SIDS and Crib Mattresses


Many Mattresses, Sleep Pads, and Sleep Surfaces Claim to be “Breathable.”

Crib mattresses claiming to be “Breathable” often have thick, dense or wiry core material with an open celled cover or overlay.  These types of mattresses are shown to have high levels of carbon dioxide retention – A known risk hazard for infant safe sleep.

“…Infants resting in the prone (tummy) position or lying with soft bedding may rebreathe exhaled carbon dioxide, potentially leading to hypercarbia and hypoxia.  If the infant’s environment does not change or infants are unable to extract themselves from the hazardous situation, they will ultimately die of asphyxia.”

JAMA Pediatrics February 2017 Volume 171, Number 2

This information is confirmed in a notable SIDS research study.  “A mattress filled with tea tree bark made in Australia in the 1980s and ’90s and marketed as “breathable” turned out to increase the risk of SIDS” according to a study by renowned SIDS expert, 
Dr. James Kemp

What We’ve Known

SafeSleep Breathe-through Crib Mattress What We Have Known about SIDS and Crib Mattresses

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 such as overlay or suffocation. These deaths are often unwitnessed and there are no tests to tell SIDS apart from suffocation. To complicate matters, people who investigat 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 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 retained 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 Still Do Not Know

SafeSleep Breathe-Through Crib Mattress SIDS and Crib Mattresses What We Still Do Not Know about SIDS

What We Now Know

SafeSleep Breathe-Through Crib Mattress SIDS and Crib Mattresses What we now Know about SIDS and a Breathe-Through Crib Mattress
  • 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 and References >


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

SafeSleep Breathe-Through Crib Mattress back sleeping is best