Back still best sleep position for infants

Nine years ago when our first daughter was born, the Back to Sleep campaign was in its infancy. This campaign was the first major effort to attack the incidences of SIDS (Sudden Infant Death Syndrome) by advocating the back or side sleeping position for the majority of infants. Literature about the campaign was everywhere. My Husband and I dutifully placed our infant in one of those soft wedges, bundled her in many receiving blankets to keep her in place, and even alternated which side of the crib we placed her head each night to avoid it flattening out – an annoying side effect of a baby sleeping on its back. Our relatives had a field day with this and thought we had lost our marbles completely. The pressure from them was huge to place our adorable infant on her
tummy because “that is how babies sleep best”.

This campaign is a true success story and the incidences of SIDS has dropped 40% in the United States since the campaign was initiated in 1992. At the same time, SIDS is still the leading cause of death among infants one month to one year of age.

SIDS is a “diagnosis of exclusion” made only after other diagnoses have been eliminated such as major illness, congenital anomaly, child abuse. SIDS is not caused by immunizations. There are some strategies parents can use to minimize the chance of SIDS as much as possible:

1. Good prenatal care
2. Avoiding drugs, alcohol and cigarettes during pregnancy
3. Avoiding smoking around the baby – including second hand smoke
4. Breastfeeding
5. Avoiding overheating the baby with extra clothes and blankets
6. Maintaining regular well-baby visits and immunizations
7. Having the baby sleep on a firm mattress
8. Placing babies on their backs at home and in daycare

Two other words to the wise. Never let your infant sleep unattended in a car seat – her head can flop forward and cut off her airway. Second, while co-sleeping is popular, it is also very dangerous – a few infants die each year by a parent rolling on top of them during sleep. While neither of these are “SIDS” they are very avoidable causes of a few infant death’s a year.

Sleeping on their backs has produced a rise in mild skull deformities. Positioning babies on alternate sides of the crib each night helps prevent the majority of funny-shaped heads. “Tummy time” when the baby is awake and supervised also helps, as well as being important for infant development. Very rarely a baby’s particular head shape requires more aggressive strategies, like special baby-sized helmets. Your pediatrician can discuss with you the various options available should you have further concerns.

The scary reality is that SIDS can occur even if we follow these tips to the T. As parents, the best we can do is to control what we can and not become too paralyzed by the “what ifs”. Parents whose babies do die of SIDS should never blame themselves – so much of SIDS is still unknown and very likely due to variables we just can’t control.

Would you believe that every relative who has had a baby since our daughter was an infant has followed suit with placing their babies on their backs? Just goes to show that sometimes the most odd practices have something to them – although I’m not sure my sister-in-law will be able to say that about the baby wipe warmer she uses on her little one…now that is a fad to laugh about.

© 2005 Pediatrics Now.
All rights reserved. PEDIATRICS NOW is a trademark of Pediatrics Now.

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