Safe Sleep for Baby: Revisiting SIDS Prevention

It was 6 o’clock* on a Tuesday morning. I was quietly writing some patient notes. The end of my 12-hour overnight shift in the Emergency Room was coming to a close. Suddenly, the quiet was shattered as the pager on my hip came alive with piercing beeps. This familiar sound elicited an uncontrollable surge of adrenalin in my veins, and a needed quickening to my pace. An ambulance was about to arrive.

I joined the team that was gathering together near the ambulance entrance. I assumed my position at “head left”. I was to stay at the head of the bed, on the left side of the patient, in order to perform any needed care. The other team members assumed their positions in the elegantly controlled chaos resulting from the pager’s beeps.

A five-week old little girl was in the back of an ambulance, speeding towards the hospital’s emergency room. That’s all we knew. And we were ready.

Her gurney shot through the loud metal entrance to the trauma bay. The medical team began to move together like dancers on a stage. I immediately grabbed the blue bag being held by an obviously distressed EMT. He had been using the bag to breathe for the baby while she was in the back of the ambulance. I began to squeeze the bag regularly, slowly, and intently.

I was breathing for the lifeless infant whom I was unprepared to meet on that Tuesday morning.

Her parents were at the foot of the bed while we tried to revive the baby girl. Her mother’s tear-soaked face and guttural sobs were beyond consolation. Her father stood silent, staring straight ahead, as if he was not sure if this was really happening. Then, he vomited in the closest trash can.

The medical team worked aggressively and appropriately for over an hour. Breathing tube, blood tests, chest compressions, medications, prayers, tears. We did everything we could. She never breathed. She never woke up. She was gone.

The lead trauma doctor declared her death at 7:26 AM.

At that minute, the image of her small, lifeless body was burned into my brain. Her death certificate read, “Death due to cardiopulmonary arrest, secondary to sudden infant death syndrome (SIDS).”

It wasn’t until 2 weeks later that investigators revealed the true cause of her death. The baby girl was a victim of a tragic choice.

She had been suffocated to death while sleeping in bed with her parents.

This month, the AAP released a updated policy statement on the prevention of sudden infant death syndrome (SIDS). This new policy extends previous recommendations for safe infant sleeping to include action steps to reduce the risk of sleep-related suffocation.

To reduce the risk of SIDS, and sleep-related suffocation:

  1. Keep baby in the same room as a parent, but NOT in the adult’s bed. Infants should be placed on their backs to sleep, for every sleep, on a firm sleep surface; not in a swing, car seat, or infant carrier. Babies should not be sleeping on their tummies, or on their sides.
  2. This sleep area should be free of any pillows, bedding, or bumper pads. Avoid any alarm-device, mattress, positioner, or wedge marketed to prevent SIDS. There is no evidence these devices reduce the risk. In addition, do not use any devices marketed as “safe” co-sleepers, they are not recommended.
  3. Put baby to sleep with a pacifier. And, keep baby from getting too warm while sleeping. One layer of clothing and a wearable blanket should be enough for the average temperature of a home.
  4. Practice tummy time when awake. This will help baby develop needed muscular strength to roll and move freely in the crib. Once an infant can roll from front to back, and back to front, they may position themselves for comfort in the crib.
  5. Get regular prenatal care. Don’t smoke, drink alcohol, or use illicit drugs while pregnant; or after the infant’s birth. Breastfeed. Get regular well child care. Vaccinate.

These guidelines are intended to save lives, and following them would have saved the life of a five-week old baby girl.

By encouraging families to follow these safer sleep guidelines, I hope to never share in the devastating loss of another young family.

For more information about a safe sleeping environment for your baby, talk to your pediatrician. Until then, check out these tips on safe sleep for baby.

*The details of this medical case have been changed to protect the identity of the patient.