Back to Sleep: The Campaign against SIDS

Updated August 5, 2020 | Infoplease Staff
by Elaine Rho

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The leading cause of death in the U.S. for babies between one and twelve months is Sudden Infant Death Syndrome (SIDS), the sudden death of an apparently healthy infant for inexplicable reasons. In SIDS cases, the cause of death remains undetermined after a complete investigation, which includes an autopsy, examination of the death scene, and a review of the medical history of the infant and family.

Back to Sleep

Studies conducted by the National Institute of Child Health and Human Development (NICHD) have demonstrated a strong association between babies who sleep on their stomachs and SIDS. Although researchers claim that a causal relationship cannot be proven, the success in reducing SIDS deaths by having babies sleep on their backs has been dramatic.

As a result of a 1992 American Academy of Pediatrics (AAP) recommendation, and the increased awareness produced by the "Back To Sleep" campaign,1 SIDS deaths in the United States have declined by 38 percent between 1992 and 1995.2 This accounts for approximately 1,500-1,800 fewer infant deaths annually.

SIDS Facts

  • SIDS is the leading cause of death in infants between one month and one year of age.
  • Most SIDS deaths occur when a baby is between two and four months of age.
  • SIDS is not the cause of every unexpected infant death.
  • African American children are two to three times more likely than white babies to die of SIDS, and Native American babies are about three times more susceptible.3
  • More boys are SIDS victims than girls, but boys in general have a higher infant mortality rate than girls. (see infant mortality tables)

Which babies are most at risk for SIDS?

  • infants who sleep on their stomachs
  • those with mothers who smoke and exposure to passive smoking by members of the household4
  • those whose mothers were less than 20 years old at the time of their first pregnancy
  • premature or low birthweight babies
  • infants whose sibling(s) died of SIDS

What can be done to lower the risk of SIDS?

  • Place infants to sleep on their backs.
  • Get good prenatal care.
  • Make sure the baby sleeps on a firm mattress or other firm surface and avoid using fluffy blankets or covering, as well as pillows, sheepskins, blankets, or comforters under the baby.
  • Do not allow babies to get too warm. Overheated infants are more likely to go into a deep sleep from which they are difficult to arouse.
  • Breast-feeding. Breast milk can provide protection from some infections that can trigger sudden death in infants.
  • Immunize babies.5
  1. The "Back to Sleep" campaign was launched in June 1994 by the U.S. Public Health Service, AAP, SIDS Alliance, and Association of SIDS and Infant Mortality Programs.
  2. Preliminary figures from the NICHD for 1997 show a SIDS rate of .69 per 1000 live birth, or 2,705 SIDS deaths per year, reflecting a 43 percent decrease in SIDS deaths since 1992.
  3. A study by the NICHD found that 40 percent of low-income, inner city mothers placed infants to sleep on their stomachs, about twice the national average.
  4. Recent studies suggest that some SIDS babies are born with brain abnormalities that make them more vulnerable to sudden death in infancy. Many SIDS infants have abnormalities in the "arcuate nucleus," a portion of the brain that is likely to be involved in controlling breathing and waking during sleep. These abnormalities may stem from exposure to toxic substances, such as smoke, or lack of a vital compound such as oxygen prenatally.
  5. Claims that immunizations increase the risk of SIDS are not supported by data, and babies who receive their scheduled immunizations are less likely to die of SIDS.

Source: National Institute of Child Health and Human Development (NICHD)

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