Sudden Infant Death Syndrome (SIDS) is the unexpected and unexplained death of a seemingly healthy baby less than one year old. It is the leading cause of death for infants between one month and one year of age. SIDS is sometimes known as crib death because the infants often die in their cribs. According to the Centers for Disease Control and Prevention (CDC), about 3,400 babies in the United States die suddenly and unexpectedly each year. SIDS is more prevalent in the first six months of an infant’s life, with most deaths occurring between two and four months.
How does breastfeeding reduce the risk of SIDS?
Research has consistently shown that breastfeeding reduces the risk of SIDS. According to the American Academy of Pediatrics, any breastfeeding is protective against SIDS, and exclusive breastfeeding for six months provides the most protection. Specifically, studies have found:
- Babies who are exclusively breastfed for at least six months are about half as likely to die from SIDS compared to babies who are exclusively breastfed for less than six months.
- Breastfeeding for any amount of time is associated with a lower risk of SIDS compared to bottle feeding.
- The longer an infant is breastfed, the lower the risk of SIDS.
Although the exact mechanisms are still being studied, experts believe breastfeeding protects against SIDS in several ways:
1. Nutritional benefits
Human milk provides optimal nutrition for infants. The components in breastmilk support infant health and development in many ways that may help prevent SIDS:
- Brain development: The long-chain fatty acids, cholesterol, and amino acids in breastmilk promote healthy brain growth and development. SIDS victims have been found to have abnormalities in the brain regions that control breathing, heart function, and temperature regulation.
- Immune protection: The antibodies and immune factors in breastmilk protect infants from infections that can lead to SIDS. Formula-fed infants have a higher risk of minor infections compared to breastfed infants.
- Gut microbiome: Breastfeeding promotes healthy gut bacteria, which support the immune system. The gut microbiomes of SIDS victims differ from healthy infants.
2. Safer sleep
Breastfeeding supports behaviors that create a safer sleep environment for babies. The safest sleep practices recommended to reduce SIDS risk are:
- Placing baby on their back to sleep
- Using a firm sleep surface without any soft bedding
- Keeping the sleep area clear of loose blankets, pillows, stuffed toys, etc.
- Avoiding exposure to secondhand smoke
Research shows that breastfed infants are more likely to be placed to sleep in the safe supine (on the back) position. Breastfeeding facilitates feeding on demand and frequent nighttime feedings. Since breastfed babies wake more often at night, they have more opportunities for their parents to check that their face remains uncovered and re-position them as needed.
3. Reduced sleep apnea
Sleep apnea is a leading risk factor for SIDS. It involves repeated episodes where breathing stops and starts during sleep. Studies show breastfed infants have lower rates of sleep apnea and periodic breathing abnormalities compared to formula-fed infants. The nutrients in breastmilk help strengthen respiratory muscles and neurological pathways that control breathing.
What other factors explain the protective effects of breastfeeding?
In addition to the direct health benefits for infants, breastfeeding promotes parenting behaviors that may also reduce SIDS risks:
- Closer monitoring: Breastfeeding requires frequent feeding and skin-to-skin contact. This creates more opportunities for parents to monitor baby’s breathing, sleep position, bedding safety, etc.
- Delayed pacifier use: Earlier introduction of pacifiers is linked to higher SIDS risk. Breastfed babies are less likely to use pacifiers.
- Increased infant arousal: Breastfed infants awaken more easily from sleep compared to formula-fed infants. Arousal from sleep is protective if breathing is impaired.
- Decreased bed sharing: Breastfeeding makes it easier to feed in separate sleep spaces. Bed sharing with parents is controversial regarding SIDS risk.
Additionally, women who breastfeed experience hormonal changes after birth that promote maternal caretaking behaviors and bonding. This further motivates safety practices that can lower SIDS risk.
Are there any other factors that protect against SIDS?
Yes, in addition to breastfeeding, other factors are also associated with decreased SIDS risk:
- Room sharing without bed sharing
- Infant pacifiers at nap time and bedtime
- Avoiding overheating and head covering in sleep
- Immunizations (specifically DTaP vaccination)
- Use of a firm sleep surface
- Avoiding exposure to tobacco smoke
Combining breastfeeding with these other protective factors creates the lowest risk environment for infants. However, breastfeeding remains one of the most highly effective preventive measures parents can take against SIDS.
Conclusion
In summary, breastfeeding significantly reduces the risk of SIDS compared to formula feeding. The components in breastmilk support infant health and development in ways that protect against some of the suspected biological causes of SIDS. Breastfeeding also encourages parental behaviors and infant arousal patterns that lead to safer sleep practices for babies. When combined with other SIDS risk reduction strategies, breastfeeding provides a substantial layer of protection to safeguard infants during the critical first year of life.