Sudden unexpected death in infants - risks

Sudden unexpected death in infancy (SUDI) is the unexpected death of a baby where there is no apparent cause of death. This includes sudden infant death syndrome (SIDS) and fatal sleep accidents. It used to be called cot death.

The current rate of SUDI in Australia is around one in every 3,000 births, or 120 babies each year. This compares to about 500 babies lost to SIDS back in 1990. The dramatic drop in the number of sudden unexpected deaths in infancy is due to changes made in some childcare practices.

Following recommended practices can dramatically reduce the risk of SUDI. However, a baby can still die suddenly and unexpectedly, even if recommendations are followed.

Put your baby to sleep on their back

The risk of SUDI is increased if your baby sleeps on their stomach. It is important to put your baby to sleep on their back. Over time, this may slightly flatten the back of your baby’s skull, but any ‘positional moulding’ usually improves by itself without any medical intervention before the child’s first birthday.

Make sure your baby’s head is uncovered during sleep

In some SUDI cases, the babies are found with bedding over their faces. Some suggestions to prevent this include:

• Don’t put your baby on a water bed or bean bag.
• Don’t use soft bedding like quilts, doonas, duvets or pillows.
• Use a firm, well-fitting mattress.
• Don’t use cot bumpers.
• Keep soft toys out of the cot.
• Position your baby’s feet at the bottom of the cot.
• Tuck in the bedclothes securely or use a safe baby sleeping bag (which has fitted neck and armholes and no hood).

Avoid exposing your baby to tobacco smoke

If either parent smokes during the pregnancy, the risk of SUDI is increased. Babies exposed to tobacco smoke after birth are also at increased risk of SUDI. Stop smoking before you conceive or as soon as you can into the pregnancy – the less you smoke, the lower the risk of SUDI. If your partner smokes, encourage them to quit. Make your house a smoke-free environment at all times and don’t allow anyone to smoke near your baby.

Provide a safe sleeping environment

Sleep your baby in its own safe sleeping environment next to your bed for the first six to twelve months of their life. Research in New Zealand and the UK has shown that sleeping a baby in the same room, but not in the same bed, with the parents in the first six to twelve months of life is protective. This is thought to be because parents can see the baby and easily check to see that the baby is safe.

This protective effect does not work if the baby is in the room with other children, probably because the children do not know if the baby is safe or not.

Other factors influencing SIDS and fatal sleep accidents

There are other factors that may have a bearing on the risk of SUDI. These factors include:

• Temperature – make sure your baby doesn’t overheat or get too cold. A good rule of thumb is to dress your baby as you would dress yourself, to be comfortably warm. If your baby has a fever, use fewer bed coverings or none at all.
• Bedsharing – there is an increased risk of SUDI if an adult who is a smoker shares their bed with a baby. Even if you don’t smoke, bedsharing can still be unsafe if your baby is less than four months of age, slips under the bedding or into pillows, is trapped between the bed and the parent or the wall, falls out of bed, overheats or is rolled on. Don’t share a bed with your baby if you have been drinking alcohol or are affected by other drugs. There is a very high risk of infant death and sleeping accidents when a baby shares a sofa or couch with an adult during sleep.

Some factors do not increase the risk of SUDI

Factors that don’t impact on the risk of SUDI include:

• Immunisations – the highest incidence of SUDI happens between the ages of two months and four months, which is around the same age that babies are often immunised. There is no link. In fact, there is some evidence that immunised babies are actually at a lower risk of SUDI than non-immunised babies.
• Specific baby care products – there is no convincing scientific research evidence that any specific baby care product reduces the risk of SUDI. This includes positional aids for babies such as anti-roll devices and items that fasten a baby in position.

Where to get help

• Your doctor
• SIDS and Kids Victoria Tel. (03) 9822 9611 or 1300 308 307
• Your midwife
• Maternal and child health nurse

Things to remember

• Always put your baby to sleep on their back.
• Make sure your baby’s head remains uncovered during sleep.
• Avoid exposing infants to tobacco smoke before and after birth.
• Provide a safe sleeping environment (safe cot, safe mattress, safe bedding)
• Sleep baby in their own safe sleeping environment next to the parent’s bed for the first six to twelve months of life.

You might also be interested in:

• Baby care - safety issues.
  
• Death of a baby.
  
• Grief - support services.
  
• Sudden unexpected death in infants (SUDI and SIDS).
  

Want to know more?

Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)

SIDS and Kids Victoria

Fact sheet currently being reviewed.
Last reviewed: November 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

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Reduce the risk of sudden and unexpected death in infants by providing a safe sleeping environment (safe cot, safe mattress, safe bedding). Put your baby to sleep on their back, with their head uncovered and avoid exposing them to tobacco smoke (before birth and after). Sudden unexpected death in infancy (SUDI) includes sudden infant death syndrome (SIDS) and fatal sleep accidents.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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