Winter colds, over-wrapping increase risk of SIDS

Feb 18 2007

Sudden infant death syndrome (SIDS) - the leading cause of death in infants under 1 year of age can happen at any time. But parents and caregivers should be extra careful during the cold winter months, when the flu and other infections and the urge to bundle up babies extra warmly increase the risk of SIDS, say experts from the Johns Hopkins Children's Center.

Over-wrapping, which can lead to thermal stress, is one of several risk factors for SIDS, and one that many parents are unaware of.

"In my practice, I often find that new parents haven't been told about all the risk factors for SIDS, how to properly put their baby to sleep or that they should never over-swaddle," says sleep specialist Ann Halbower, M.D., director of the Children's Center Sleep Disorders Program. "It's a conversation that's just not happening often enough in pediatricians' offices."

Many parents and caregivers might have heard that placing babies to sleep on their backs is the safest position, yet a surprising number of them continue to place their infants in face-down or side-sleep positions, both of which are risk factors for SIDS, Halbower says. Add over-wrapping and viral or bacterial infections to an unsafe sleeping position, and you have a recipe for disaster, she says.

"Several studies in inner cities have shown that many infants sleep with too many blankets or wraps on and in crowded beds with other family members," Halbower says. "Babies who are sick need to vent off the heat from their fever, so bundling baby too warmly is possibly the worst thing you can do in this situation."

Below are some SIDS-prevention tips for new parents:

• Place baby face up in the crib.
• Put baby's feet closer to the foot of the bed so he/she can't roll down.
• Tuck in blankets at baby's feet. Never tuck the blanket higher than baby's armpit.
• Never cover a baby's face or head. Infants release most of their extra body heat through the head.
• Never fall asleep with baby on the couch-as you might roll over and suffocate or drop the infant.
• Never allow baby to share a bed with older siblings and/or parents. The baby can be kept in the parents' room but in his/her own crib.
• Don't rely on baby apnea monitors. They are good for monitoring heart-rhythm disturbances or lapses in breathing. However, they are not effective in picking up other subtle changes leading up to SIDS, such as drops in oxygen levels, and they won't protect babies in unsafe sleeping conditions.
• Premature babies are at higher risk for SIDS.

Pediatricians need to make safe-sleep counseling a part of the regular well-baby exam up until the first year of life, Halbower says.