Sids and Kids Western Australia

SIDS is defined as the sudden and unexpected death of an infant under 1 year of age, with onset of lethal episode apparently occurring during sleep, that remains unexplained after a thorough investigation including performance of a complete autopsy, and review of the circumstances of death and the clinical history.

SIDS is still the most common cause of death in non-Indigenous babies between one month and one year of age. Recent statistics from a study examining infant mortality in Western Australia from 1999 to 2001 show that SIDS accounts for 25% of infant deaths (Gee V. and Green T.J. (2005). Perinatal, infant and maternal mortality in Western Australia, 1999-2001. Department of Health, Perth, Western Austalia). West Australian research shows that following death from infection (29%), SIDS is the most common cause of death (27%) amongst Indigenous babies in Western Australia under one year of age. In addition, the risk of an Indigenous baby dying due to SIDS is nearly eight times higher compared with a non-Indigenous baby (Freemantle C.J. (2003) Indicators of infant and childhood mortality for Indigenous and non-Indigenous infants and children born in Western Australia from 1980 to 1997 inclusive [Doctor of Philosophy]. Perth: University of Western Australia).

Through extensive scientific research, a number of risk factors for SIDS have been identified, including the tummy sleeping position, the side sleeping position, overheating, unsafe bedding, cigarette smoke and social factors. In addition, the risk of SIDS is higher amongst pre-term babies and those between one and six months of age. Research shows that 90% of SIDS deaths are associated with preventable risk factors.

Since SIDS and Kids implemented past and present risk reduction campaigns in Australia, there has been an overall decrease of 90% in the rate of SIDS deaths. Approximately $1 million has been spent on National Health Promotion Campaigns from 1990 to 2005, which include "Reducing the Risk", "Kids & SIDS - Three Ways to Reduce the Risk" and the current "SIDS and Kids Safe Sleeping" program.

At present, we still do not know what causes SIDS but based on the risk factors that have been identified through extensive research, there are four main recommendations to reduce the risk of SIDS and fatal sleep accidents:

Sleeping baby on the back reduces the risk of SIDS. Tummy sleeping has been identified as the high risk position for SIDS. Side sleeping is not recommended as it is unstable and babies can roll much more easily into the high risk tummy position. Healthy babies placed to sleep on the back are less likely to choke on vomit than tummy sleeping infants. There is a very high risk of SIDS if a baby normally sleeps on the back and is subsequently placed on the tummy to sleep. Therefore it is important to tell babysitters and others who care for your child about the Safe Sleeping recommendations.

Keeping a baby's face and head uncovered during sleep decreases the risk of SIDS. It is important that a baby does not get too hot while sleeping. Many babies who have died from SIDS were found with their heads and faces covered by bedding, which probably caused overheating and an increase in their arousal threshold. Sleeping on the tummy, too much clothing, heavy bedding, or a room that is too warm may also lead to overheating.

Baby re-breathing their expired air when their face or head is covered or obstructed may also contribute to SIDS. To avoid the obstruction of baby's face and head, remove all pillows, quilts, cot bumpers, soft toys and other loose items from baby's sleeping area. Some parents choose to use a safe infant sleeping bag for their baby, with fitted neck and arm holes. These sleeping bags are used as a substitute for bedding and further reduce the number of items in a baby’s sleeping area.

Smoking during pregnancy or after birth significantly increases the risk of SIDS. Research shows that the risk of SIDS doubles if a mother smokes during pregnancy or after birth. The risk is doubled again if mother and her partner smoke. It is important that babies be kept in a smoke-free environment during pregnancy and after birth.

Provide a safe cot, safe mattress, safe bedding and a safe sleeping place, night and day.

In Australia, all new and pre-loved cots sold must meet the Australian Standard for Cots and will carry a label to say so. The code is AS 2172. There is also an Australian Standard that is used for portable cots. The code is AS 2195 and portable cots that meet the standard carry a label to say so. It is recommended that mattresses are firm, flat, well-fitting, clean and in good condition. Soft and puffy bedding in a baby’s sleeping area is unnecessary and may cover a baby’s face. Therefore all loose items should be removed, including pillows, quilts, toys, cot bumpers and sheepskins. It is also important to consider the positioning of dangling cords, mobiles, electrical devices, heaters and other potential environmental hazards. The Safe Sleeping recommendations should be applied wherever baby is sleeping, both during the day and at night.

The SIDS and Kids health promotion program, "SIDS and Kids Safe Sleeping", provides expectant and new parents, health professionals, child care workers, and high school and university students with the latest information on ways to reduce the risk of SIDS and fatal sleep accidents. Resources include a brochure, poster, door hanger, video, cot card, a booklet for health professionals, and a brochure designed specifically for Indigenous communities. These resources are distributed free of charge to hospitals, antenatal clinics, child health centres, child care centres, doctors, and the print and electronic media. Students completing assignments on SIDS may also call for an information pack. Phone (08) 9474 3544 to order free literature.

For a full description of the resources available, please go to our Resources and Publications page.

An information service for concerned parents (and others) seeking advice on baby and child care practices.
Community education to the general public, schools and other interested groups.
Education of emergency response groups such as police, ambulance officers, hospital staff and fire crews in the management of situations involving sudden infant death.
Educational inservicing for health professionals involved in maternal, baby and child care, child care workers, and high school students. Phone (08) 9474 3544 to arrange an inservice.
Education and supervision of volunteer peer supporters.
Grief education and management guidelines for health professionals.
Educational displays.
Research library.

