Cot death: it’s every new parent’s worst nightmare. But, by following a few straightforward steps, you can ensure that you are doing all you can to reduce the risk of your baby dying suddenly and unexpectedly. Nicola Peckett, the Communications Manager at the Foundation for the Study of Infant Deaths (FSID), explains how.

Reducing the risk.......

The Foundation for the Study of Infant Deaths is the UK’s leading baby charity working to prevent sudden deaths and promote infant health. Since the introduction of our ‘reduce the risk of cot death’ campaign in 1991, the number of babies dying suddenly and unexpectedly has fallen by 75%.

But, 300 babies still die for no apparent reason every year in the UK, making it the leading cause of death in babies over one month. However, advances in research mean we are regularly discovering new positive steps that each and every parent can take to give their baby the chance of a lifetime.

Back to sleep

Our life-saving advice includes steps such as making sure that you always place your baby on his or her back to sleep, and that you follow this advice for both daytime naps as well as night-time sleeps. Babies settle more easily on their backs if they have been placed to sleep that way from the very first day.

At about five or six months old, it is normal for babies to roll over and they should not be prevented from doing so. This is the age at which the risk of cot death falls rapidly, but you should still put your baby on her back to sleep. If you find her on her front before five or six months old, gently turn her over onto her back but don’t feel you should be checking for this constantly through the night.

Babies may get a flattening of the part of the head they lie on. This will become rounder again as they grow. Your baby should sometimes lie on her tummy to play during the day, when she is awake. Keep an eye on her at all times and put her on her back if she falls asleep.

Smoke-free is best

Smoking in pregnancy increases the risk of cot death. If you smoke 20 or more cigarettes a day, the risk of your baby dying from cot death increases eight times. The less you smoke, the lower the risk, but it’s best not to smoke at all when you are pregnant, and it’s safest if the father doesn’t smoke either.

Babies exposed to cigarette smoke after birth are also at an increased risk of cot death. It is best if nobody smokes in your house, including visitors. Ask anyone who wishes to smoke to go outside.

Sharing a bed can be dangerous

Cot death doesn’t only happen in cots. In fact, the safest place for your baby to sleep for the first six months is in a crib or cot in a room with you. Your baby should be placed with his feet to the foot of the crib or cot, with the bedclothes firmly tucked in and no higher than the shoulders, so that he can’t wriggle down under the covers. It can be dangerous if your baby’s head gets covered when he sleeps.

Sharing a bed with your baby is especially dangerous in certain circumstances such as if you are a smoker, have drunk alcohol or taken drugs that make you sleepy, or if your baby was premature. While it’s lovely to have your baby with you for a cuddle or a feed, it’s safest if you put him back in his crib or cot before you go to sleep. Also, never sleep with your baby on a sofa or in an armchair.

Babies don’t need hot rooms

Overheating can increase the risk of cot death. Babies don’t need especially warm rooms; a room temperature of 16-20ºC is fine. All-night heating is rarely needed and babies should never sleep next to a radiator or in direct sunlight. To keep an eye on the temperature, you can buy a simple room thermometer from the FSID for £2.75.

You should also check your baby regularly to see if she is too hot or too cold. To check if your baby is too hot, look for sweating or feel your baby. Don’t worry if her hands or feet are cool, that’s normal. If she’s too hot remove one or more layers of blankets. In warm summer weather, your baby may not need any bedclothes at all.

Advice for parents to reduce the risk of cot death:

• Cut smoking in pregnancy – fathers too! And don’t let anyone smoke in the same room as your baby.

• Place your baby on the back to sleep (and not on the front or side).

• Do not let your baby get too hot, and keep your baby’s head uncovered.

• Place your baby with their feet to the foot of the cot, to prevent them wriggling down under the covers.

• Never sleep with a baby on a sofa or armchair.

• The safest place for your baby to sleep is in a crib or cot in a room with you for the first six months.

• It’s especially dangerous for your baby to sleep in your bed

if you (or your partner):

• are a smoker, even if you never smoke in bed or at home

• have been drinking alcohol

• take medication or drugs that make you drowsy

• feel very tired;

or if your baby:

• was born before 37 weeks

• weighed less than 2.5kg or 5½ lbs at birth

• is less than three months old.

• Don’t forget, accidents can happen: you might roll over in your sleep and suffocate your baby; or your baby could get caught between the wall and the bed, or could roll out of an adult bed and be injured.

• Settling your baby to sleep (day and night) with a dummy can reduce the risk of cot death, even if the dummy falls out while your baby is asleep.

• Breastfeed your baby. Establish breastfeeding before starting to use a dummy.