Family Matters

‘Back to Sleep’: Why Are 2,500 U.S. Babies Still Dying of SIDS Each Year?

Putting babies on their back to sleep has dramatically reduced the number of SIDS deaths, but thousands of babies still die each year. A look at the key risk factors.

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There’s no doubt that the Back to Sleep campaign launched in 1994 to get parents to stop putting babies to sleep on their tummies has been a success. In the 1970s and 1980s, the rate of infant deaths per 1,000 live births was 1.5; it’s now 0.5.

Within a generation, most babies are now put to bed on their backs, and yet 2,500 U.S. infants still die each year in the U.S. Researchers trying to understand why have noticed a curious byproduct of the trend toward back-sleeping: as fewer babies were being put to sleep on their bellies, more babies were documented engaging in other pediatric no-nos — sleeping with their parents, for example — which is another risk factor for SIDS.

A study published Monday in the journal Pediatrics takes a look at how risk factors for SIDS have evolved over the years. In an analysis of the 954 babies who died suddenly and unexpectedly in San Diego County between 1991 and 2008 — 568 of these deaths were attributed to SIDS — researchers found that the percentage of babies put to sleep on their backs increased from 30% to 85%. Meanwhile, the rate of bed-sharing at the time of a SIDS death jumped from 19% to 38%; the incidence of babies asleep in an adult bed instead of in a crib increased from 23% to 45%. Being put to sleep in a standard bed is concerning to doctors because beds generally have generous amounts of bedding — fluffy pillows and layers of blankets — which can lead to infant suffocation.

(MORE: Controversial Posters of Babies with Knives Aim to Reduce Co-Sleeping Deaths)

Risk factors for SIDS include being born prematurely, being male and being exposed prenatally to alcohol or cigarettes; after birth, parents can unwittingly pile on other risk factors, such as overbundling baby or tucking him in for the night with a cozy quilt. When analyzing the data, lead author Henry Krous, a pediatric pathologist and director of the San Diego SIDS Research Project at Rady Children’s Hospital, noticed that the number of risk factors hadn’t actually decreased; it had just changed. “Most babies had two or more risk factors,” says Krous. “What that says to us is that Back to Sleep should emphasize multiple risk factors.”

In other words, Back to Sleep should stress much more than just back-sleeping. Just putting a baby on his back at bedtime is not the entire solution; parents bringing a new baby home from the hospital should be educated about avoiding baby’s exposure to all the risk factors for SIDS.

(MORE: New Guidelines: How to Put Baby Safely to Bed)

Co-sleeping, for example, is associated with a greater risk of SIDS, so much so that Milwaukee last year launched a graphic blitz against the practice, with posters showing babies asleep in adult beds right next to butcher knives. The caption: “Your baby sleeping with you can be just as dangerous.” As with almost any parenting practice, the issue isn’t straightforward: proponents insist that bed-sharing — when done correctly — can be safe.

Furthermore, despite the prevailing message of Back to Sleep, 30% of babies are still being put to bed on their bellies. “We still have a lot of work to do,” says Krous. “The problem isn’t solved yet.”

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Countries that primarily co-sleep have far less deaths than we do.  There are many more crib deaths still per year than "co-sleeping" deaths.  I use the term lightly because most deaths from "co-sleeping" are from unintentional co-sleeping or improper co-sleeping.  American bed systems are simply not created for co-sleeping.  Still, your baby is statistically safer in your bed than in a crib.  Other countries are far ahead of us when it comes to healthy babies.  Let's take some tips from them.


Hi readers. As a new dad this is a real concern of mine so I've come up with an idea for helping to prevent these tragic deaths.

The general idea is a device that monitors your babies heart rate and breathing pattern. The device is paired with your smart phone using an app. The device will alert you via your handset if your baby stops breathing or if babies heart rate drops or becomes erratic etc.

This could be built into a blanket, wrist band or similar but the important part is you always have your smart phone with you (i take mine to bed) so you get added security and real peace of mind she you settle down to sleep your self.

If we can save just 1 baby then we would have already achieved a great deal and also justified manufacturing such a device.

I've submitted the invention idea on so just need enough votes for the Quirky team to start manufacturing the device. Please visit this link to vote on my idea and to start saving babies lives.


Of the 70,000 babies born in the U.S. last week, the great majority will grow into normal, healthy children. But 1,600 or so will die before their first birthday—an annual total of 80,000. The amount that babies are dieing is alarming. We are a developed country with a vast amount of resources of knowledge as well as materiel. We have to educate our selves with the subject of human growth and development. This subject looks into how human life can be better and well maintained. With regards to infancy death, we have to look back to theory's and science of  a babies growth and development. The more we know about that, the more we will be prepared for a babies life. For SIDS we see that there is No clear cause but there are risk factors such as, Sleeping on stomach instead of back, Low birth weight and APGAR score, Smoking, Soft bedding  and so on. We have to educate ourselves when we are in high school. We have to educate everyone before they are even in the age of having a baby. That way when someone knows they are pregnant, they will be prepared so they don't risk their child's life. That way we can know how the prenatal risks are and etc. Ignorance might be an excuse but it also kills.