Sids and Kids Western Australia

SIDS is defined as the sudden and unexpected death of an infant < 1 year of age during their sleep, that remains unexplained after a thorough investigation (autopsy, medical history, circumstances of death). SIDS is the main cause of death in infants < 1 year of age. The peak time for SIDS deaths to occur is between the ages of 2 and 4 months. Although it can happen to younger babies and older infants, approximately 90% of SIDS deaths occur in babies aged less than 6 months.

SIDS and Kids Western Australia has achieved more than a 70% reduction in the number of SIDS deaths through its past and present health promotion campaigns, "Kids & SIDS - Three Ways to Reduce the Risk" and "SIDS and Kids Safe Sleeping".

At present, we do not know what causes SIDS or how to prevent SIDS. However, research from Australia, New Zealand, the United Kingdom and the Netherlands suggests that some factors may reduce the risk of SIDS.

Sleeping on the back reduces the risk of SIDS. Tummy or side sleeping increases the risk of SIDS. Healthy babies placed to sleep on the back are less likely to choke on vomit than tummy sleeping infants.

Keeping a baby's face and head uncovered during sleep decreases the risk of SIDS. It is important that a baby does not get too hot while sleeping. Many babies who have died from SIDS were found with their heads and faces covered by bedding, which probably caused overheating and an increase in their arousal threshold. Sleeping on the tummy, too much clothing, heavy bedding, or a room that is too warm may also lead to overheating. Re-breathing by baby of expired air when the face or head is covered or obstructed may also contribute to SIDS.

Smoking during pregnancy significantly increases the risk of SIDS, particularly if the mother smokes during the second or third trimester of her pregnancy. It is important that babies be kept in a smoke-free environment during pregnancy and after birth.

The SIDS and Kids health promotion program, "SIDS and Kids Safe Sleeping", provides expectant and new parents, health professionals, child care workers, and high school and university students with the latest information on ways to reduce the risk of SIDS. Resources include a brochure, poster, video, door hanger and a brochure designed specifically for indigenous communities. These resources are distributed free of charge to hospitals, antenatal clinics, child health centres, child care centres, doctors, and the print and electronic media. Students completing assignments on SIDS may also call for an information pack. Phone (08) 9474 3544 to order free literature.

For a full description of the resources available, please go to our Resources and Publications page.

* Safe Sleeping Education In-Services to hospitals, child care centres, child health centres, universities and schools.

* Education to emergency response groups including police, ambulance workers and hospital staff.

Although much research has been carried out over the past twenty years into the mechanism of SIDS,

no definitive cause has been identified. Perinatal risk factors such as premature birth, low birth weight, being one of a multiple pregnancy or being exposed to maternal smoking in utero have all been identified as significant risk factors for SIDS. Environmental risk factors such as prone sleeping position, infant overheating or overcooling, and ambient room temperatures above 24°C, have also been identified. In addition, social factors such as infants born to teenage mothers, young and unsupported mothers, and mothers of low socioeconomic status, increase the risk for SIDS.

Currently, many researchers investigating the mechanism of SIDS believe that an infant dies only when a number of factors occur simultaneously. This hypothesis encompasses both epidemiological and scientific data on SIDS. It is also well documented that the incidence of SIDS peaks between 2 - 4 months of age. During this period, major changes are occurring in virtually all physiological systems, as infants attain adaptive mechanisms, enabling them to maintain homeostasis (balance). These include automatic control of ventilation, sleep/wake state organisation, temperature regulation and development of circadian rhythms. If during this critical period the "at risk" infant is also exposed to an external stressor, such as a respiratory tract or gastrointestinal infection, fever, the prone sleeping position, or hyperthermia due to over wrapping, then the threshold for SIDS may be reached (Filiano & Kenny 1994).

Positional Plagiocephaly is a disorder in which the back or one side of a baby's head is flattened, often with little hair growing in the area. Constant pressure on one area of a baby's skull can flatten or deform it, due to the thinness and softness of the bones of babies' skulls.

It is important to vary baby's position so that baby is not always resting on the same part of the occiput (back of the head).

Turn baby's head to alternate sides when putting baby to bed (on the back), in order to prevent prolonged pressure on the same spot.

Week about, put baby to bed at alternate ends of the cot (feet to the bottom of the cot). This varies their head position as they turn towards sounds, activity, or a favourite image (mobile, picture etc.).

"Tummy time" while baby is awake and being supervised is very important. This not only allows an infant to strengthen many muscles which are not used when lying on the back, but also gives the back of the head time without external pressure pushing against it. Strong neck muscles and good head control may also reduce the risk of SIDS. Even if baby does not enjoy "tummy time", it is important to persist and gradually increase the time spent on the tummy during "awake" times.

Babies should sleep on their backs, play on their tummies, and sit up, supported, to watch the world go round.

Cots which meet the Australian Standard are safe cots. All new and second hand cots sold in Australia must meet the Australian Standard for Cots (AS 2172), and will carry a label to say so.

The safest cot mattress is one which is the right size for the cot, and is firm and clean.

Try not to have baby sleep on the tummy before six months of age. Do this by sleeping baby on the back or using a safe infant sleeping bag, as these delay rolling over. Most back-sleeping babies can't roll onto the tummy by themselves until about 5 or 6 months of age when the critical risk period has passed.

No. There is no research to show that any specific baby care product reduces the risk of SIDS.