Since 1992, SIDS has dropped from 2^nd to 3^rd place amongst the leading causes of death in infants between 1 month and 1 year of age. The incidence of SIDS has decreased over 40% since 1992, when parents were first told that putting babies to sleep on their backs or sides could reduce the likelihood of SIDS.

The cause of the condition is unknown. Multiple theories have been promoted. Many physicians and researchers now believe that SIDS is not a single condition which is always caused by the same medical problems, but infant death caused by several different factors.

These factors may include problems with sleep arousal or an inability to sense a build up of carbon dioxide in the blood. Almost all SIDS deaths occur without any warning or symptoms when the infant is thought to be sleeping.

The National Center for Health Statistics reports a rate of 0.784 SIDS deaths per 1,000 infants for 1996 and 0.69 SIDS deaths per 1,000 infants for 1997. The peak incidence occurs between 2 and 4 months of age (90% occur by 6 months of age). There is an increased incidence in winter months with the peak in January. There is also a greater incidence in Native Americans and African-Americans.

Risk factors include babies who sleep on their stomachs (up to 4 months of age), soft bedding in the crib (up to 1 year of age), multiple births, prematurity, a history of a sibling who had SIDS, smoking or illegal drug use in the mom, teen mother, short intervals between pregnancies, late prenatal care, and poverty.

Boys are affected more than girls. While studies show that babies with these risk factors are more likely to be affected, the impact or importance of each factor is not well defined or understood in SIDS.

In fact, several of the cases once believed to show that there was a genetic factor in SIDS were actually cases where the mother had murdered each of her children during infancy due to a rare psychological condition called Munchausen's-by-proxy.

Parents who have lost a child to SIDS are in tremendous need of emotional support. Because no cause is found for the infant's death, many parents suffer from guilt feelings.

These feelings may be aggravated by investigations of police or others who, by law, must determine the cause of death. Timing of a subsequent pregnancy is a concern for many parents after experiencing SIDS.

Parents and caregivers of all infants and children should be trained in CPR. A member of a local chapter of the National Foundation for Sudden Infant Death Syndrome can assist with counseling and reassurance to parents and family members (see SIDS - support group).

Family counseling may be recommended to help siblings and all family members cope with the loss of an infant.

The only ways currently known to reduce the odds of SIDS are to put your baby to sleep on his or her back and avoid the use of certain bedding.

The incidence of SIDS has dropped significantly (by almost one-half) since the medical community began the "Back to Bed" campaign. Enough data now has been collected to show that this simple procedure is capable of reducing the risk of SIDS dramatically. Putting babies to sleep (naps included) on their back instead of on their stomach has drastically decreased the incidence of SIDS.

The U.S. Consumer Product Safety Commission released a statement in April 1999 saying that "as many as 900 infant deaths each year are still associated with suffocation in soft bedding." They recommend babies being placed on a firm, tight fitting mattress and removing all comforters, etc. (for complete details, contact The Office of Information and Public Affairs in Washington, DC 20207)

In the past, for homes in which there has been a previous sibling death from SIDS, home apnea (breathing) monitors were recommended, but research found that they had no effect, and the use of home monitors has largely stopped. Until the nature of the disease is fully understood, complete prevention will not be a reality.

Recommendations from other countries also include:

• Do not let your baby become too hot.
• Keep your baby in a smoke-free environment.
• Breast-feed your baby. (Breast-feeding has not been shown to decrease the incidence of SIDS, however, it does decrease the incidence of some upper respiratory infections which may influence the development of SIDS).
• Do not lay your baby on pillows, bean bags, or sheepskin mattresses.