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Bear with me, as I'm not very good with statistics. As far as I can tell the risk of SIDS as of 2014 is 1 in 2,500 according to the CDC (obtained by reducing the 38.7 deaths per 100,000 to lowest terms). However, the CDC gives no information about the risk of SIDS for a baby whose parents follow all the recommended guidelines. In other words, the SIDS statistics include parents that smoked and wrapped children in large warm blankets. Is there any information about the risk of SIDS for a child which prone sleeps in a situation with a firm mattress, non-smoking parents, no extra bedding, etc.? It would also be great to know the risk of SIDS for the same baby sleeping on his back too. Please include sources.

The only information I could find on the risks of SIDS without other risk factors is this blog. It states:

Taking this into account, for people who have no other risk factors, here are the new odds (roughly):

— Chances of a prone-sleeping infant succumbing to SIDS with no other risk factors: about 1 in 20,000 (range 10,000–25,000)

— Chances of a supine-sleeping infant succumbing to SIDS with no other risk factors: about 1 in 50,000 (range 25,000–60,000)

(Note — the numbers don’t quite match up with the other statistics quoted above, because the estimates were generated from a few different studies and calculated in a couple different ways.)

However, the author admits that he cannot provide sources but claims that he looked at several medical studies.

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    Well, one simple reason is they can't lift their heads yet at that small age and they might block their breathing system (nose) as they try turning from one side to the other because they want to try turning. So it's not good. As a parent I observed my son at only 2weeks turn his head while sleeping, so I tried letting him sleep on his tummy as I watch him and trust me they get tired and can't lift heads up. It's bad.
    – user22314
    Sep 5 '16 at 16:14
  • @SyombuaMuthoka, I appreciate the information, but this seems like anecdotal evidence. Do you have a source for this information?
    – user13449
    Sep 6 '16 at 21:18
  • This source is also worth reading: nichd.nih.gov/sts/about/SIDS/Pages/progress.aspx
    – user13449
    Sep 6 '16 at 21:32
  • That was not based on any research but just my observation and use of common sense. I don't think sometimes we need research for such. Just try observing on your own, just be near.
    – user22314
    Sep 7 '16 at 16:17
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    "However, the CDC gives no information about the risk of SIDS for a baby whose parents follow all the recommended guidelines." - that's because no one does detailed investigations into "why did your child live?" Something goes wrong, they try to pinpoint a cause, so unless it's a controlled experiment (unethical to have them specifically engage in actions that are believed to increase the chance of killing their baby, so that's not going to happen), you're not going to have statistics on what happened when everything worked out okay. Sep 8 '16 at 19:24
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I think that the position in that blog is likely to be close to the truth. The dirty little secret is that SIDS is likely most closely related to parental, and in particular maternal, alcoholism and overweight. Alcohol makes it less likely that a parent will wake up in response to sounds of distress from the infant; the mechanism for overweight is less clear, but the correlation exists.

Here's an article showing that diagnosed alcoholism in the mother increases the chance of SIDS by a factor of 7, accounting for at least 16% of SIDS deaths:

http://www.ncbi.nlm.nih.gov/pubmed/23439895

Considering how much alcohol use does not rise to the level of alcoholism, and how much alcoholism is undiagnosed, alcohol accounts for a large chunk of SIDS deaths.

Here is a study saying that maternal overweight and obesity accounts for a 1 in 4000 chance of infant death:

http://www.bmj.com/content/349/bmj.g6572

The study is from Sweden so it didn't use the SIDS classification, but if many of those are SIDS cases, that would account for another big chunk of SIDS deaths, perhaps more than half. U.S. studies have come up with similar risk factors. While being obese only increases the chances of infant death by about a factor of 2, rather than the factor of 7 for alcoholism, obesity is so much more common that it probably accounts for a larger absolute number of deaths.

Note that another risk factor is having the infant sleeping in a different room from the parents, presumably because it's more difficult to hear a distressed infant in a different room.

So, don't drink, control your weight, and have the baby in the same room as you, along with the care you are taking with bedding and such, and you should have covered most of the major bases.

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    It's also worth noting that breastfeeding decreases the risk of SIDS about 50%, and breastfeeding rates are also increasing.
    – user13449
    Sep 6 '16 at 21:53
  • @user1534044535 Yes, breastfeeding is beneficial for infants in just about every respect.
    – Warren Dew
    Sep 7 '16 at 3:13
  • I think the prevalence of bedsharing in those studies is likely a crucial component to the SIDS deaths, but neither paper has that information. The Swedish paper has some weird stats, SIDS deaths are lower for mothers with BMIs of 30-34.9 than for mothers with BMIs between 25-29.9. Infections show the same pattern, which doesn't make much sense.
    – swbarnes2
    Sep 13 '16 at 18:59
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    Pacifiers provide the same level of protection as breastfeeding pediatrics.aappublications.org/content/116/5/e716
    – swbarnes2
    Sep 13 '16 at 19:02
  • @swbarnes2 Interesting. Pacifiers can cause problems with dental development, but still a tradeoff worth considering if you can't breast feed.
    – Warren Dew
    Sep 14 '16 at 2:20
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I'm afraid I don't have the exact statistics that you're asking for but here is an interesting article about how the advice to put babies on their backs for sleeping came to be so widely recommended and campaigned for:

https://www.theguardian.com/society/2016/aug/26/back-to-sleep-sudden-infant-death-syndrome-cot-death-peter-fleming

This advice has saved a huge number of lives. According to the article:

"(SIDS) became an epidemic between 1970 and 1991, and, at its peak, babies in some of the world’s richest countries were dying at the rate of one in every 250 live births each year."

Since the campaign to put babies on their backs to sleep, the SIDS death rate in England and Wales in 2013 was one in every 3,000. This particular article doesn't say how many of these 1 in 3000 babies were sleeping on their back or front or have other risk factors but you could make a rough assumption that before the campaign, the majority of babies were put to sleep their tummies as that was the advice and since the campaign, most babies sleep on their backs, resulting in around a ten fold reduction in SIDS deaths.

During the time when this link was discovered between front sleeping and SIDS, the sleeping position was the main thing that was changed, leading to this massive reduction in deaths:

"In December 1991 the Back to Sleep campaign was launched. Sids deaths in the UK fell instantly, and with astonishing speed. In 1989 there were 1,545 Sids deaths. Now there are barely 200 a year."

The 200 a year may be related to other risk factors or parents who are unaware of or don't follow the advice. It seems that however careful you are about the other risk factors, on this basis, the simple advice of having your baby sleep on its back is most likely worth following.

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    Thanks for the answer. This statement needs a citation: "During the time when this link was discovered between front sleeping and SIDS, the sleeping position was the main thing that was changed,..." Note that smoking rates also fell during this time, so there were other risk factors that were reduced as well. Secondly, correlation does not imply a cause, so this statement "...leading to this massive reduction in deaths" does not necessarily follow.
    – user13449
    Sep 6 '16 at 20:52
  • The article has a lot more information about how the whole process occurred. I didn't want to type it all here so I just summarised the main points
    – MiniMum
    Sep 6 '16 at 20:55
  • To be honest the article looks like the journalist wrote it first then tried to fill in supporting arguments which didn't actually support it very well. For example, it says the SIDS rate "instantly" fell, but cites numbers showing a decrease from 1989 to 2016, a 27 year period. A lot can change in 27 years.
    – Warren Dew
    Sep 7 '16 at 11:26

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