Back to Sleep: SIDS & the Misconception of Choking

by Wendy Haldeman, MN, RN, IBCLC, Co-Founder of The Pump Station& Nurtury^™

New parents experience numerous emotions upon the birth of a new baby; overwhelming love, awe that something so small could be so very perfect, and fear that something might harm this little being. One such concern is the possibility of sudden infant death syndrome (S.I.D.S.) also known as crib death. The scary thing about S.I.D.S. is that the cause(s) is unknown. The good news is that there are a number of ways parents can protect their infants.

Research found that when babies were placed on their backs to sleep the baby was less vulnerable. The National Institute of Child Health and Human Development began a campaign in the 1990s called “Back to Sleep”. As a result over a 10-year period the incidence was reduced by 50%. In the past few years the rates for S.I.D.S. have not changed with over 2,000 infants experiencing crib death in 2010. Despite mass public awareness that infants must sleep on their backs, a new study has found that in the U.S. almost 30% of babies are placed on their sides or stomachs for sleep.

The Misconception of Choking

If parents are aware that back sleeping is much safer for their infant, why do they continue to go against this recommendation? Ask any parent and they will tell you that they are more afraid that the baby will choke. This misconception is perpetuated by anyone who raised a child prior to 1990 as everyone believed that babies were much more likely to choke if placed on the back. This is simply not true for healthy, full-term infants.

Image Credit: http://www.healthybabiesjacksonville.org/fear-of-aspiration/

Babies are anatomically protected in several ways against choking while lying on their backs. First off, when a human is placed on the back, the trachea (wind pipe) is on top of the esophagus (food pipe). If stomach contents come up the esophagus, the baby will cough to prevent anything from getting into the trachea. Infants placed on their stomachs are actually more likely to choke then if they are lying on their backs. Second, nature further protects young babies in a unique way. Until a baby is about 9 months old she is able to breathe and swallow at the same time. This is possible because the larynx (upper end of the trachea) and hyoid bone are higher up in the infant’s throat. As the baby matures, the larynx and hyoid bone move down, allowing for increased vocal ability.

Placing babies to sleep on their sides can be just as risky as stomach sleeping. Infants can easily roll onto their stomachs from a side position. To prevent this parents will often roll up blankets or use some other device to prop the baby. Unfortunately, blankets and sleep positioners can also become a smothering hazard. Bottom line, infants belong on their backs while sleeping with nothing in the crib except for the baby.

What you can do to help prevent SIDS
Although back sleeping appears to be the most effective measure a parent can take to provide for healthy sleep there are other strategies that can be effective in reducing the risk of S.I.D.S. Don’t smoke around the baby. Provide good air circulation around the baby’s little body. Avoid overheating. Babies who sleep in their parent’s room for at least the first 6 months are less likely to experience crib death. Pacifiers are also thought to help reduce the risk. And lastly, we would not be The Pump Station & Nurtury if we did not also mention that numerous studies have shown breastfeeding to be an important factor in protecting babies against a number of things including S.I.D.S.