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Health Department
Health and Community Services
43525 Elizabeth Road, Mount Clemens, MI 48043
(586) 469-5235

INFANT Safe Sleep


Reducing the Risk of Sudden Infant Death Syndrome (SIDS) & Sudden Unexpected Infant Death Syndrome (SUIDS)

What is SIDS & SUIDS?

Sudden Unexpected Infant Death (SUID): The death of an infant younger than 1 year of age that occurs suddenly and unexpectedly. These deaths often happen during sleep or in the baby’s sleep area. After a full investigation, these deaths may be diagnosed as:

  • Suffocation: When no air reaches a baby's lungs, usually caused by a block in the airway
  • Entrapment: When a baby gets trapped between two objects, such as a mattress and wall, and can't breathe
  • Infection
  • Ingestion: When a baby takes something into the mouth that blocks the airway or causes choking
  • Medical Conditions
  • Trauma
  • SIDS: Is one subgroup of SUID and is the sudden death of an infant younger than 1 year of age that cannot be explained even after a full investigation.


  • SUID is the leading cause of death among babies between 1 month and 1 year of age.
  • Most SUID deaths occur when a baby is between 1-4 months old, and 90% of SUID deaths occur before a baby reaches 6 months old. However, SUID deaths can occur anytime during a baby’s first year.
  • SUID is silent and can occur even in babies who seem healthy.
  • In Michigan, Black infants are dying of sleep-related causes at a rate more than 3 times higher of White infants.
  • In Michigan, a baby dies every 3 days due to unsafe sleep.
  • In Macomb County:
    • 2 in 5 infants found unresponsive are not found on their backs
    • 3 in 4 sleep-related deaths occur in an unsafe sleep location
    • 1 in 3 sleep-related deaths involve an infant sharing a sleep space


Risk Factors For SIDS/SUIDS & Sleep-Related Deaths

Babies are at a higher risk for SUID/SIDS if they:

  • Sleep on their stomach
  • Sleep on soft surfaces such as adult mattresses or couches
  • Sleep on or under soft or loose bedding
  • Share a sleep space with an adult, another child, or pets
  • Get too hot while sleeping
  • Are exposed to cigarette smoke while in the womb or in their environment after they are born such as in the home or vehicle
  • Are born pre-term or have low birth weight

Other known risk factors for SUIDS/SIDS include:

  • Young maternal age (giving birth before age 20)
  • Late or no prenatal care


Safe Sleep Recommendations

  • Back to Sleep- Babies should be placed on their backs to sleep, every time.
  • Use a Firm Sleep Surface- A firm crib mattress, covered by a tight fitting crib sheet, is the recommended sleep surface.
  • Keep Soft Objects & Loose Bedding Out of the Crib- Pillows, blankets, crib bumpers, toys, and other objects should be kept out of a baby’s sleeping environment. Consider the use of a sleep sack instead of a blanket.
  • Avoid Exposure to Cigarette Smoke- Do no smoke during pregnancy and also avoid exposing a baby to second-hand smoke such as in the home or vehicle.
  • Stay Close, Sleep Apart- Sharing a sleep space with your baby is not recommended. Instead, place your baby in a separate crib or bassinet in the parent’s bedroom. Room sharing can reduce the risk of SIDS by 50% and is recommended until the baby is at least 6 months old, but preferably until they are 1 year old.
  • Avoid Overheating- The baby should be placed in light clothing for sleep, and the temperature of the room should be kept comfortable for a lightly clothed adult.
  • Avoid Drugs & Alcohol- Do not use drugs or alcohol while caring for your baby.
  • Offer a Pacifier- Consider offering a pacifier at nap time and bedtime. The pacifier does not need to be reinserted once the baby falls asleep.
  • Breastfeed- Consider breastfeeding your baby exclusively for at least 6 months, as this can reduce the risk of sudden infant death by approximately 50%.
  • Vaccinate- Keep your baby up to date on all vaccinations, as this also can reduce the risk of sudden infant death by approximately 50%.
  • Avoid Commercial Devices Marketed to Reduce  the Risk of SIDS- Although various devices have been developed to maintain sleep position or reduce the risk of re-breathing, none have been tested sufficiently for effectiveness or safety.
  • Avoid Home Monitors as a Strategy to Reduce the Risk of SIDS- There is no evidence that the use of such home monitors reduces the risk of SIDS.
  • Avoid the Development of Flat Spots- Babies can develop flat spots on their head which are often not serious, but to prevent this, encourage supervised tummy time for you baby. 
    Tummy Time
  • Infants Should Not Sleep in Car Seats, Infant Carriers, Strollers, Swings, or Bouncers- When babies fall asleep while sitting in car seats, infant carriers, strollers, swings, or bouncers, the position of their upper body can restrict their airways. When they fall asleep in these items, they should be moved to a crib, bassinet, or pack-n-play as soon as possible.
  • Make Sure Others Know How to Provide a Safe Sleep Environment- Make sure you educate anyone else that may be caring for your baby about how to provide a safe sleep environment.


Frequently Asked Questions

  • Are products marketed for bed-sharing safe to use?
    • A firm and flat sleep area that is made for infants, like a safety-approved crib or bassinet, and is covered by a fitted sheet with no other bedding or soft items in the sleep area is recommended by the American Academy of Pediatrics (AAP) Task Force on SIDS  to reduce the risk of SIDS and other sleep-related causes of infant death. Keeping baby in your room and close to your bed, ideally for baby's first year, but at least for the first 6 months is also recommended by the AAP. Room sharing reduces the risk of SIDS. Having a separate safe sleep surface for baby reduces the likelihood of suffocation, entrapment, and strangulation.
    • A crib, bassinet, portable crib, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC) is recommended by the AAP Task Force on SIDS. For information on the safety of specific sleep products, visit
  • Won’t my baby choke if I place him/her on their back to sleep?
    • No. Babies may actually clear such fluids as spit-up better when sleeping on their backs because of the location of the opening to the lungs in relation to the opening to the stomach. There has been no increase in choking or similar problems for babies who sleep on their backs.

      Trachea esophagus image.jpg

    • When the baby is in the back to sleep position, the trachea (tube to the lungs) lies on top of the esophagus (tube to the stomach). Anything regurgitated or refluxed from the stomach through the esophagus has to work against gravity to enter the trachea and cause choking. When the baby is sleeping on its stomach, such fluids will exit the esophagus and pool at the opening for the trachea, making choking much more likely.
  • If my baby rolls onto his/her stomach while sleeping, do I need to put them back to the back to sleep position?
    • No. Most babies start rolling over on their own around 4 to 6 months of age. If your baby rolls over on his or her own during sleep, you do not need to turn the baby back over onto his or her back. The important thing is that your baby starts every sleep time on his or her back to reduce the risk of SIDS, and that there is no soft objects, toys, crib bumpers, or loose bedding under baby, over baby, or anywhere in baby's sleep area.
  • Why can’t I use bumper pads in my baby’s crib?
    • Evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries or death because babies can become trapped in between the bumper pads and the crib and suffocate. Keeping bumper pads and other objects out of your baby's sleep area is the best way to avoid these dangers.
  • What if my baby won’t get used to sleeping on his or her back?
    • While a baby's comfort is important, safety is more important. Parents and caregivers should place babies on their backs to sleep even if they seem less comfortable or sleep more lightly than when on their stomachs. Some babies don't like sleeping on their backs at first, but most get used to it quickly. The earlier you start placing your baby on his or her back to sleep, the more quickly your baby will adjust to the position.

Safe Sleep Printable Resources

If you have any questions, or would like to speak to a Registered Nurse, call (586) 469-5520 or email us now.