The following Frequently Asked Questions (FAQs) are common questions parents, family members and caregivers ask about SIDS and how to reduce the risk of SIDS. At this time, there is no known way to prevent SIDS. However, by following a few simple infant care practices, it is possible to lower a baby's risk of dying of SIDS. We hope you find the answers here helpful. You can also visit the SIDS Facts section of our web site for more information and the Risk Reduction Materials section for available resources.

1. What is Sudden Infant Death Syndrome (SIDS)?

SIDS is the sudden and unexpected death of a baby who seems perfectly healthy. Even after an autopsy, the reason for the baby's death remains unexplained. SIDS happens quickly and quietly. The baby is put to bed for a nap or for the night. When someone checks the baby later, they discover that the baby has died while sleeping.

Most babies have no sign of serious illness before the SIDS death. Some babies may have a slight cold or other mild illness. The autopsy may find little breaks in blood vessels of the lungs or some swelling of the airway. None of these things would account for the death.

SIDS is the number one cause of death among babies between the ages of one month and one year. Most babies who die of SIDS are between two and four months of age. Over 2000 infants die of SIDS every year in the United States alone. Approximately one out of every 2,000 live births will die from SIDS in the U.S. SIDS happens everywhere in the world in families of all social, economic and ethnic groups.

2. What causes SIDS?

No one really knows what causes SIDS. A great deal of research is going on. Scientists are studying babies and how their brains, hearts, and lungs work. They are learning about breathing and sleeping patterns. They are also looking into autopsy findings, among many other things, to determine any causes for SIDS.

We actually know much more about what does not cause SIDS:

• It is not caused by suffocation
• It is not caused by immunizations
• It is not contagious
• It is not hereditary

3. Why should our baby sleep on his back?

One of the easiest ways to lower your baby's risk of SIDS is to place your infant to sleep on his/her back at night and naptime. Research studies show that the number of babies dying of SIDS has become much lower since more parents and caregivers began placing babies on their backs to sleep. Make sure everyone who cares for your baby including grandparents, babysitters, childcare providers and other caregivers place your baby on their back to sleep. Other important ways to keep your baby safe when asleep are included in the Reducing the Risk section of this website. Keep in mind that:

• Babies that roll over on their own should not be forced to stay on their back.
• Babies should be placed in a variety of positions when awake. It is safe for babies to be on their stomachs when they are awake and supervised, but they should always be placed on their back to sleep.

4. Are there ways we can lower our baby's risk of SIDS?

• Always place your baby to sleep on his or her back to sleep, for naps and at night.
• Always provide a smoke free environment around your baby. You should never smoke anything around your baby. Do not let others smoke around your baby. SIDS is more common among those babies who are exposed to smoke.

5. What are the "Safe Sleep Top Ten" recommendations?

1. Always place a baby on his or her Back to Sleep, for naps and at night.
2. Place a baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet.
3. Keep soft objects, toys, and loose bedding out of a baby's sleep area.
4. Do not allow smoking around a baby.
5. Keep the baby's sleep area close to, but separate from, where you and others sleep.
6. Think about using a clean, dry pacifier when placing an infant down to sleep. Do not force the baby to take it. When a baby breastfeeds, wait until he or she is one month old or until after breastfeeding has been established.
7. Do not let a baby overheat during sleep.
8. Avoid products that claim to reduce the risk of SIDS.
9. Do not use home monitors to reduce the risk of SIDS.
10. Reduce the chance that flat spots will develop on a baby's head by placing a baby on their tummy when he/she is awake and someone is watching.

6. Where should my baby sleep?

The best place for your baby to sleep is in a crib or bassinet in your room near your bed (within an arm's reach if possible). Make sure to use a crib and mattress that is firm, and which meets the U.S. Consumer Product Safety Commission safety standards. The mattress should fit tightly in the crib so that the baby's face is not trapped between the mattress and the side of the crib.

7. How do I make my baby's sleep area safe?

Always place your baby to sleep on their back. Soft bedding including pillows, quilts, comforters, sheepskins, pillow-like stuffed toys and other soft products should be removed from the sleep area. If bumper pads are used, they should be firm, thin, secured and not pillow-like. Keep your baby's head uncovered.

8. How many blankets do I need when my baby sleeps?

Consider using a sleeper or other sleep clothing instead of blankets. If using a blanket, place your baby with their feet at the bottom of the crib. (This is called feet to foot; your baby's feet go to the foot of the bed). Tuck a thin blanket around the crib mattress, reaching only as far up as the baby's chest. Make sure your baby's head remains uncovered during sleep.

9. If my baby sleeps on her back won't she choke?

No. Healthy babies automatically swallow or cough up fluids. There has been no increase in choking or other problems for babies who sleep on their backs.

10. Won't my baby's head get flat if he sleeps on his back?

A good way to reduce the chance that flat spots will develop is to provide tummy time when your baby is awake and someone is watching him. You can also change the direction that your baby lies in the crib from one week to the next. Make sure your baby doesn't spend too much time in a car seat, carrier or bouncer.

