Sudden infant death syndrome – the silent killer that haunts every parent’s nightmare and leaves behind only questions.

Fortunately, since 1992, research shows there’s been a 50 percent decline in the rate of SIDS cases due to heightened awareness of the need for babies to sleep on their backs rather than on their stomachs. Unfortunately, there are still about 4,500 babies under age 1 who die unexpectedly in their sleep each year.

The most shocking part? Most of the babies who die of SIDS have no apparent health problems, says Katie Sanders, M.S.N., RN, assistant professor of nursing at Texas A&M Health Science Center College of Nursing.

Rarely is there an underlying disorder that can be identified, but 90 percent of these deaths are likely preventable by implementing safe sleep practices. Research also is ongoing to understand the role of brainstem abnormalities as a factor for SIDS.

As scary as this silent killer may be, education is the key to risk reduction and prevention, Sanders says.

At its 2011 national conference, the American Academy of Pediatrics (AAP) released new recommendations for safe sleeping practices. The AAP continues its prior recommendations that infants should always be placed on their backs to sleep, on a firm surface.

“Following the conference, the AAP recommends breastfeeding, as there has been a demonstrated reduction in SIDS rates among babies who are breastfed,” Sanders says. “Routine immunizations can reduce the incidence of SIDS by 50 percent, and avoid bumper pads in the crib as they can potentially suffocate or entrap an infant.”

Additional AAP recommendations include using cribs free of soft bedding, pillows and toys; do not use car seats for routine sleeping; use pacifiers for naps and nighttime sleeping; and do not smoke during pregnancy.

— Blair Williamson