The Ministry of Health and the “Atid” Society launch a campaign to raise public awareness of “Safe sleep – back up your baby”
​In view of a recent increase in cases of sudden death among infants during the winter months, The Ministry of Health and the Atid Society for research and prevention of sudden infant death syndrome, launch a campaign to raise public awareness of “Safe sleep – back up your baby”.Every year some 45 infants die a sudden death in Israel. 87% of the sudden infant death syndrome (SIDS) in Israel occur before six months of age. Half of the cases (50%) occur during the winter months of January to March.
Among the reasons for the seasonal increase: over-heating as a result of over-dressing the infants with multiple layers of clothing. The infant regulates its body temperature via the face and head and placing it on the stomach doubles the risk of SIDS. Infants lying on their stomachs tend to overheat and have trouble regulating their body heat. They breath oxygen-depleted air, sleep deeper, move less, are less sensitive to noise, experience a drop in blood pressure and have difficulty waking up. Furthermore, Blankets, caps, hooded sweaters and objects in the infant’s vicinity might cover the infant’s face and inhibit the free flow of air. In view of the worrisome seasonal increase, the Ministry of Health and the Atid Society for research and prevention of sudden infant death syndrome, are launching a campaign to raise public awareness, intended to ensure a safe sleeping environment for infants.
Prof. Itamar Grotto, Head of Public Health Services: “In the wintertime especially, parents can prevent a large proportion of the SIDS cases by correct behavior. The seasonal spike in cases of SIDS, which we are witnessing in Israel, has been eradicated in countries which have successfully disseminated the message of placing infants on their backs. The regrettable increase in the number of cases of SIDS in Israel during the winter months compared with the summer months, indicates that we still have a long way to go and there is much to improve, and that it is within our reach to reduce the number of cases, if we put infants to sleep on their backs”.
“The risk of sudden infant death syndrome as a result of putting infants to sleep on their stomachs is 5 times greater in the winter compared with 2.1 times in the summer”, explains the chair of the Atid association for research and prevention of SIDS, “The dramatic success of the campaign to place infants on their backs to reduce the SIDS mortality rates in the western world compels us to continue to increase awareness to the risk factors, to their prevention and to promote the creation of a safer sleeping environment, especially among populations with a higher rate of SIDS”.
Despite the Ministry of Health recommending already since 2000 to place infants on their backs for daytime and nighttime sleep, a phone survey of MABAT Larach (infant health and nutrition state), which the Ministry of Health conducted between 2009-2011 found that only 4 of every 10 parents of infants aged two months, put their infants to sleep exclusively on their backs. These findings are similar to those of the Atid association, which was conducted in 2006. Follow-up conducted by the mother and child department in the Ministry of Health found, that 8 of very 10 infants (80%) who died a sudden death were not placed on their backs. Hundreds of studies published over the past 20 years indicate, that placing infants on their sides is also a risk factor for SIDS. An infant who has been put to sleep on its side may very easily roll onto its stomach. Use of accessories such as the “secure sleeper”, which are intended to retain the infant’s sideways sleeping posture, have also been identified as elevated risk factors for SIDS and choking.
By placing the infant exclusively on its back, incidences of SIDS can be reduced by between 50% and 70%. Countries which have successfully disseminated the practice of placing infants on their backs have experienced a steep drop in the incidence of SIDS. It is therefore recommended to put the infant to sleep on its back from the very start, to acclimatize it with this sleeping posture.
So what should we do?

  • It is recommended to put the infant to sleep on its back.
  • If an infant is able to roll over independently, there is no need to return it to the stomach sleeping posture.
  • It is recommended to remove soft objects such as plush dolls, pillows, quilts, bed protectors, diapers and loose-lying blankets from the infant’s cot. These pose a choking danger to the infant and may induce SIDS.
  • When covering the infant with a blanket, it is recommended that the infant be placed close to the end of the bed, where its legs are in contact with the bottom of the cot. It is recommended that the blanket be laid no higher than the infant’s armpits. Tuck the blanket beneath the mattress.
  • Infants are best dressed with one layer more than adults.
  • It is recommended that the infant’s head and face be kept exposed while sleeping.
  • 22 degrees centigrade are the recommended heating temperature for the infant’s room as well as any other spaces where the infant may be staying.
  • It is recommended that the infant be placed on a rigid mattress in a cot or cradle bearing the stamp of approval of the Standards Institute of Israel. Sleeping in a cot or crib in the parents’ room up to half a year of age has proven to risk-reducing. On the other hand, placing the infant on soft bedclothes and on the adults’ bed, without the parents being present, increases the risk of SIDS by a factor of 5!
  • It is recommended not to sleep together with the parents.
  • Prenatal and postnatal smoking in the infant’s presence is discouraged. Updated research indicates that between 24% to 32% of the cases of SIDS involve exposure of the infant to parental smoking in the infant’s close environment. According to a survey conducted by MABAT LARACH, about a quarter (24.8%) of the Jewish infants have been exposed to cigarette smoke at two months of age. The exposure rates among Jewish infants who died of SIDS, were 61.5%! Over half of all Arab infants (52%) were exposed to cigarette smoke. 3 of 4 infants who died of SIDS had a smoking parent (75%).
  • Respiratory tract diseases are another risk factor for SIDS. Many studies attribute parental smoking to the increased incidence of disease among children. If one of the parents smokes, the relative risk of that parent’s children, who are exposed to smoking, to suffer from asthma, is 20% higher than among children whose parents do not smoke; the relative risk of respiratory difficulty increases by 24% and the relative risk of coughing increases by 40%.
  • In addition to its known advantages, nursing is also a contributor to the prevention of SIDS. Mother’s milk is rich in antibodies to viral diseases and is helpful in prevention of respiratory infections, which may also be a risk factor in SIDS.
  • Use of a pacifier when putting an infant to sleep is apparently also a protective factor. It is recommended to accustom nursing infants to use a pacifier already at the age of one month. A baby with a pacifier wakes up more easily and is better equipped to respond to life-threatening situations.
  • It is recommended that all those handling babies be informed of, and follow, these guidelines: family members, care givers at day care centers and at home.

For more timely information on sudden infant death syndrome (SIDS), on handling of the risk factors and on maintaining a safe sleeping environment for the infant, and for support, you are welcome to contact the hot line operated by the Israeli association for SIDS research and prevention, at 02-6666833.
Or through information on this issue at the Ministry of Health website (Hebrew) and at the Atid association website: www.atidbaby.org