Baby's second month: SIDS

Swaddling baby helps keep him sleeping on his back
Swaddling baby helps keep him sleeping on his back 

SIDS (this stands for Sudden Infant Death Syndrome and is also known as cot death) is when a seemingly perfectly healthy infant dies during sleep.

There is no known reason for SIDS but it is believed to be related to a baby’s inability to wake up when breathing irregularly, as part of a larger defect of the arcuate nucleus in the brain or elsewhere in the body that goes undetected. It has been therorised that some infants have a brain-stem defect which increases their risk of being unable to be aroused from deep sleep which puts them at an increased risk of SIDS.

There are no warning signs to alert parents to the risk of SIDS and more research is still needed. However there have been several things that have been linked to SIDS include putting babies to sleep on their stomachs, sleeping with pillows and toys in their cot, high temperatures and overheating, and exposure to second hand smoke. Very recent research has even linked SIDS with co-sleeping on beds and sofas, particularly when one of the parents has been drinking.

The best way to prevent SIDS to put your baby asleep on their back (not even on their side), keep your baby’s room at a moderate temperature, use a firm mattress  and to keep anything else out of the cot. This is because pillows and toys near the face could create a small enclosure around a baby's mouth and trapping exhaled air. When a baby breathes exhaled air, the oxygen level in the body drops and carbon dioxide accumulates which could contribute to SIDS because normally if a baby is breathing stale air and not getting enough oxygen, the brain usually triggers the baby to wake up and cry which alters breathing and heart rate, making up for the lack of oxygen. But a problem with the arcuate nucleus could deprive the baby of this involuntary reaction. In addition recent studies have shown breastfed babies are less likely to die from SIDS as are those who use dummies.

Some parents worry about having their baby sleep on their back all the time because of plagiocephaly or flat head syndrome, which is when a flat spot on the back or side of his head forms, but if your baby is allowed to lie on his stomach when he is awake, this can be reduced.

Very brief lapses of breathing (less than twenty seconds) that resemble apnoea, can occur during sleep (especially to babies that are born prematurely) but anything longer than this is abnormal and requires medical attention.

Babies may start to flip from their backs onto their stomachs during sleep as they get older but if babies are able to do this then they are at a much lower risk for SIDS. It is at this two month point that babies are most susceptible and swaddling can help babies to stay in this position.

Very brief lapses of breathing (less than twenty seconds) that resemble apnoea, can occur during sleep (especially to babies that are born prematurely) but anything longer than this is abnormal and requires medical attention, especially if you see your baby turning blue or if their heart rate slows down dramatically. Learning infant CPR may give you more peace of mind.

By having your baby sleep in your room until six months of age you are in a better position to monitor your baby as they sleep. The risk for SIDS is highest in the first six months, although it is recommended that babies sleep on their backs for at least twelve months. In Australia, SIDS is a leading cause of death for babies between the ages of one month and one year but the incidence is still fairly low (about 1 in 1,500) due to the education parents and child carers now receive on the issue and safe sleeping practices being more widely used, and there has been a 70 per cent decrease in SIDS deaths since the first ‘Back to Sleep’ campaign in the early nineties. 

Discuss sleeping concerns in our dedicated Sleeping forum.