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SIDS: What parents need to know

Lisa Capra's headshotApproximately 3,600 infants die every year in the U.S. from sudden infant death syndrome (SIDS), the sudden death of an infant under the age of 12-months-old that remains unexplained after the performance of an autopsy and investigation. Experts are still unsure of the exact cause, but research shows that certain preventative measures can reduce the risk of SIDS.

We sat down with Nursery Director, Lisa Capra, MD, to better understand SIDS and learn what parents can do to maximize a safe sleep environment for their infants.

What is SIDS?

According to Dr. Capra, Sudden Infant Death Syndrome (SIDS), otherwise known as Sudden Unexplained Infant Death (SUID), is the leading cause of death in infants between one and 12 months of age. Statistics reported by the National Institute for Children’s Health Quality (NICHQ), show that there is one death every two-three hours.

SIDS vs. suffocation

SIDS and suffocation are often confused with one another. Suffocation happens when an object blocks a person’s airway. SIDS can occur without the interference of an object – the baby just stops breathing without any obvious explanation.

Risk factors + prevention

Within the first six months of life, babies are already vulnerable as they are in a critical development stage. Researchers have found evidence of a brain stem abnormality in some SIDS cases, with studies showing serotonin levels to be 26% lower in these infants.

“Serotonergic neurons in the medulla project to nuclei in the brain stem and spinal cord, which help regulate vital functions including blood pressure, temperature control, respiratory control and upper airway reflexes,” explains Dr. Capra. Other risk factors include:

  • Smoking
  • Prematurity
  • Alcohol and illicit Drugs
  • Hypoxia (oxygen deficiency)
  • Growth restriction
  • Prone/side sleep position
  • Soft/loose bedding
  • Over-bundling/over-heating
  • Bed-sharing
  • Bed-sharing coupled with smoking and/or alcohol

Some populations are more vulnerable than others. “Research has shown that SUID is two times as likely in Non-Hispanic Black babies and American Indian/Alaskan Native babies,” says Dr. Capra.  

While SIDS is often unpreventable, there are still measures parents can take to lower the risk of SIDS claiming their baby’s life. Dr. Capra notes that “a vulnerable infant in a vulnerable time of development placed in a vulnerable situation” is a recipe for disaster.

If a parent removes the baby from a vulnerable situation, risk will always go down. The American Academy of Pediatrics (AAP) provides safe sleep guidelines with prevention tips.

"Back to Sleep" worries, debunked

Head flattening

newborn baby feet sleeping on backWhile doctors agree that SIDS has notably decreased since the Back to Sleep Campaign was implemented, head-flattening has also increased. However, there are ways parents can prevent this during the baby’s wake time. Parents can supervise tummy time, change the baby’s position in the crib or swing and avoid prolonged time in car seats.


Some parents worry that if their baby spits up while sleeping, there is a higher risk of aspiration if the baby is lying on his or her back. The opposite is true: being on the back is actually less risky than being on the stomach, because secretions pool near the esophagus at the back of the throat.


Some babies sleep longer when positioned on their stomachs, but remember that deep sleep can put a baby at a greater risk of SIDS when startling reflexes are subdued. “This may be why breastfeeding and pacifier use has been shown to decrease SIDS,” explains Dr. Capra. You don’t want your baby in too deep of a sleep, because they may not have reached the point of development that enables them to rouse themselves – known as the “protective wake up signal.”

Spread the word

One thing that many new parents forget is to make sure the baby’s other care-givers (day cares, nannies, grandparents, etc.) practice the same safe-sleep methods and risk-reducing practices. It is important to educate all care-givers, since many may use outdated practices that could potentially put the baby at risk.

Talk with your child’s pediatrician if you have any questions or concerns. If you are looking for a pediatrician, please call 617-636-5255 or request an appointment online.