SIDS and Crib Mattresses

Back is best

Infants should be placed on their back, alone, in a crib for every sleep.

When your infant begins to roll, have peace of mind knowing your baby can breathe normally, even if face straight down.

Best Crib Mattress to protect against SIDS

What we have known

X  Prone sleep is a known risk factor for SIDS, and face-down sleep increases this risk further (1).

X  Even after a thorough investigation, it can be hard to tell SIDS apart from other sleep-related infant deaths like overlay or suffocation. These deaths are often unwitnessed and there are no tests to tell SIDS apart from suffocation. To complicate matters, people who investigate SIDS deaths may report the cause of death in different ways and may not include enough information about the circumstances of the event from the death scene (3).

X  Infants in the face down position on fiberfill crib mattresses, quilted surfaces, soft surfaces, pillow-like surfaces, vinyl pads, mattresses filled with tea tree bark and other natural fibers, and even surfaces that claim to be breathable, show increased risk of rebreathing of carbon dioxide which leads to hypoxia, a condition associated with SIDS (5-9).  According to Dr. James Kemp and Dr. Brad Thach, some bedding materials may act to retard the dispersal of exhaled gasses (carbon dioxide), retaining the gasses near a face down infant’s mouth. With each subsequent breath, the infant takes in an air mixture which is progressively less adequate to sustain life. The more conducive an item is to rebreathing (retaining carbon dioxide), the more hazardous the item would be (8).

X  It is important to keep fresh oxygen flowing to a sleeping baby and avoid anything in the crib that can cause the build-up of carbon dioxide and heat.


What we still don’t know

?  What causes SIDS.  SIDS is a diagnosis of exclusion when no cause of death can be scientifically determined (2).

?  Which infants are more likely to rebreathe carbon dioxide.  Most infants will turn their head to avoid “rebreathing” but some do not. We have no way of testing to find out which infants are “vulnerable” so all infants remain at risk (10).

The carbon dioxide retention level of all crib mattresses and sleep surfaces that claim to be “breathable.”  As scientific studies show, some air permeable crib mattresses and sleep surfaces that have porous cores, actually retain higher levels of carbon dioxide than thick fiberfill materials (5-8).

?  No studies exist comparing infants who sleep on various crib mattresses to see which one has fewer SIDS deaths.  No published studies or valid scientific testing is available that shows if one crib mattress or sleep surface has a lower/higher SIDS risk.  These gold standard studies do not exist for any of the AAP Task Force recommendations and likely never will; it is not feasible to enroll the number of infants required to get sufficient data.  To perform suffocation testing, unethical testing would have to be performed on infants to find out the “suffocation threshold” (4). 

Therefore, we focus on reducing key SIDS risk factors.

What we now know

Scientific evidence shows some air permeable mattresses provide a “significant” decreased risk of rebreathing of carbon dioxide (5,6,7,8,9,11).

The SafeSleep® Breathe-Through Crib Mattress has been tested for carbon dioxide retention and has a ten-fold decrease in carbon dioxide retention when compared to a fiberfill mattress with a tight-fitting sheet. 

It takes 2 minutes for carbon dioxide to dissipate on a firm crib mattress with a tight sheet; it takes less than 1/2 a second for it to dissipate on the SafeSleep® Crib Mattress (11). 

An infant takes a breath every 1-2 seconds, meaning the carbon dioxide (poisonous gasses) on the SafeSleep® Breathe-Through mattress would be gone before the infant takes their next breath of air – even if face straight down (12).

Resources & References >


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