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What are the top risk factors for SIDS?

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Every parent needs to know the top risk factors for SIDS. Sudden Infant Death Syndrome rates have declined in recent decades, from 130.3 deaths per 100,000 live births in 1990 to 38.4 deaths per 100,000 live births in 2020. This is believed to be in large part due to the Back to Sleep campaign which encouraged parents to place their infants on their back to sleep. Building on the success of the Back to Sleep campaign, today’s Safe to Sleep Campaign encourages further safe sleep practices such as room sharing, human milk feeding, not overdressing babies, and more. There is a laundry list for safe sleep, but what is the most important? What are the top risk factors for SIDS? 

“Nothing in the crib except the baby”

Independent sleep in an up-to-date crib or bassinet is the safest place for babies to sleep. Well-meaning parents might want to send their baby to bed with a stuffy or blanket, but this isn’t safe until at least baby’s first birthday. Until that one year mark, there should be nothing in the crib except the baby. No loose blankets, crib bumpers, stuffed animals. For warmth, newborn can be swaddled before they learn to roll. Older babies can wear a wearable blanket or sleep sack. The one additional object parents can safely place in the crib is a pacifier, which has been shown to reduce SIDS risk. 

Protect your baby by:

  • Avoiding loose bedding, crib bumpers, and blankets
  • Deferring stuffed animals and loveys until at least one year of age
  • Using a swaddle blanket (newborns) or sleep sack (older babies)
  • Using a tightly fitted sheet on the crib mattress or bassinet pad


Babies exposed to smoking and/or vaping during pregnancy are at a significantly higher risk for SIDS. SIDS risk also increases due to secondhand smoke, such as in the home or car that a baby spends time in. Secondhand smoke can also lead to an array of health issues for parents and children including heart and lung disease and an increase in middle-ear infections. 

Protect your baby by:

  • Not smoking or vaping during pregnancy and beyond
  • Not allowing others to smoke or vape in or near your home or car
  • Ensuring your baby’s childcare center is tobacco-free

Don’t let baby get overheated

Many new parents aren’t sure how to dress their baby for sleep. Babies can become overheated because parents tend to worry more that they’ll be cold. In fact, avoiding overheating is an important factor to reduce SIDS risk. First off, set the room temperature to 68°F-72°F. At this temperature range, most babies will be comfortable in one simple layer with a swaddle blanket or sleep sack. In warmer months, this could be a onesie and a light swaddle/sleep sack. In colder months, this could be footed pajamas and a warmer sleep sack. Test your baby’s skin to determine if they’re overheated. Cold hands and feet can be normal – if your baby has cold hands and feet but is otherwise content, don’t stress it. Feel the skin on the back of their neck – slightly warm is normal. Test the skin at their hairline – this is likely the first place babies will become sweaty if they’re overheated. Though it’s important to note that brand newborns do not yet have fully functional sweat glands and can become overheated easily without sweating. 

Protect your baby by:

  • Keeping the room at 68°-72°F
  • Dressing baby in one layer + a swaddle or sleep sack
  • Testing baby’s skin at the back of their neck and hairline for signs of overheating

Top Risk Factors for SIDS: Conclusion

Over the years we have discovered many nuances to safe infant sleep. But learning how to reduce your baby’s risk of SIDS should not be over-complicated. When asking “What are the top risk factors for SIDS?”, parents need to know the essentials:

  • Place baby alone, on their back, in a crib or bassinet 
  • Avoid smoking and secondhand smoke during pregnancy and beyond
  • Avoid overheating the baby

To learn more about safe sleep, read the AAP guidelines for safe infant sleep here