by Charles H. Booras, MD

Revised 5/26/97

 

Previous studies have found that an infants risk for sudden infant death syndrome (SIDS) is increased by sleeping in the prone (face down) position. Consequently, several countries have launched campaigns in the past few years to discourage prone sleeping.


Although these efforts have helped reduce infant death rates,
SIDS remains one of the largest causes of infant death.

A large British study recently confirmed the role of several SIDS risk factors. The researchers found that prone and side sleeping positions were major risk factors. Because more infants overall tended to sleep on their sides, this position had a higher population attributable risk than prone sleeping even though the prone sleeping position itself is more dangerous. Other risk factors included sleeping with a mother who smoked or with bed covers over the infants head. A pacifier had a protective effect.

In a separate analysis of the impact of smoking, it was found that the risk for SIDS was twice as high if the mother smoked during pregnancy. There was also an increased risk if the mother and father smoked after the birth of the child.


Smoking was found to have a pronounced dose-response effect.
Over 61% of infant deaths were attributable to parental smoking!

In summary, a major finding of this study was that side sleeping, which often results in rolling into the prone position, increased SIDS risk almost twofold. The American Academy of Pediatrics has therefore recently recommended placing infants to sleep in the supine (face up) position. Tucking in the bedding so it does not cover the face may also help. And, once again, parental smoking emerges as an ugly perpetrator of death and disease in infants.

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