Originally published by CBSHealthwatch.com in August 2000

Kimberly Nelson, Medical Writer

Making simple changes to your baby's sleep environment may save a young life, but unfortunately this news has not reached everyone. Statistics show that African-American babies are twice as likely to die from SIDS as other babies are.

The US Consumer Product Safety Commission (CPSC) and Gerber Products Co. conducted a national survey on SIDS (sudden infant death syndrome) awareness. The study shows that only 43% of parents put babies to bed on their backs, which is the safest position.

The survey also found that more than half of African-American parents put their babies to bed on their stomach or side. African Americans are also likely to place soft bedding like quilts, comforters, or pillows in the crib with an infant--a major SIDS danger.

"We don't want anything impeding the child from getting fresh air. If you look at your baby and can see anything around his face that may keep him from breathing fresh air, then he may be in danger," says Betty McEntire, PhD, executive director of the American SIDS Institute.

"The African Americans we are talking about have access issues. These vulnerable populations have problems with access to healthcare and are at high risk for not having the right information," says Dr. Marilyn Hughes Gaston, US Assistant Surgeon General and associate administrator of the Bureau of Primary Healthcare.

Mixed Messages

Part of the confusion over the proper way to put a baby to sleep may come from generations of changing advice on infant sleep safety.

"When I was training in the 1960s, I was taught that you put babies on their stomach. In fact, the word got out so well that now there are some fears about putting babies on their back," says Dr. Gaston. "The back is still the safest."

The mothers who listened to their doctor's advice in the 1960s are now grandmothers.

"Every group you look at is going to listen to the baby's grandmother. If she is a young mother, she's going to listen to the baby's grandmother and great-grandmother. Compound that with having no other sources of medical information, and it's not a good thing," says Dr. Gaston.

Kathleen Baehl, mother of a newborn girl and two other children, says she has heard mixed messages even in the past few years.

"When our first child was born in 1994 it was 'on her back.' For our second child, it was 'on his side.' We even purchased a cushion so that he did not roll. With this child, the hospital told us that the baby has to be on her back," says Baehl.

Baehl says her doctor also recommends putting the baby on her stomach while awake so she can practice moving her head.

Soft Bedding Suffocates

Comforters and other soft bedding are SIDS dangers. Blankets can get around your baby's face and keep it from breathing fresh air.

"The other reason a blanket can be bad is that a child should not be overheated. This occurs especially in the wintertime when your baby's room can get too hot," says McEntire.

Babies do sometimes stop breathing for a brief period of time. This is called apnea. "We know from studies that babies in warm rooms have more periods of not breathing," says McEntire. Long pauses in breathing may trigger SIDS in vulnerable infants.

Bundling up babies at night may put them at risk. "These long periods of babies sleeping soundly and not crying may not necessarily be good," says McEntire.

Instead, keep your baby's room at a comfortable temperature, and consider putting your baby in a sleeper.

Besides sleep position and soft bedding,

Smoking.
Teen pregnancy.
A previous case of SIDS in the family.can also increase the risk of SIDS.

To protect against SIDS, the CPSC suggests:

Place your baby on its back on a firm, tight-fitting mattress in a crib that meets current safety standards.
Remove pillows, quilts, comforters, and sheepskins from the crib.
Consider using a sleeper as an alternative to blankets. Use no other covering if you put your baby in a sleeper.
If using a blanket, place your baby in the crib with its feet at the foot of the crib. Tuck a thin blanket around the crib mattress, covering the baby up to its chest.
Make sure your baby's head stays uncovered during sleep.
Never place a baby to sleep on a waterbed, sofa, soft mattress, pillow, or other soft surface.

"The overall message is to talk this over with your healthcare provider where you get good advice and answers to your questions," says Dr. Gaston.

Everyone who deals with the mother or baby, from grandmother to healthcare worker, needs to be educated about SIDS, says Dr. Gaston. She encourages women to get in touch with one of the Bureau of Primary Health Care's 3,000 health centers.

For information on the center nearest you, contact the CPSC at (800) 638-CPSC.

Kimberly Nelson is a freelance medical writer.

Reviewer: Beth Israel Deaconess Medical Center. Reviewed for medical accuracy by physicians at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School. BIDMC does not endorse any products or services advertised on this Web site.