In 1994, the American Academy of Pediatrics recommended that parents position babies on their backs for sleep to reduce the risk of sudden infant death syndrome.
Since then, the nation's SIDS death rate has dropped by half.
There are plenty of other rules to follow when it comes to safe sleeping conditions for children younger than 1, said Lisa Stanley, Green River District Health Department's maternal and child health coordinator.
"An unsafe sleeping environment is a No. 1 risk factor for SIDS," Stanley said.
Babies are at the greatest risk of SIDS between birth and 4 months old. It is the leading cause of death in babies during their first year.
According to the Centers for Disease Control and Prevention, 3,600 babies 1 year old and younger died in the U.S. during 2017 due to sudden unexpected infant death.
The CDC listed the three common SUID types as:
• SIDS, 1,400 children
• Unknown causes, 1,300
• Accidental suffocation or strangulation in bed, 900
Kentucky has one of the highest rates nationwide for SUID -- nearly 160 deaths per 100,000 babies. Alabama had the highest rate at 189 deaths per 100,000. Vermont had the lowest at 37 deaths, according to the CDC.
SIDS is not 100% preventable, Stanley said, but there are precautions parents and caregivers can follow to greatly reduce risks.
Stanley teaches the ABCs of safe sleep. They are:
• Alone -- No pets or shared sleep surfaces. "Co-sleeping," or putting an infant in bed with a parent or other family members, is unsafe.
• Back -- Every time a baby is put down for sleep, they should be placed on their backs. Even for naps.
Parents worried about causing a flat spot on the back of a baby's head should consider giving the child supervised tummy time, especially as they age and start to hold up their heads.
• Crib -- The only thing that should be placed on the sleeping surface is the baby in a onesie or sleep sack. The mattress should fit snugly in the crib, and the mattress should be covered with a tight-fitted sheet.
The baby's sleeping surface should not be surrounded by bumper pads or contain pillows, blankets and stuffed animals, Stanley said.
"Babies can't go to bed with a bib on," she said.
A pacifier is OK if it is loose and not attached to the baby's clothing.
In July 2011, crib safety legislation went into effect. Since then, it has been illegal to sell drop-side cribs.
The legislation pertains to cribs sold at yard sales, thrift stores and consignment shops.
"It's pretty strict," Stanley said. "We tell parents never to use a crib that is 10 years old or older."
Antique cribs, though they can be cheaper and visually appealing, may have lead paint, drop rails and other safety concerns. Here's a tip: If a soda can passes between the slats of a crib, they are too far apart.
Overhead mobiles should be removed from cribs as soon as a baby starts to pull up.
If parents smoke, drink alcohol or abuse drugs, it increases their child's risk for SIDS. Also, women who smoke, drink or abuse drugs during pregnancy put their children at greater risk.
Breastfed babies run a lower risk of SIDS, Stanley said, and sharing a room with a baby lowers the risk up to 50%.
Stanley recommends keeping every appointment with an obstetrician during pregnancy.
Never allow babies to sleep in car seats or swings.
Make sure infants don't get too hot in bed. Babies are comfortable at the same temperatures adults prefer for sleep.
Unless a doctor prescribes a heart or breathing monitor, Stanley feels they provide a false sense of security.
"Make sure everyone who cares for your baby understands what safe sleep is," she said.
Renee Beasley Jones, 270-228-2835, firstname.lastname@example.org