For comprehensive information on our Safe Sleeping guidelines, please click on the link below:

Although much research has been carried out over the past twenty years into the mechanism of SIDS, no definitive cause has been identified. Perinatal risk factors such as premature birth, low birth weight, being one of a multiple pregnancy or being exposed to maternal smoking in utero have all been identified as significant risk factors for SIDS. Environmental risk factors such as prone sleeping position, infant overheating or overcooling, and ambient room temperatures above 24°C, have also been identified. In addition, social factors such as infants born to parents of low socioeconomic status, increase the risk for SIDS. This is largely due to reduced levels of access to services that provide maternal and child health information, and a higher prevalence of cigarette smoking amongst lower socioeconomic groups.

Currently, many researchers investigating the mechanism of SIDS believe that an infant dies only when a number of factors occur simultaneously. This hypothesis encompasses both epidemiological and scientific data on SIDS. It is also well documented that the incidence of SIDS peaks between 2 - 4 months of age. During this period, major changes are occurring in virtually all physiological systems, as infants attain adaptive mechanisms, enabling them to maintain homeostasis (balance). These include automatic control of ventilation, sleep/wake state organisation, temperature regulation and development of circadian rhythms. If during this critical period the "at risk" infant is also exposed to an external stressor, such as a respiratory tract or gastrointestinal infection, fever, the prone sleeping position, or hypothermia due to over wrapping, then the threshold for SIDS may be reached (Filiano & Kenny 1994).

SIDS and Kids is currently funding research entitled "Transplacental transmission of viruses and pathogenesis of stillbirths, preterm births and congenital anomalities". The project aims to find new techniques for testing whether pregnant mothers have infections. Many stillbirths, preterm births and abnormalities have no known reason. Early studies have shown that these problems are due to infection with viruses. Viruses can only be found using very specific tests. The aim of this project is to develop new techniques to find viruses, and to determine what types of viruses cause stillbirth, preterm births and abnormalities (Professor Bill Rawlinson, University of NSW).

Positional Plagiocephaly is a disorder in which the back or one side of a baby's head is flattened, often with little hair growing in the area. Constant pressure on one area of a baby's skull can flatten or deform it, due to the thinness and softness of the bones of babies' skulls.

It is important to vary baby's position so that baby is not always resting on the same part of the occiput (back of the head).

Turn baby's head to alternate sides (left and right) when putting baby to sleep on the back in order to prevent prolonged pressure on the same spot.
As babies become more alert and interested in the environment they like to look at certain objects before falling asleep. Sleeping baby at alternate ends of the cot will encourage him or her to look in different directions. Week about, put baby to sleep at alternate ends of the cot (feet to the bottom of the cot). This varies the head position as he or she turns towards sounds, activity, or a favourite image (mobile, picture etc.). Changing the position of the cot in the room may also have the same effect.
When baby is awake, minimise the time that he or she spends lying down with pressure on the same part of the head by carrying and cuddling baby in upright positions.
Avoid prolonged periods in car seats, strollers, swings and bouncers as this places additional pressure on the back of the head.
Alternate the holding position when feeding baby i.e. hold in left arm for one feed and the right arm for the next feed.
Give baby increasing amounts of side lying and tummy time to play on a firm surface when awake and being observed by an adult but never put baby on the side or the tummy to sleep. This not only allows an infant to strengthen many muscles which are not used when lying on the back, but also gives the back of the head time without external pressure pushing against it. Strong neck muscles and good head control may also reduce the risk of SIDS. Even if baby does not enjoy tummy time or side lying, it is important to persist and gradually increase the time spent on the tummy or the side during "awake" times.

Babies should sleep on their backs, play on their tummies, and sit up, supported, to watch the world go round.

The SIDS and Kids WA Safe Sleeping in Aboriginal Communities Project is a unique pilot project which commenced in May 2005. The project has since become an important part of SIDS and Kids WA. The main aim of this research project is to develop culturally appropriate education programs and interventions to reduce the rate of Sudden Infant Death Syndrome (SIDS) among Aboriginal infants. This project involves a collaboration between Aboriginal and non-Aboriginal researchers, health workers, health professionals and policy makers.

The project will ensure consultation amongst a range of Aboriginal communities throughout Western Australia. To date, consultation has taken place in the following West Australian health regions:

Focus groups within these regions have resulted in specific findings which will be used to develop a specialised training program and much needed resources. Subject to extra funding, additional regions will be approached in 2006 and 2007.

The project has generated much enthusiasm and interest amongst communities, and empowered Aboriginal people to feel a sense of ownership and control over their own destinies. Above all, the project has inspired hope for the future of Aboriginal peoples.

Cots which meet the Australian Standard are safe cots. All new and second hand cots sold in Australia must meet the Australian Standard for Cots (AS 2172), and will carry a label to say so.

The safest cot mattress is one which is the right size for the cot, and is firm, flat, clean and in good condition.

Try not to have baby sleep on the tummy before six months of age. Do this by sleeping baby on the back or using a safe infant sleeping bag, as these delay rolling over. Most back-sleeping babies can't roll onto the tummy by themselves until about 5 or 6 months of age when the critical risk period has passed.

No. There is no research to show that any specific baby care product reduces the risk of SIDS.