Sudden Infant Death ( SIDS) is the leading cause of death among infants who are one month to one year old. It claims the lives of about 2,500 infants each year in the United States. Shannon Sullivan, MD, pediatrician at University of Iowa Children's Hospital answers these questions:

At what age are infants most likely to die suddenly?

All infants under one year of age are at risk. It appears the peak incidence for SIDS is between two to four months of age.

Do children outgrow the risk of SIDS?

SIDS is defined as the sudden unexplained death of an infant under one year of age. Following one year of age, infants do not appear to be at risk.

Are there risk factors or environments that make some children more susceptible to die suddenly? What are those?

There are known risk factors. While the cause of SIDS is currently unknown, we know that there are risk factors identified which do increase the risk for SIDS and these are:

• Infants who are placed to sleep on their tummies or sides are more likely to die from SIDS than infants who are placed on their backs  
• Infants put to sleep on soft surfaces, such as a bed, a couch, sofa, pillow, or sleeping with stuffed toys has been associated with an increased risk of SIDS. Sleeping with pillows or loose bedding such as comforters, quilts, and blankets also increase the risk for SIDS
• Infants who are overheated because either they are overdressed, they have too many blankets, or are in a room that is too hot are also at increased risk  
• Infants born to mothers who smoke during pregnancy are at increased risk
• Infants exposed to smoke at home or at day care are also more likely to die from SIDS. Sharing a bed with anyone other than a parent or caregiver and with individuals who smoke or are under the influence of alcohol or drugs, we know this to increase the risk of SIDS.  
• Infants born premature or of low birth weight are also more likely to die from SIDS  

What is the "Back to Sleep" program?

Thirteen years ago, the American Academy of Pediatrics (AAP) released its first policy statement on reducing the risk of SIDS. The statement recommended that all healthy infants be placed on their backs to sleep in order to reduce the risk of SIDS. Following that policy statement, several other organizations joined the AAP, and these included the National Institute of Child Health and Human Development, the SIDS Alliance, the Association of SIDS, and the U.S. Public Health Service. Together these groups launched the Back to Sleep campaign to inform parents, and really all care givers, about the importance of back sleeping.  

Has Back to Sleep decreased the number of cases of SIDS?

Absolutely. Since the introduction of the Back to Sleep campaign, the percentage of infants placed on their backs to sleep has increased dramatically, and with that the rates of SIDS have declined more than 50 percent.

What other tips are there for parents to reduce the risks of SIDS in their infants?

In addition to eliminating the risk factors for SIDS we already talked about, recent studies have shown that infants who are accustomed to sleeping on their backs and then are placed on their stomachs are at an increased risk for SIDS. Now what this means for parents is that they must educate all of their secondary care givers, such as grandparents, family members, and their child care providers, on the importance of placing their infant on their backs to sleep.  

Is the University of Iowa Children's Hospital currently involved in any research with regard to SIDS?

Well, there is research ongoing in a number of laboratories here at the Children's Hospital that may ultimately identify the cause of SIDS. However, I think one of the most important activities we do here is the education of our parents on the risk factors for SIDS. This education really begins in all of our nurseries and continues on through each health maintenance visit through the first year of life and beyond.

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