There is no guaranteed method to prevent SIDS (sudden infant death syndrome). However, physicians have studied the syndrome for years and have developed practices that may help reduce the risk of SIDS. However, SIDS deaths still occur among infants with no risk factors and whose parents followed all of the suggested guidelines.

Putting infants to sleep on their backs has been recommended. A significant amount of research indicates an association between stomach sleeping and SIDS. In 1992, the American Academy of Pediatrics (AAP) recommended that all healthy infants be placed on their backs to sleep to help prevent SIDS. Since then, the rate of SIDS has dropped by approximately 50 percent.  

Parents who rely on other caregivers (e.g., babysitters, daycare providers, family, friends, neighbors) should ensure that everyone caring for their child always puts the infant to sleep on their back. The changes in recommendations from the AAP make this especially important. For example, grandparents may last have cared for infants 30 years ago, when back sleeping was discouraged. They should be made aware of the dangers of stomach sleeping for infants.

Side-sleep positioning is also not recommended, because infants may easily move from their side into an abdomen-down position. Parents should visually check on their sleeping baby as often as possible.

Between the ages of 4 months and 7 months, infants may be able to roll themselves over and may not choose to remain on their backs while sleeping. By this age, however, the peak risk of SIDS has decreased. Parents of infants with chronic reflux or certain airway obstructions should consult their pediatrician about the best position for sleeping for their infant.

Placing infants on their backs does not increase the risk of choking. A flat spot on the head (positional plagiocephaly) may sometimes develop as the result of sleeping on the back. However, this spot usually rounds out as a child grows older and learns to sit up. In addition, supervised “tummy time” (short periods of time when infant is placed on the abdomen while awake) is recommended to help strengthen an infant’s neck and shoulder muscles. This may be appropriate after a diaper change or when the baby wakes from a nap. 

The back sleeping position is the most important recommendation of the AAP to lessen the risk of SIDS. Other AAP recommendations include:

• Place baby on a firm mattress. Avoid placing an infant on a waterbed or other soft surface (e.g., beanbag chair, sofa, cushion) that may restrict breathing.
  
  
• Avoid the use of soft, fluffy blankets, toys or pillows in a crib with an infant, which may also restrict breathing. Bumper pads on a crib should be thin and firm, not pillow-like.
  
  
• Maintain a smoke-free environment. Ensuring a baby is not exposed to second-hand smoke may help prevent the risk of SIDS.
  
  
• Keep baby in a crib close to parents. Putting babies to sleep in their own crib or bassinet in the same room as parents is associated with lowered rates of SIDS. Parents should avoid sleeping with infants in the same bed because of the risk of accidental suffocation.
  
  
• Use a pacifier when putting a baby to sleep. The AAP added this recommendation in 2005. The use of pacifiers has been associated with a decreased risk of SIDS. If breastfeeding, avoid using pacifiers for the first month until breastfeeding has become an established routine with the infant. Pacifiers should not be forced on infants who refuse them. A pacifier that falls out of a baby’s mouth while asleep should not be placed back into the infant’s mouth.
  
  
• Avoid overheating or overbundling. Dress the baby lightly. Keep the room temperature comfortable for a lightly clothed adult. Cover a baby only up to the chest or shoulders with a light blanket, if necessary (sides of the blanket may be tucked in along the bottom half of the crib). A baby’s head and face should remain uncovered during sleep. Excessive warmth may make it difficult for a baby to awaken. Damp hair, flushed cheeks, heat rash and rapid breathing may indicate that a baby is overheated.

SIDS and other problems in infancy may be prevented by:

• Avoiding smoke, alcohol and drugs while pregnant
• Receiving early, regular prenatal care
• Taking the infant to regular well-child checkups
• breastfeeding to boost a baby’s immune system