Part 2: SIDS in South Africa

In Part 1, we looked at the most recent report released by the American Academy of Paediatrics regarding the risks and recommendations surrounding Sudden Infant Death Syndrome. This advice may have shocked many South African families for whom co-sleeping and baby-wearing are a part of our daily lives.

In Part 2 we take a look at SIDS in South Africa and safe to sleep practices in countries beyond the borders of the USA.

There is very little research available about the incidence of SIDS here in South Africa, where infants are more likely to die from infectious diseases such as Tuberculosis and HIV and fatal injuries due to drownings, car accidents and fires.

In general, Asian and African countries reported a lower incident rate of SIDS compared to the Western world. They also have the highest incidence of co-sleeping. Are Africans co-sleeping in a different way to Americans and could co-sleeping actually be a protective factor for South African babies?

In America, there are 0.5 deaths per 1000 live births. In Zimbabwe, the incidence is only 0.2 deaths per thousand live births in black township communities. In South Africa, statistical data showed a rate of 1.06 deaths per 1000 live births for white babies, but only 0.3 deaths per thousand for black infants.

This means that the majority of South African babies are less at risk of SIDS than American babies despite the common practice in Zimbabwean and South African townships where babies do not have their own room and co-sleeping is the norm.

Because of these cultural differences, the Child Safe campaign (a South African initiative)  is a great place for South African families to gather advice on how to keep their babies and children safe at home.  The Child Safe campaign recommends avoiding any product with loose fittings and strings and staying away from non-breathable fabrics that could cause your baby to overheat. The Sealy Cot mattress takes this into consideration in its design – the mattress is breathable but also easily cleaned with the wipe of a cloth.
Another sleep safe initiative may be the simplest of all: A cardboard box.  Finland recently introduced the Maternity Box, a cardboard box that gives all Finnish babies a safe place to sleep for their first six months. The country has seen a significant reduction in infant mortality rates.


Read Part 1: What parents can do to prevent the risk of SIDS

Written by Roxanne Atkinson

Part 1: What parents can do to reduce the risk of SIDS

Sudden Infant Death Syndrome (SIDS) is a new parents’ greatest fear. SIDS is an inexplicable phenomenon that occurs across the globe in all cultures – some infants die suddenly in their sleep. Despite thorough investigations including a review of the clinic history and autopsy, no cause of death can be found.

Because newborns spend between 12 and 17 hours asleep in their first few months of life, the infants are often unsupervised at the time of death and so parents are left with many unanswered questions. Did they die peacefully? Is there anything we could have done to prevent this happening?

In Part 1 we cover how you can help reduce the risk of SIDS in your home

There are a lot of questions we cannot yet answer, but what we do know about SIDS has been gathered through studying thousands of cases: >>>

• The incidence of SIDS peaks in infants between 2-4 months
• Premature infants are more at risk than full–term infants
• More infants died whilst sleeping on their stomachs than on their backs
• Breastfeeding was a protective factor – exclusive breastfeeding had the most protective effect, but some breastfeeding was better than none at preventing SIDS.
• Co-sleeping (especially with a parent/partner who was a smoker) is a common factor in SIDS cases
• Another risk factor is a baby sleeping on or near parents who are under the influence of alcohol, prescription medicine or sleeping pills
• Sleeping in a room away from parents increased the risk of SIDS
• Co-sleeping on a couch or on an old, soft mattress were also risk factors
• Interestingly, devices that recorded a baby’s heart rate and breathing did not seem to be a protective factor in reducing SIDS.
• The use of a dummy/pacifier is a protective factor, even if the dummy falls out the infant’s mouth.
• Swaddling is a risk factor once a baby has learned to roll.

The American Association of Paediatrics (AAP) recently held a press conference to unveil the “Safe to Sleep” campaign. This is the first time since 2011 that infant sleep guidelines have been published.

Here is a summary of the recommendations to new parents:

1. Babies should sleep on their backs in a separate cot/crib/bassinette in the same room as their parents until at least one year of age
2. A baby’s cot should be fitted with a firm mattress that fits snuggly in the cot, such as the Sealy cot mattress
3. The mattress can be covered with a thin, fitted mattress protector, such as the Sealy Posturepedic® Soft Touch Cot Mattress Protector, made from natural bamboo fabric and a breathable fitted sheet. There should be no loose sheets, bumpers, wedges, pillows or toys in the cot.
4. The baby should be dressed in the correct amount of layers of clothing and/or use wearable blankets. Loose blankets, quilts and weighted blankets should be avoided.
5. All electrical wires, window blind cords and dummy cords should be removed from the cot.
6. Place them in their cot for every nap and every night sleep.
7. Avoid allowing baby to sleep in a baby car-chair or sling where they may overheat or suffocate. Move them to their cot as soon as possible.

In terms of cot alternatives, parents are encouraged to think critically when buying products such as co-sleeping bed extensions and baby crib hammocks such as the Cresent Womb newborn hammock and to apply the same recommendations to these devices.