenly and inexplicably stopping breathing while asleep, and dying, usually within the first year of life, and especially at around two or three months of age.

The cause isn't known, but there are several ways to reduce the risk.

And, reports The Early Show medical correspondent Dr. Emily Senay, new guidelines have been issued by the American Academy of Pediatrics on the best ways to avoid SIDS.

Perhaps the most important new recommendation is to put babies to sleep in their own cribs, rather than in bed with their parents. Babies shouldn't be put to sleep in the same bed with adults or other children, or sleep with an adult or other child on a couch or armchair. The guidelines strengthen the old recommendations, which say only that allowing a baby to sleep in an adult bed can be dangerous.

Bed-sharing is a controversial subject, Senay notes. Some argue it can foster closeness and promote breastfeeding. But a big fear is that an adult bed environment increases SIDS risks because of the higher chance of suffocation from bedding.

The new guidelines do recommend that parents sleep nearby. An infant's crib can be placed in the parents' bedroom to make breastfeeding and contact easier, Senay adds. It's OK to nurse or comfort a baby in an adult bed, but the baby should be put to sleep a crib or bassinet when the parent is ready to sleep.

In addition, a new study confirms that giving a baby a pacifier at naptime and bedtime is associated with a reduced risk of SIDS. The pacifier should be used when placing a baby in for sleep, but shouldn't be reinserted once the infant falls asleep. If the baby refuses the pacifier, it shouldn't be forced.

Consider using a pacifier at naptime and bedtime throughout the first year of life, after breastfeeding is firmly established.

The updated guidelines still include advice we've heard often, including putting infants on their backs to sleep, not on their stomachs or sides. Sleeping on the side increases the risk of rolling over onto the stomach.

Senay says the latest statistics show that, since 1992, when the guideline first came out indicating babies should be put to sleep on their backs, the number of babies dying of SIDS has dropped dramtically, by 53 percent.

Babies should sleep on a firm crib mattress, covered by a sheet, with no soft, cushy bedding that might interfere with breathing.

Don't smoke: That can raise the risk of SIDS before a baby's birth and after.

Don't overheat the baby's sleeping room.

Also included in the advice, Senay points out, is encouraging "tummy time," avoiding too much stroller time, and varying a baby's head's sleeping position from left to right, to avoid a developmental abnormality linked to an increased risk of SIDS.

Make sure that other people in the household who care for a baby are aware of SIDS recommendations.

Also, don't rely on home monitors and devices marketed to help prevent SIDS.