By Raising Children Network
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Child sleeping soundly

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There are six main ways to reduce the risk of SIDS:

  • Sleep baby on back, never on the tummy or side.
  • Make sure baby’s head is uncovered during sleep.
  • Keep baby smoke-free, before birth and after.
  • Provide a safe cot, mattress and sleeping place, and safe bedding.
  • Sleep baby in a cot in your room for the first 6-12 months.
  • Breastfeed your baby if you can.
It’s natural to find yourself checking your sleeping newborn to make sure everything is OK. You can also take simple and effective steps to minimise the risk of Sudden Infant Death Syndrome (SIDS) and fatal sleep accidents.

SIDS risk factors

Investigations into the deaths of children from SIDS, both in Australia and overseas, have consistently shown that one or more of the following risk factors are associated with almost all SIDS-related infant deaths:

  • tummy and side sleeping
  • soft sleeping surfaces (sofa, soft mattress, pillow, waterbed, lamb’s wool)
  • face and head covered by bedding (can lead to accidental asphyxia, and overheating – a known cause of SIDS) 
  • smoking during pregnancy or after birth.

Over the years, SIDS deaths have been decreasing in Australia. This is because we have been discovering and adopting safe sleeping practices for our babies.

Practical steps to avoid SIDS risk factors

1. Put babies to sleep on their backs
This is the safest position for healthy babies. Babies are more likely to die of SIDS if they sleep on their sides or tummies. By the time babies can roll onto their tummies at around six months, most of the risk of SIDS will have passed. If you’re worried about your baby choking on vomit, it might help to know that healthy babies put to sleep on their backs are less likely to choke on vomit than babies put to sleep on their tummies. Once your baby can roll over (4-6 months), continue putting him to sleep on his back, but allow him to find his own sleeping position.

2. Make sure babies’ heads can’t get covered while they’re sleeping
Put your baby low down in the cot, so her feet are near the bottom end. Tuck in the bedclothes securely so they can’t cover your baby’s head. You could choose to use a baby sleeping bag instead of blankets. Sleeping bags with a fitted neck and arm holes are the safest.

3. Share a room
Have your baby in a cot in your room for the first 6-12 months.

4. Avoid smoking
There’s strong evidence that exposure to second-hand smoke harms babies, and that smoking during pregnancy and after birth increases the risk of SIDS. The link between SIDS and smoking is strong even when parents smoke away from the baby. If you want to quit smoking and you’re not finding it easy, call Quitline on 13 7848. You could also speak to your doctor or child and family health nurse.

5. Avoid cot bumpers, soft toys, pillows, doonas and soft sleeping surfaces
These items can suffocate infants. Babies have suffocated when they’ve rolled into cot bumpers or soft toys. It’s safer to keep these out of the cot.

6. Use a cot that meets current Australian safety standards
Only well-maintained cots built to strict safety standards are good enough for your baby. Cots that meet the standard will have a clear label (AS 2172, or AS2195 for portable cots). Lead paint, gaps that a young child can get caught in, and sides that are too low and can be climbed over easily are just some of the risks of second-hand cots that don’t meet modern standards.

7. Use a firm and well-fitting mattress
Make sure there are no gaps between the mattress and the edge of the cot, where a baby’s head could get jammed. Don’t tilt the mattress. If you’re using a portable cot, only use the firm, thin, well-fitting mattress that comes with it. Don’t add a second mattress or any padding over the mattress.

8. Avoid baby sleeping on couches or makeshift bedding
Sleeping on a couch, with or without someone else, is very dangerous for babies. Also beware of makeshift bedding. Some situations where your baby might be in danger include getting wedged between a mattress and a wall, getting stuck between pillows or cushions, or slipping down until his head is covered by blankets. 

9. Dress your baby in clothing that’s warm, but not hot
Overheating is a risk factor for SIDS. Ask yourself what you would wear to bed and use that as a guide. Keep your baby’s head uncovered indoors – this allows your baby to cool and not overheat. Don’t worry if your baby’s hands and feet feel cool – that’s normal.

10. Make sure your baby’s carers know how to protect against SIDS and fatal sleep accidents
It’s best not to assume that others have knowledge of safe sleeping practices, even professional child carers. Reassure yourself by having a look at the planned sleeping arrangements, and satisfy yourself that your baby will be positioned for sleep correctly. For example, it isn’t recommended to leave a baby sleeping in a pram unsupervised.

Video Safe sleep: SIDS precautions

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This short video shows how to reduce the risk of Sudden Infant Death Syndrome (SIDS). It also includes tips on safe sleeping, sleeping baby on back, sleeping baby at the end of the cot, avoiding a flat head, and sleeping arrangements. It highlights the importance of providing a smoke-free sleeping environment for your child.

Flat spots on baby’s head

When babies are young, their heads are still very soft. Sleeping on their backs can sometimes make the backs of their skulls a little bit flat over time. This is called positional plagiocephaly. It normally gets better, without any medical help, by the time babies are 12 months old.

If it’s worrying you, you can gently alternate the tilt of your baby’s head each time you put baby into bed to sleep. But always put babies on their backs to sleep. Then keep them off the back of their heads as much as possible when awake. 

  • Last updated or reviewed 26-10-2012
  • Acknowledgements Thanks to SIDS & Kids for their helpful comments on early versions of this article.