The following practices may place infants at a higher risk for injury or death in the sleep environment. (Created by the RNAO Expert Panel, 2012)
LIFESTYLE RISK FACTORS OF THE PREGNANT WOMAN, PARENTS, OR OTHER CAREGIVERS:
- Smoking
- Alcohol use
- Substance use
RISK FACTORS RELATED TO INFANT SLEEP POSITION AND THE SLEEPING ENVIRONMENT:
- Non-supine sleep position,
- Use of sleep surface not recommended for infant sleep
- Adult bed, Sofas, couches, armchairs
- Baby seats, swings, bouncers, strollers, slings, car seats
- Play pens, play-yards
- Sharing the same sleep surface with another person or animal
- Extra items in the sleep environment
- Blankets and duvets
- Pillows and pillow-like items
- Positioning devices or wedges
- Bumper pads
CAREGIVING PRACTICES:
- Non-breastfeeding
- Lack of immunization and/or health care for the infant
- Over-dressing (overheating) infant
- Exposing infant to potential hazards in their sleep environment (cords, open windows, heating devices)
The following characteristics have an increased association with the incidence of infant death. While these factors may not all be modifiable, it is especially important to create a safe sleep environment for infants affected by them.
CHARACTERISTICS OF PARENTS / CAREGIVERS:
- Parental mental illness
- Low socio-economic status
- Young maternal age < 18 years
- Non-married
- Low maternal educational level
- Low income
- Beliefs that are incongruent with safe sleep recommendations
- Knowledge deficit about safe sleep recommendations
OBSTETRICAL FACTORS OF THE MOTHER
- Lack of or late initiation of prenatal care
- High parity
- Multiple pregnancies
- Short intervals between pregnancies
- Previous infant small for gestational age or pre-term
- Placental abnormalities (placenta previa or abruptio placentae)
- Premature rupture of membranes
- Anemia during pregnancy
- Preeclampsia/eclampsia
The following infant characteristics are associated with a higher incidence of sudden infant death. While these factors may not be modifiable, it is especially important to create a safe sleep environment for these infants.
CHARACTERISTICS OF THE INFANT (0-12 MONTHS OF AGE)
- Male sex of infant
- Twins
- Infant development or size
- Low birth weight or small for gestational age
- Shorter gestational age at birth
- Poor infant growth rate
- Infant age 1-6 months (peak 2-4 months)
- Infant illness or congenital conditions