• Covering of Head During Sleep Associated With Increase Risk of SIDS

    Sudden infant death syndrome (SIDS) occurs in about 58 per 100,000 live births in the US. It is the unexplained sudden death of an infant under one year of age. There is no known definitive cause for SIDS but experts recommend steps to reduce the risk. Placing the baby to sleep on the back instead of the stomach, eliminating exposure to tobacco smoke , avoiding overheating, and proper bedding are important steps in SIDS prevention. Research continues to understand the cause and contributors of SIDS.
    Information collected about incidents indicated that some infants with SIDS are found with their heads covered by bedclothes. The Institute of Child Life and Health at the University of Bristol in the UK wanted to understand if the head cover was just a consequence of the death or a contributing factor. The study, published in the Archives of Diseases in Childhood , found that the head covering may be a risk factor for SIDS.

    About the Study

    The systematic review searched the results of several SIDS studies that had recorded information specifically about head covering. All the studies reviewed were observational studies . The study defined the head covering as an infant with SIDS discovered with the head covered by bedclothes or a control infant waking from reference sleep with head covered by bedclothes. Two groups were compiled :
    • A case group had infants with SIDS. There were 1,234 cases.
    • A control group had infants of the same age that did not have SIDS. There were 3,822 controls.
    When comparing the two groups:
    • 24.6% of the case (SIDS) group reported head covering
    • 3.2% of the control group reported head covering
    Researchers also determined that the head covering was not due to the infant’s movement just before death, but rather a common pattern of movement. While in the crib infants tended to squirm which slid them further under a blanket.

    How Does This Affect You?

    Researchers in this study found that babies’ normal movements tend to cause blankets to rise over their head. The American Academy of Pediatrics (AAP) do not recommend soft materials including blankets, quilts, loose bedding, or pillows be placed in the crib. Consider the use of sleep clothing instead of blankets.
    Talk to your doctor about steps you can take to reduce the risk of SIDS . Placing a baby on their back is still the most known beneficial habit to decrease the risk of SIDS. AAP also recommends keeping the room at a comfortable temperature, using safety-approved cribs and a firm mattress, removing extra linens and toys from the crib, sleeping only one baby per crib, and keeping baby away from tobacco smoke.


    American SIDS Institute http://www.sids.org/

    National Institute of Child Health and Human Development http://www.nichd.nih.gov/


    Blair P, Mitchell EA, Heckstall-Smith EM, Fleming PJ. Head covering—a major modifiable risk factor for sudden infant death syndrome: a systematic review. Arch Dis Child. 2008 Sep;93(9):778-83.

    Healthy child care America back to sleep campaign. American Academy of Pediatrics website. Available at: http://www.healthychildcare.org/section%5FSIDS.cfm . Accessed November 11, 2008.

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