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Sleep Related Infant Death

Last Updated: November 1, 2021
HealthLinkBC File Number: 46
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What is sleep related infant death?

There are two kinds of sleep related infant death.

The first is called Sudden Infant Death Syndrome, or SIDS, which occurs when a baby dies suddenly while sleeping without a clear explanation or cause. SIDS is most likely to occur in babies between 2 and 4 months of age.

The second kind of sleep-related infant death is accidental. These deaths are usually caused when a baby is accidentally smothered by items in the bed, such as pillows, toys, heavy blankets, or by a parent, child, or pet rolling onto the baby during sleep.

What causes SIDS?

The cause of SIDS is not fully understood but there are known safer sleep practices that reduce a baby’s risk of SIDS. Some babies, such as premature babies and those with low birth weight, are at higher risk of SIDS than others.

What can I do to reduce the risk of sleep related infant death?

Put your baby to sleep on his or her back every time (at night and for naps)

Babies who sleep on their backs are at lower risk than babies who sleep on their stomach or sides. Even babies who spit up a lot are safer sleeping on their backs. Healthy babies will naturally swallow or cough up fluids on their own.

Avoid using items that prop the baby in one position during sleep. If your baby has a health condition that requires a different position for sleep, discuss safe options to meet your baby’s needs with your health care provider. In the first months after birth, if your baby rolls onto their tummy while sleeping, gently place them on their back. When your baby can roll over easily on their own from back to front and back again, you do not need to return them to their back for sleeping. Babies can usually roll over on their own at 5 to 7 months of age.

Place your baby on a firm surface that is free of hazards

The safest place for your baby to sleep is in their own crib, cradle, or bassinet when at home or traveling. Make sure that the crib, cradle, or bassinet has a firm mattress and a tight-fitting sheet. Do not use bumper pads or place pillows, heavy blankets, sheepskins or toys in the crib. Ensure the crib, cradle or bassinet meets Canadian safety regulations.

For more information about Canadian safety regulations and to check for product recalls, visit Health Canada - Consumer Product Safety at www.canada.ca/en/health-canada/services/consumer-product-safety.html.

For more information on crib safety, see the resource Safer Sleep for my Baby at www.healthlinkbc.ca/pregnancy-parenting/parenting-babies-0-12-months/baby-safety/safer-sleep-my-baby.

It is not safe for a baby to sleep on a couch or chair–either alone or with a caregiver. Your baby can fall to the floor or slip between your body and the cushions and leave them unable to breathe. Have a bassinet or crib ready, or someone else to take the baby when you need to rest.

Some babies fall asleep while travelling in a car seat. Keep a close eye on a baby sleeping in the car and take your baby out of the car seat once you have reached your destination. Babies should not be left to sleep in a car seat, a stroller, baby swing, or bouncer seat because the incline of these devices can cause their airway to become restricted.

Keep your pregnancy smoke-free and give your baby a smoke-free environment

A baby exposed to second-hand smoke, or whose mother smoked before or after birth, has a much higher risk of SIDS.

Speak with your health care provider if you or your partner want help to reduce or stop your cigarette use. You can also call QuitNow helpline toll-free at 1 877 455-2233 in B.C. or visit www.quitnow.ca.

Stop or reduce your use of alcohol and other drugs

The use of certain substances during and after pregnancy may also increase the risk of sleep- related infant death. This includes alcohol, cannabis (marijuana), crack, cocaine, heroin, and others

If you would like support for any kind of substance use (including alcohol or other drugs), free, confidential information and telephone support is available from the Alcohol and Drug Information and Referral Service. Call 1-800-663-1441 (toll-free in B.C.) or 604-660-9382 (in the Lower Mainland). Support is available 24 hours a day, 7 days a week, in multiple languages

Share a room with your baby

Sharing a room helps protect your baby against sleep-related infant death, and it is a safer sleeping arrangement than sharing a bed. For the first 6 months, have your baby sleep on a separate surface in the same room where you sleep. Many families choose to bedshare, or find that they end up bedsharing even if they did not plan to do so. There are ways to make bedsharing as safe as possible. For more information about reducing the risks of bedsharing, see www.healthlinkbc.ca/pregnancy-parenting/parenting-babies-0-12-months/baby-safety/safer-sleep-my-baby.

Breastfeed your baby

Breastfeeding helps protect your baby against SIDS. Breastfeeding also helps protect your baby from many childhood illnesses.

Breastfeeding is easier when you share a room with your baby. This means your baby sleeps near you, allowing you to be close to your baby.

For help with breastfeeding, speak with your doctor, registered midwife, public health nurse, doula, or local breastfeeding support group.

For more information about breastfeeding, see HealthLinkBC File #70 Breastfeeding.

Keep your baby warm but not hot

An over-heated baby has a higher risk of SIDS. You know your baby is warm enough when your baby’s head is warm. A baby’s hands and feet are normally a little cool. Check the back of your baby’s neck, and take off a layer if your baby is sweating or appears flushed.

The temperature of the room should be comfortable for an adult. A well-fitted sleep sack, sleeper, or light blanket should be all that is needed to keep your baby warm. Hats are not needed.

Swaddling is also not needed. It is safest for your baby not to be swaddled. Tight swaddling can make it hard for your baby to breathe, and can also cause your baby to overheat and increase the risk of SIDS. Swaddled babies can also get stuck on their stomachs and be unable to move into a safer position if they roll over

Share this information with anyone who may take care of your baby; it is important for all parents, babysitters and caregivers to be informed about how to reduce the risk of sleep related infant death.

What if my baby has died during sleep?

If your baby has died during sleep, remember that not all cases of sleep-related infant death can be prevented. There are people who can provide you and your family with grief support. Your health care provider can help you to find counselling or a parent support group. You can also call the BC Bereavement Helpline, toll free 1 877 779-2223 or visit www.bcbh.ca/.

For more information on a safe sleeping resource for parents and caregivers see Safer Sleep For My Baby at www.healthlinkbc.ca/pregnancy-parenting/parenting-babies-0-12-months/baby-safety/safer-sleep-my-baby.