11. Is it ever safe for my baby to be on her stomach?

Yes. Your baby needs tummy time. Babies should be placed on their stomach when awake and someone is watching. Tummy time helps your baby's head, neck, and shoulder muscles get stronger and helps to prevent flat spots on the head. Talk to your child care provider about making supervised tummy playtime a part of your baby's regular activities.

12. What is the best temperature to keep the house when my baby is sleeping?

Set the room temperature in a range that is comfortable for a lightly clothed adult. Avoid letting your baby get too hot. If you notice sweating, damp hair, flushed cheeks, heat rash, and/or rapid breathing, your baby could be too hot. Make sure to dress your baby lightly for sleep. Don't use a hat or cover your baby's head.

13. I heard that smoking causes SIDS. Is that true?

Tobacco smoke is harmful to babies before and after they are born. Unborn babies are hurt when their mothers smoke during pregnancy; these babies have a greater risk of SIDS. Babies that breathe second hand smoke after they are born are also at a greater for SIDS. Babies who are exposed to cigarette smoke for eight-hours per day have a ten-times increased risk of dying from SIDS. Because their bodies are developing, poisons in smoke hurt babies even more than adults. Babies under a year of age are in the most danger. Children are also more likely to have lung problems, ear infections and severe asthma from being around smoke. Do not smoke cigarettes around your baby. Do not let anyone else smoke cigarettes around your baby. Never smoke cigarettes in the room where your baby sleeps, even if your baby is not there.

14. Now that my baby rolls over I'm worried because he is not always sleeping on his back.
      What should I do?

Although your baby is able to roll over from his back-to-tummy and from his back-to-side, you should still place him on his back to sleep. Do this through his first year birthday.

15. Is there any harm in having my baby sleep with me in my bed?

Many parents and caregivers are unaware of the SIDS risk and hidden hazards when placing babies on adult beds. The issue of bedsharing with your baby is complicated. The evidence shows that bedsharing with your baby can increase the risk of SIDS and suffocation. An alternative to bedsharing is to place the baby's crib or bassinet near your bed for more convenient feeding and contact. The American Academy of Pediatrics recommends that all infants be returned to their own sleep area (crib, bassinet, cradle or bedside cosleeper) after being brought into an adult bed for nursing or comforting. Never put your baby to sleep with other children who can accidentally roll over and suffocate the baby. Other dangerous places for a baby to sleep are:

• Couch/sofa
• Recliner
• Waterbed
• Soft mattress
• Any soft surface including pillows, sheepskins, quilts or cushions
• Any bed with another adult or child

16. If I want to share my bed with my baby, is there anything I can do to make it as safe as possible?

The best place for your baby to sleep is in a crib or bassinet in your room near your bed (within an arm's reach if possible). Bedsharing can be dangerous because of the increased risk of SIDS and suffocation. That being said, if you choose to have your baby sleep in the same bed for some or most of the night it is necessary to take special precautions. Always place your baby on their back to sleep. If you have been drinking alcohol, or taking drugs/medicines that make your sleepy, do not bring your baby into bed with you. If you are tired, or if you had less than four hours of sleep the previous night, do not bring your baby to bed with you. It is advised that you return your baby to their own bed after nursing or comforting them. Other safety measures that are recommended are:

• Avoid soft surfaces or loose covers. Comforter covers (duvets) and pillows should not be used if sleeping with a baby.
• Make sure the baby's head is uncovered while asleep.
• Move the bed or furniture away from the wall to prevent the baby from being trapped.
• Make sure the baby sleeps on a mattress that is firm. The baby's face can get stuck in soft bedding and he/she might not be able to breathe.
• If you choose to bedshare routinely you should consider removing the mattress and placing it on the floor in the middle of the room. This will help prevent the baby from falling or being trapped.

17. My baby goes to sleep with a pacifier. Is that okay?

Yes. In fact, several research studies have reported that pacifier use at the time of sleep reduces the risk of SIDS. The American Academy of Pediatrics recommends that parents/caregivers consider offering a pacifier at naptime and bedtime. Once your baby falls asleep, it is not necessary to reinsert the pacifier. If a baby refuses the pacifier, he /she should not be forced to take it. Do not coat the pacifier with anything sweet, especially honey. Make sure to clean it often and replace it regularly. If you are breastfeeding your baby, wait until your infant is one month of age or until you are sure that breastfeeding is well established before using a pacifier. Pacifier use is recommended during the first year of life.

18. Do baby monitors prevent SIDS?

There is no device that can prevent SIDS. Baby monitors often give new parents a sense of comfort and reassurance but they do not reduce the risk of SIDS. Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety. The best way to reduce the risk of SIDS is to place your baby on their back to sleep. If you have questions about using a home monitor, talk to your doctor or clinic.

19. What should I be feeding my baby?

Breast milk is the best nutrition for your baby. If possible, breastfeed your baby at least through the first year of life. Sleeping close to your baby can make breastfeeding more convenient. It is recommended that the baby's crib be placed near your bed. If you bring your baby into your bed for breastfeeding, return your baby after nursing to their crib for the night and naps.

20. When should I take my baby to the doctor?

Your baby needs to have regular check-ups and receive his or her immunizations on time. Follow the schedule for check-ups that your clinic or doctor recommends. If your baby seems sick, call your doctor or clinic right away.