Cot death advice should be followed for both day-time and night-time sleeps

Press release issued: 30 January 2007

New research led by Bristol University reveals that advice on how to reduce the risk of cot death needs to be heeded just as much for an infant’s day-time naps as it is for their night-time sleep.

New research led by Bristol University reveals that advice on how to reduce the risk of cot death needs to be heeded just as much for an infant’s day-time naps as it is for their night-time sleep. This not only includes the advice that babies should be placed on their back to sleep, but also that they should sleep in the same room as their parents or another adult during the day.

The study, Sudden Infant Death Syndrome and the time of death: factors associated with night-time and day-time deaths, published in the International Journal of Epidemiology and partly funded by the Foundation for the Study of Infant Deaths (FSID), found that 75 per cent of the babies who died in the day-time were sleeping in a room where there was no adult present.

The study also found that the babies who died during the day were more likely to have been placed on their side than on their back for their day-time naps, despite current safe sleeping advice which recommends always placing babies on their back to sleep. They were also more likely to be found with their heads covered by the bedclothes than the babies who didn’t die.

The latest research, carried out by experts from Bristol University, Newcastle's Royal Victoria Infirmary and the Nuffield Institute for Health, was conducted over three years and included 325 infants in the UK who died and 1,300 of a similar age who did not.

Report co-author Peter Fleming, Professor of Infant Health and Developmental Physiology at Bristol University, said: "I think what this shows is that we cannot ignore what has traditionally been done.

"In the past and in other cultures it is unheard of to leave babies on their own, it is something people in western countries should get back to."

Joyce Epstein, FSID’s Director, added: “Parents have long been advised of the importance of sleeping babies on their back and not letting their head get covered by bedclothes, and this study shows that the advice needs to be followed day and night. Parents have also long been advised that the safest place for a baby to sleep is in a cot at the side of the parents’ bed for the first six months. This study shows that it is important for babies to always sleep in the same room as an adult. For day-time naps, we suggest keeping your baby nearby in a carrycot or in a playpen while you go about your daily chores or, if possible, having a nap whenever your baby naps.”

Blair, P.S. et al, ‘Sudden Infant Death Syndrome and the time of death: factors associated with night-time and day-time deaths’, International Journal of Epidemiology, 2006 35(6):1563-1569.

Further information

The research, conducted over a three-year period in five regions of the UK, studied 325 infants who died and 1,300 infants of a similar age who didn’t die. It found that the majority (83 per cent) of deaths occurred during the night, but that at least four deaths occurred during every hour of the day.

The study also found that death can occur relatively quickly. Amongst the deaths that happened during the day-time, 38 per cent of the infants who died were observed to be alive 30 minutes before they were found dead, and nine per cent were observed to be alive ten minutes before they died. At last observation, 78 per cent of the babies who died during the day-time were described by their parents as apparently healthy.

Of the infants who died during the day-time, 44 per cent were placed on their side to sleep. A further 17 per cent were placed on their front to sleep, while only 39 per cent were placed in the recommended position – on their back – to sleep. Of the babies who didn’t die, 80 per cent of infants were placed in the recommended position on their back for their day-time sleep.

Of the babies who died during the day-time, 25 per cent of those sleeping separately from their parents were found with bedclothes over their head, compared with only 11 per cent where a parent was present.