Best guidelines for reducing the risk of SIDS

Red Nose is a national charity working to save little lives and support families impacted by the death of a baby or child.

They are the leading authority on safe sleep advice and bereavement support. Their ‘Back to Sleep’ public health program has so far resulted in an 85% reduction in SIDS in Australia. However, 3,000 babies and young children still die suddenly and unexpectedly each year in Australia.

We want to do our part in spreading their important messages, so we’ve taken some of the key pieces of advice from Red Nose, and compiled this condensed and ultimate guide to reducing the risk of SIDS.

Your quick guide to reducing the risk of SIDS

We hope that this answers all of your questions about SIDS and reducing the risks to your baby:

What is SIDS?

Sudden Unexplained Death in Infancy (SUDI) is the broad term that refers to all cases of sudden and unexpected death in infancy, and includes death from Sudden Infant Death Syndrome (SIDS) and fatal sleeping accidents.

Following investigations of these deaths, some are explained (such as accidental deaths, asphyxiation by bedclothes, pillows, and overlaying whilst co-sleeping, infection, metabolic disorders, genetic disorders, or non-accidental injury), but when no cause of death can be found, it is called SIDS.

What are the key steps to reduce the risk of SIDS?

Red Nose recommends six key steps to reduce the risk of sudden unexpected death in infancy (SUDI) including SIDS and fatal sleeping accidents:

1. Always place baby on their back to sleep
2. Keep baby’s face and head uncovered
3. Keep baby smoke free before and after birth
4. Safe sleeping environment night and day
5. Sleep baby is safe cot in parents’ room for the first 6-12 months
6. Breastfeed baby if possible

For further information about each step, read six ways to sleep a baby safely – Avoid SIDS.

What is the safest way to wrap my baby?

Read our article swaddling your baby – the basics for the benefits, safety considerations, types of swaddles, and when to transition your little one out of a swaddle.

Is tummy time important for helping to avoid SIDS?

Supervised tummy time is good for your baby because it strengthens their neck, shoulder, arm and back muscles. This is important as it helps them to lift their heads when they roll onto their tummy. Read our tips to make tummy time more enjoyable. 

Is it safe for my baby to sleep in a baby carrier or sling?

Babywearing has been practiced for centuries around the world, and the growing evidence has shown the benefits of close mother-baby interaction which are associated with optimal infant development. Read baby wearing safety precautions. Caregivers should follow the T.I.C.K.S. Principles for the safe use of baby carriers and slings at all times:

1. Tight
2. In view at all times
3. Close enough to kiss
4. Keep chin off the chest
5. Supported back

What type of bassinet is safest for my baby?

All cots and portable cots sold in Australia must meet the mandatory Australian Standard for Safety, and must clearly display evidence of this on the cot and its packaging. However, for a variety of reasons, the use of a cot is not always possible or practical for some families.

Currently, there are no Australian Standards bassinets. Read considerations when choosing a baby safe bassinet, as recommended by Red Nose (including which bassinets fail the safety requirements).

What is the best room temperature to keep my baby safe while sleeping?

Red Nose does not recommend a specific room temperature for healthy babies. Overheating has been implicated in SUDI for many years, and avoiding overheating has been one of the strategies to reduce it.

Babies control their temperature predominantly through their face and head, so to protect your baby from overheating and to help keep their airways clear:

• Sleep them on their back with their face and head uncovered.
• Dress your baby as you would yourself – comfortably warm, not hot or cold.
• A good way to check your baby’s temperature is to feel their back or tummy, which should feel warm.
• Never use electric blankets, wheat bags, or hot water bottles in the cot for babies.
• If your baby has a cold, you might be tempted to add more bedding to keep them warm. But, to help them regulate their temperature when they are unwell, it is best to remove some bedding or clothing.

Can I use pillows, bumpers, doonas/duvets, blankets, or lambs’ wool in the cot?

A baby’s face can become covered by anything in the cot. A good way to avoid this is to only use a safe sleeping bag (one with fitted neck, armholes or sleeves, and no hood), and ensure there are no pillows, bumpers (even the mesh ones), doonas/duvets, or lambs’ wool.

If you choose to use covers/bedclothes instead of a sleeping bag, it is best to use lightweight cotton blankets that can be added or removed according to the room temperature. Ensure that it is tucked in under the mattress, and the bed should alway be made up at the foot of the cot to avoid the head or face being covered by bedding.

How do I keep my baby safe when they sleep in the car?

• Remove your baby’s bonnet, beanie, hood, or hat in the car, and any extra layers they were wearing outdoors, even if it means waking your baby.
• If your baby falls asleep in their capsule, never leave your baby unsupervised.

How do I keep my baby safe when they sleep in the pram?

• Check that your pram meets the Australian standard for prams and strollers.
• Always do up the restraints. It can become dangerous if baby becomes tangled in loose restraints.
• Ensure that the footrest is strong and secure. A weak footrest can become an entrapment hazard.
• Always use the break when it is stopped.
• Never leave your baby unattended in a pram or a stroller. It is not a substitute for a cot.
• Do not cover the pram with a wrap or blanket as it can create an unsafe and hot environment for baby with little airflow.

Can I give my baby a comforter or soft toy in the cot?

Red Nose advises not to place soft toys and other soft objects in the cot for babies under seven months of age, due to the risk of suffocation. Some babies over seven months may appreciate a transitional object (read more about this here) to provide comfort and connection during times of separation (such as sleep times) from their caregivers.

Small toys, toy parts, and toys on strings are a major cause of accidental suffocation and strangulation in babies and choking in young children. Toys that are hung across or near the cot should be removed before the baby can push up on their hands and knees or they are 5 months of age.

Do dummies/pacifiers/soothers reduce the risk of SIDS?

There is strong evidence that dummies are associated with a reduced risk of sudden infant death when used consistently, but the mechanisms that provide that protection are not understood.

Therefore, there is currently no definitive recommendation regarding the use of dummies as a specific SIDS risk preventative strategy. To explain this further, read what to know before introducing a dummy to baby.

Is it safe to share a sleeping space with my baby?

Sharing a sleep space with your baby can increase the risk of SUDI, including SIDS and fatal sleeping accidents, in some circumstances. Read our article on sharing a bed with baby: risk reduction and benefits. It looks at which circumstances increase the risks of bedsharing, the strategies to reduce these risks, as well as the benefits of shared sleeping with a baby.

Is it safe to elevate my baby’s bed if they have reflux?

If your baby has Gastro-Oesphageal Reflux (GOR), they should be placed to sleep on their back from birth on a firm, flat mattress that is not elevated. The risk of SIDS for a baby sleeping on their side or tummy outweighs any benefits to their reflux.

A baby in an elevated cot may introduce further hazards into the sleeping environment. Babies are more likely to slip down the cot and become covered by bedding.

If your baby has been diagnosed with Gastro-Oesphageal Reflux Disease (GORD) after a medical assessment, medical staff should advise the parents in writing if there is a rare medical reason your baby must be slept in a position other than the back position.

Is it safe for my twins to share the cot?

Occasionally twins share the same cot in the hospital for the first few weeks of life while they’re being cared for and monitored by health professionals. When it comes to sleep twins in the home, research has found that the safest way is in their own sleeping space in the parents’ room for the first 6-12 months.

Let us know if you have any further questions about SIDS, by messaging us through our Facebook page