October is Sudden Infant Death Syndrome (SIDS) Awareness Month, and while no one ever wants to experience this first-hand, about seven in 1,000 infants succumb to SIDS every year, according to World Development Indicators.

Understanding the cause of SIDS would help pinpoint effective prevention strategies. Unfortunately, the nature of SIDS remains mysterious. “SIDS is the No. 1 cause of infant death beyond the neonatal period,” says Dr. John Spivey, a specialist in pediatric sleep medicine at Mercy Children’s Hospital. “By definition, it is the sudden death of an infant less than one year of age, which remains unexplained after a thorough case investigation. Given the complex nature of SIDS, it likely involves multiple factors.”

Researchers continue to explore theories about the cause of SIDS in hopes of discovering the key to prevention. “We think that it’s something to do with problems with the baby’s ability to wake up—what we call sleep arousal—or the inability of the baby’s body to detect a buildup of carbon dioxide,” says Dr. Timothy Lackey, a pediatrician with SSM Pediatrics at Sunset Hills.

Dr. Bradley Thach, a professor of pediatrics at Washington University who researches SIDS, adds that inherited metabolic disorders, genetic heart defects that cause fatal arrhythmias and accidental suffocation also are potential SIDS causes.

One of the biggest misconceptions that persists among new parents is the notion of SIDS as ‘crib death.’ This moniker was coined as a synonym for SIDS due to the fact that babies were often found dead in their cribs for no apparent reason. Yet the term had an unfortunate effect.

“Parents may think, I don’t want my baby todie in his crib, so I will take him to sleep with me. But the crib is the safest place,” Thach notes. That is, a modern crib that does not contain bumper pads, soft bedding, quilts and blankets, pillows or stuffed animals. While these items may seem to add comfort, they have been implicated in cases of SIDS due to potential suffocation risk. In fact, experts agree that parents should never take their baby to bed with them.

Putting babies to sleep on their back in a crib without fluffy hazards is credited with decreasing SIDS deaths in the past two decades. “Data first collected from Europe and Australia in the early ’90s and here in the U.S. showed simple positioning—placing the child supine or ‘back to sleep’—resulted, independent of other factors, in a 50 percent or more reduction in the rate of SIDS,” Spivey says.

A more recent recommendation is to give the baby a pacifier once he or she is put in the crib. Lackey recommends waiting a month or so to ensure that breastfeeding patterns are well established. “The pacifier helps to open the airway,” he says.

Finally, parents should make sure the baby’s room is not too warm, avoid smoking around the baby, keep the baby’s head uncovered while he sleeps and breastfeed, if possible. All these actions have been linked to a decreased risk of SIDS.