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Reducing the risk of cot death

Sudden Infant Death Syndrome (SIDS) risk factors explained plus information on how you baby should sleep, stopping smoking and other ways to reduce the risk of cot death.
Place your baby on the back to sleep from the very beginning. This will reduce the risk of cot death. Side sleeping is not as safe as sleeping on the back. Healthy babies placed on their backs are not more likely to choke.

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 still put your baby on the back to sleep. If you find your baby on the front before five or six months old, gently turn your baby over but do not feel you should be checking for this constantly through the night.

Stop smoking during pregnancy. Fathers should stop too. Smoking in pregnancy increases the risk of cot death. It is best not to smoke at all.

Do not let anyone smoke in the same room as your baby. Babies exposed to cigarette smoke after birth are also at an increased risk of cot death. It is best if nobody smokes in the house, including visitors. Anyone who wishes to smoke should go outside. Do not take your baby into smoky places. If you are a smoker, sharing a bed with your baby increases the risk of cot death.

Do not let your baby get too hot or too cold. Overheating can increase the risk of cot death. Babies can overheat because of too much bedding or clothing, or because the room is too hot. Remember, a folded blanket counts as two blankets.

When you check your baby, if he or she is sweating or their tummy feels hot to the touch, take off some of the bedding. Do not worry if your baby's hands or feet feel cool, this is normal. It is easier to adjust the temperature with changes of lightweight blankets. Babies do not need hot rooms, all night heating is rarely necessary. Keep the room at a temperature that is comfortable for you. About 18?C (65?F) is comfortable.
  • In summer, if it is very warm, your baby may not need any bedclothes other than a sheet.
  • Even in winter, most babies who are unwell or feverish need fewer clothes.
  • Babies lose excess heat from their heads, so make sure their head cannot be covered with bedclothes.
  • Babies should never sleep with a hot water bottle or electric blanket, next to a radiator, heater or fire, or in direct sunshine.
  • Remove hats and extra clothing as soon as you come indoors or enter a warm car, bus or train, even if it means waking your baby.
In the nursery:
  • Keep baby's head uncovered, place your baby in the feet to foot position
  • Babies whose heads are covered accidentally with bedding are at an increased risk of cot death.
  • Sleep your baby on a mattress that is firm, flat, well fitting and clean. The outside of the mattress should be waterproof, like PVC. Cover the mattress with a single sheet. Use sheets and lightweight blankets but not duvets, quilts, baby nests, wedges, bedding rolls or pillows.
  • To prevent your baby wriggling down under the covers place your baby's feet at the foot of the cot or pram. Make the covers up so that they reach no higher than the shoulders. Covers should be securely tucked in so they cannot slip over the baby's head.
  • Keep your baby's cot in your room for the first six months. Do not sleep on a sofa with your baby.
  • Your baby should not sleep in your bed with you if you or your partner are a smoker, take any form of drugs or medication which makes you sleep more heavily, have recently taken alcohol, or if you are extremely tired.
  • If your baby is unwell, seek advice promptly.
  • Babies often have minor illnesses which you do not need to worry about. Make sure your baby drinks plenty of fluids and is not too hot. If your baby sleeps a lot, wake him or her regularly for a drink.
It may be difficult to judge whether an illness is more serious requiring prompt medical attention. The following guidelines may help you:

Serious illness

There may be serious illness if your baby has any of the following symptoms:
  • has a high pitched or weak cry, is less responsive, is much less active or more floppy than usual.
  • looks very pale all over, grunts with each breath, seems to be working hard to breathe when you look at their chest and tummy.
  • takes less than a third of usual fluids, passes much less urine than usual, vomits green fluid, or passes blood in their stools.
  • has a high fever or is sweating a lot
Urgent medical attention is needed if your baby:
  • stops breathing or goes blue
  • is unresponsive and shows no awareness of what is going on
  • has glazed eyes and does not focus on anything
  • cannot be woken
  • has a fit. Even if your baby recovers without medical attention, still contact your doctor.

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