ISPID - International Society for the Study and Prevention of Perinatal and Infant Death

How to Keep Your Baby Healthy and Reduce the Risk of Sudden Infant Death (SIDS)

In spite of a dramatic reduction (50-70%) in SIDS rates in developed countries, SIDS is still the leading cause of death of infants between one month and one year of age.  Although SIDS is unpredictable and not all SIDS can be prevented, we can reduce the overall SIDS rate by understanding the risk factors and adopting protective measures to minimize the risks. Links to leaflets with recommendations in various countries are provided here.

Recommendations for reducing the risk of Sudden Infant Death Syndrome:

Always (day and night) place the baby on his/her back when it's time to sleep

  • The most significant proven risk factor is the sleep position. The risk of SIDS is over three times higher for a baby sleeping on the stomach.
  • The practice of always placing the baby on his/her back when its time to sleep should begin at birth. The baby will become accustomed to sleeping on the back and will have no problems falling asleep.
  • Make sure every caregiver uses the "back to sleep" position. A caregiver placing a baby to sleep on his/her stomach or side when the baby is accustomed to sleeping on the back raises the risk of SIDS 18-fold.
  • Place the baby on the stomach only when he/she is awake and under adult supervision.

Always keep the baby's environment smoke-free

  • Do not smoke during pregnancy. The more you smoke, the greater the risk for SIDS.
  • Second-hand smoke is also a risk factor: stay in a smoke-free environment when pregnant.
  • Always maintain a smoke-free environment for the baby.

Make the sleeping environment as safe as possible and avoid overheating

  • Place the baby to sleep in its own crib next to the parents' bed for the first six months (room sharing).
  • Never share a bed with baby if you or your partner smoke. Babies whose parents smoke are at increased risk of SIDS while co-sleeping.
  • Never share a bed with baby when you have had alcohol or drugs. (Don’t use alcohol or drugs when caring for your baby, especially ANY TIME you may fall asleep.) Babies whose parents have recently used alcohol or drugs are at increased risk of SIDS (and accidental suffocation) while co-sleeping.
  • There is a slightly increased risk of SIDS with bed sharing for infants less than 3 months even if they were not exposed to cigarettes, particularly if the baby was small (less than 2.5 kg) at birth or born prematurely.
  • In some countries there is a recommendation to avoid all bed sharing, although some disagree and advise avoiding bed sharing only if there are other risk factors present such as smoking or alcohol use.
  • Never sleep with baby on a couch or sofa. This increases the risk of SIDS and fatal sleep accidents.
  • Keep the crib free of soft objects and anything loose or fluffy (bedding, toys, bumpers, pillows, duvets).
  • Do not allow the baby's head to be covered with bedding/blankets. 
  • Keep the room temperature at 18°C to 22°C and avoid over-dressing (i.e. too many layers of clothes; particularly avoid the use of a hat when indoors) when placing the baby to sleep. Overheating has been cited as a risk factor for SIDS in the past, however, it has been shown that thermal factors are less important if the infant sleeps on the back.
  • Use a safe, firm mattress that fits the crib properly.
  • Use a mattress that is in new or used and in good condition (no tears).

A word about breast feeding and pacifiers

  • Breast feeding is always recommended for its numerous benefits for babies and mothers (as a source of multiple necessary nutrients, disease protection and as a contributor to mother-baby bonding). Several studies show that breastfeeding also offers a risk reduction for SIDS.
  • Research suggests that using a pacifier may reduce the risk of SIDS. Start using a pacifier after one month of age when breast feeding is usually well established. Give a pacifier when you put the baby to sleep, but do not force it. Some but not all studies have shown that pacifiers may have an adverse effect on breast feeding.


  • Infants that are immunised have half the risk of SIDS and are protected against diphtheria, tetanus, whooping cough, etc.

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