The memory of losing her infant son, Colton, is still unbearable to Kristen Marr nearly seven years later. "He was 2 months old and in perfect health when I put him down on his back for a nap," she recalls. But when she tiptoed into the nursery of her home in Crofton, Maryland, to check on him, Colton had stopped breathing. Marr dialed 911 and tried to perform CPR on her infant. But it was too late. Doctors later concluded that Colton was a victim of sudden infant death syndrome (SIDS). While its incidence has dropped by half since the launch of the Back to Sleep campaign in 1994, SIDS is still linked to about 2,500 baby deaths every year. And even taking the right precautions (as Marr did) doesn't guarantee that your child will be protected. But here's some reassuring news: Recent research is revealing more ways than ever to reduce your child's risk. Are you doing everything you can to fend off SIDS? Here are answers to your top questions.
Q: What causes infants to stop breathing while they sleep?
A: Experts believe SIDS victims have an immature arousal center in the brain. Put simply, they can't wake themselves up when they're having trouble breathing. Infants who sleep on their stomach are particularly vulnerable to SIDS. One theory is that this position increases the likelihood that they will re-inhale oxygen-depleted air. "The peak danger is between 2 and 4 months," says Marian Willinger, Ph.D., special assistant for SIDS at the National Institute of Child Health and Human Development, in Bethesda, Maryland. However, you should continue to safeguard your child until he turns 1.
Q: Who's most at risk?
A: Three out of five SIDS victims are boys. African-American and Native American infants are two to three times more prone to the syndrome. Other groups at increased risk include preemies, low-birthweight babies, and infants who are exposed to cigarette smoke.
Q: Is putting my baby down on her back really that important?
A: It's vital. Back-sleeping increases a baby's access to fresh air and makes her less likely to get overheated (another factor linked to SIDS). But not all new mothers are getting the message: Eighteen percent of Parents readers say they usually put their infants to sleep on their stomach, and another 13 percent do so some of the time. "Some exhausted new parents may do it out of desperation, because infants tend to sleep better and more deeply on their stomach," says Parents advisor Jodi Mindell, Ph.D., author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep. "But having your baby sleep on her tummy is a no-no."
Q: I put my child to sleep on his back at night, but can I let this rule slide for a short nap?
A: It's not worth the risk. Babies who normally sleep on their back are 18 times more likely to die of SIDS when placed down on their tummy for a snooze. "Infants seem to have difficulty adjusting to the change," says Rachel Moon, M.D., a SIDS researcher at the Children's National Medical Center, in Washington, D.C.
Q: Is side-sleeping safe?
A: No. Studies show that putting a baby down on her side rather than on her back doubles the SIDS risk. "It's easier for an infant to roll onto her tummy from her side than from her back," says John Kattwinkel, M.D., chair of the American Academy of Pediatrics (AAP) Task Force on SIDS. "And she may not yet have the skills to roll back in the other direction."
Q: My baby has a flat spot on his head from sleeping on his back. Will it go away?
A: That depends. Flattened-head syndrome, or positional plagiocephaly, occurs when the back of an infant's pliable skull is reshaped from constantly lying in the same position. By some estimates, the incidence has jumped sixfold during the past decade. Yet back-sleeping isn't entirely to blame. "This condition is preventable," says John Persing, M.D., a craniofacial specialist at Yale-New Haven Hospital, in Connecticut. "Most babies with this problem spend way too much time on their back when they're awake." To correct (or prevent) a flat spot, give your baby several supervised "tummy time" sessions every day. You can also position your baby's head when you put him down to sleep -- one night to the left, the next night to the right -- to help balance the shape of his head. And don't let your child spend too much time in car seats, bouncy seats, or infant swings. If the flattening doesn't show significant improvement by the time he's 6 months old, consult a pediatric craniofacial specialist.
Q: I'm worried about my baby getting cold. Is it safe to cover her with a blanket?
A: Wait until her first birthday. Blankets, pillows, comforters, and stuffed toys can hinder your child's breathing; even soft or improperly fitting mattresses can be dangerous. If you're worried that your little one may get chilly, swaddle her in a receiving blanket or use a sleep sack. According to a Belgian study, swaddling helps fussy infants sleep better on their back and may protect them from SIDS by causing them to startle more easily. But make sure you don't overheat your baby. "A nursery that's too warm substantially increases an infant's SIDS risk," says Warren Guntheroth, M.D., professor of pediatrics at the University of Washington, in Seattle. Set the thermostat at 68 degrees, don't put the crib near a radiator, and dress your child in light layers that you can remove easily if she gets hot.
Q: Is it dangerous to give my baby a pacifier?
A: Not at all. Binkies actually reduce the risk of SIDS, possibly by preventing babies from falling into an extremely deep sleep. The AAP now recommends that you consider giving your child a pacifier at night and for naps during his first year. Note: If you're breastfeeding, don't introduce a Binky until your infant is 1 month old and nursing well.
Q: My baby has started to flip onto her stomach during the night. How can I stop this?
A: You can't -- but don't worry. "Once a baby can roll over by herself, her brain is mature enough to alert her to breathing dangers," says Dr. Moon. "And by the time she's 6 months old, her improved motor skills will help her to rescue herself, so the SIDS risk is greatly reduced."
Q: My baby sleeps better in my bed. What's the big danger of co sleeping?
A: Actually, there are lots of them. Your infant could be suffocated by a pillow or a loose blanket. His air supply may be cut off if you or your spouse inadvertently rolls over onto him. And he could be strangled if his head gets trapped between the headboard and mattress.
Despite numerous studies that confirm the heightened SIDS risk caused by co sleeping, many moms continue to do it. According to a parents.com poll, 52 percent of readers do it all or some of the time, citing the added convenience for nighttime feedings and the security of having their infants next to them.
If you decide to co sleep, don't put your baby right in the bed. Instead, get a co sleeping crib that clamps onto the frame of your bed. Or you might simply try moving your baby's crib into your room. Several studies show this sleeping arrangement reduces the SIDS risk (presumably because you're more likely to hear your baby if he's in distress).
Thursday, September 20, 2007