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Back to sleep during the day

29 June 2007

In the mid-1980s it was recognised that the number of babies dying from Sudden Infant Death Syndrome (SIDS, commonly referred to as cot death) had increased in many countries, but no-one knew quite why.

Peter Fleming, Professor of Infant Health and Developmental Physiology, was just starting the Avon Cot Death Study when he read a Dutch report which suggested that putting babies to sleep on their fronts led to a high risk of cot death. Fleming immediately analysed the Avon data and found that indeed, 93 per cent of the babies who had died had been put to sleep lying on their fronts.

 Initially researchers refused to believe that something as simple as this could have such a profound effect and it wasn’t until a follow-up study in 1991 that Fleming felt confident enough to approach the government’s health advisers with his findings. Following a high profile campaign on the issue by TV presenter Anne Diamond – who lost her own child through SIDS – the Government gave its official support to the study and launched the highly successful Back to Sleep campaign. As a direct result, cot deaths across the country fell by 70% – the equivalent of saving 12 babies a week.

 Since then, much work has been done on this distressing syndrome, by Fleming and others, and parents have further been advised that for the first six months the safest place for a baby to sleep is in a cot by the parents’ bedside. But new research by Dr Peter Blair, a Senior Research Fellow working alongside Fleming, reveals that this advice is just as important for an infant’s day-time naps as it is for their night-time sleep.

The new study found that the babies who died during the day were more likely to have been placed on their side than on their back for their day-time naps; they were more likely to be found with their heads covered by the bedclothes than the babies who didn’t die; and, in particular, 75 per cent of the babies who died in the day-time were sleeping in a room where there was no adult present.

Day or night, the advice is the same

One important aspect of the study looked at the time that had elapsed since the baby was last seen alive. Three quarters of the infants who died during the night were observed alive after midnight; a fifth were still alive within two hours of death. Of those who died during the day, over a third were alive 30 minutes prior to death and nine per cent were alive within 10 minutes of death. The fact that most parents described their infants

as seeming to be well the last time they saw them alive suggests that for some of these deaths the onset of the final event was very quick. The protective effect of having an adult in the same room as the sleeping infant is therefore important as it may reduce the risk of young infants rolling onto their front, or bedclothes covering their head.

In summary, most of the risks associated with SIDS were significant for both night-time and day-time deaths, although the fact that the father smoked was only significant for night-time deaths, and placing infants on their side to sleep was more marked amongst the day-time deaths. So fundamentally the advice remains the same – put your baby to sleep on its back – whether it’s at night or during the day.


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