News Release

Wednesday, January 18, 2006

NICHD Alerts Parents to Winter SIDS Risk and Updated AAP Recommendations

The number of infants who die from Sudden Infant Death Syndrome, or SIDS, increases in the cold winter months, according to the National Institute of Child Health and Human Development (NICHD), one of the National Institutes of Health. During these colder months, parents often place extra blankets or clothes on infants, hoping to provide them with more warmth. In fact, the extra material may actually increase infants’ risk for SIDS.

“Parents and caregivers should be careful not to put too many layers of sleep clothing or blankets on infants — or to keep room temperatures too warm — because overheating increases the risk of SIDS,” said Duane Alexander, M.D., Director of the NICHD. “Of course, parents and caregivers should always place infants to sleep on their backs for naps and at night.”

For more than a decade, the NICHD has led the Back to Sleep campaign, which recommends a number of ways to reduce the risk of SIDS. Unless there’s a medical reason not to, infants should be placed on their backs to sleep, on a firm mattress with no blankets or fluffy bedding under or over them. If a blanket is used, it should be placed no higher than the baby’s chest and be tucked in under the crib mattress. The baby’s crib and sleep area should be free of pillows and stuffed toys, and the temperature should be kept at a level that feels comfortable for an adult. Since the NICHD campaign began, the overall SIDS rate in the United States has declined by more than 50 percent.

Despite the campaign’s progress, SIDS is the leading cause of death in infants between 1 month and 1 year of age and claims the lives of approximately 2,500 infants each year. SIDS is the sudden unexplained death of an infant in the first year of life. Most SIDS deaths happen when babies are between two and four months of age. The causes of SIDS are still unclear, but it is possible to reduce factors that increase SIDS risk.

The American Academy of Pediatrics (AAP) recently issued updated recommendations for reducing the risk of SIDS:

  • Always place your baby on his or her back to sleep, for naps and at night
  • Place your baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet
  • Keep soft objects, toys, and loose bedding out of your baby’s sleep area
  • Do not allow smoking around your baby
  • Keep your baby’s sleep area close to, but separate from, where you and others sleep
  • Consider offering a clean, dry pacifier when placing your baby on his or her back to sleep
  • Do not let your baby overheat during sleep
  • Avoid products that claim to reduce the risk of SIDS
  • Do not use home monitors to reduce the risk of SIDS
  • Reduce the chance that flat spots will develop on your baby’s head by providing “Tummy Time” when your baby is awake and someone is watching; changing the direction that your baby lies in the crib; and avoiding too much time in car seats, carriers, and bouncers

Although the rate of SIDS among African American infants has declined by almost 50 percent since the Back to Sleep campaign began, it is still higher than that of white infants. In fact, African American infants are twice as likely to die of SIDS as are white infants. To help eliminate the racial disparity in SIDS rates, the NICHD has forged partnerships with several African American organizations. In 2003, Alpha Kappa Alpha Sorority, Inc., the National Coalition of 100 Black Women, Women in the NAACP, and the NICHD held three SIDS Summits, which brought together thousands of participants from across the country to learn more about SIDS. Since the Summits, these partners have continued their work in communities across the country. They met recently to discuss the updated AAP recommendations and future campaign direction.

“While we have made great progress in reducing the rate of SIDS for African American infants by almost 50 percent, there is much work ahead,” said Yvonne Maddox, Ph.D., Deputy Director of the NICHD. “The winter SIDS alert is one way to remind parents and caregivers that we can reduce the risk of SIDS by placing babies on their backs to sleep for naps and at night.”

The NICHD is also working within the American Indian community to help reduce the racial disparity in SIDS rates. American Indian babies are nearly three times as likely to die of SIDS as white babies. Research has found that among the Northern Plains American Indian community, overheating is one of the biggest risk factor for SIDS. The NICHD is establishing partnerships with American Indian organizations to help create and disseminate culturally appropriate SIDS risk reduction materials.

After an extensive body of research showed that placing infants to sleep on their backs reduces their risk of SIDS, the NICHD led a coalition of organizations to launch the Back to Sleep campaign in 1994. Along with the NICHD, the coalition consists of the AAP, the Health Resources and Services Administration, the Association of SIDS and Infant Mortality Programs, and First Candle/SIDS Alliance.

The NICHD distributes a variety of free Back to Sleep education materials for parents, caregivers, and health care providers, including brochures, magnets, door hangers, and infant “onesies.” Most of the materials are available in English and Spanish. To obtain these free materials, other NICHD publications, as well as information about the Institute, visit the NICHD Web site,, or call the NICHD Information Resource Center, 1-800-370-2943; e-mail

The NICHD is part of the National Institutes of Health (NIH), the biomedical research arm of the federal government. NIH is an agency of the U.S. Department of Health and Human Services. The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site,, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

NIH…Turning Discovery Into Health®