The most up-to-date information for parents and healthcare professionals about sudden infant death syndrome (SIDS) and infant safety while sleeping was published last month in the prestigious journal, The BMJ.
The international clinical review led by The Ritchie Centre’s Deputy Director, Professor Rosemary Horne reveals the latest advice and recommendations against a background of currently confusing guidelines.
“Although the incidence of SIDS has more than halved after public health campaigns publicised the known major risk factors in the early 1990’s, SIDS remains the leading cause of unexpected death in infants in western countries,” said Professor Horne.
According to most recent statistics, 2671 infants died from SIDS in the United States in 2010 and there were 50 deaths in Australia in 2012.
“In the last thirty years it has become well known that sleeping position (face down on the stomach) is the major risk factor for SIDS, and parents have generally accepted this and sleep their baby on their backs” said Professor Horne.
Research studies also confirm exposure to maternal smoking is a significant factor, increasing the risk of SIDS by five times.
“One-third of SIDS deaths could be prevented if exposure to smoke in utero was eliminated,” added Professor Horne, “and paternal smoking and exposure to passive smoke during infancy have also been associated with increased risk of SIDS.”
Breast feeding decreases the risk of SIDS and mothers should be encouraged to breast feed for this reason and other health benefits.
In some countries such as the United States, dummy use is promoted, after breast feeding has been established, as a risk reduction strategy for SIDS.
“There is strong and consistent evidence that infants who die from SIDS are less likely to have used a dummy during their last sleep, however dummy use is not actively recommended in Australia” said Professor Horne.
Confusingly, advice to parents about sharing a sleep surface or bed sharing currently differs from country to country.
Bed sharing is reportedly normal practice for 90 per cent of the world’s population; however the sleeping environment where this is most common is typically different from that in Western society.
“For example, in Asian countries where bed sharing is common and the risk of SIDS is low, beds are often firm mats on the floor with separate mats for infants, and soft bedding or pillows are rarely used,” said Professor Horne.
“Research confirms the safest place for infants to sleep is in the parental bedroom in their own cot and in close proximity to parents for the first 6-12 months after birth.”
“Bed sharing is certainly a risk factor, with over half of infants dying suddenly and unexpectedly being found sharing a sleep surface —infants are at highest risk are younger than three months and those whose parents smoke, use illicit drugs or consume alcohol.”
“What most parents are unaware of is that even in the absence of any other risk factors, and the baby is breast fed, babies under 3 months of age are at 5 times the risk compared to when they sleep in their own cot in the parental bed room."
“Sleeping on a sofa or couch with an infant is extremely dangerous and should be avoided,” said Professor Horne.