Health experts are updating NHS recommendations to help reduce the number of babies dying unexpectedly in their sleep.

Nearly 250 babies in England and Wales die from Sudden Infant Death Syndrome (SIDS) every year[1]. No-one knows why this happens, but there have been long-standing doubts over whether sleeping with your baby is safe.

The National Institute for Health and Care Excellence (NICE) is updating its guidance. It has published new, draft recommendations for consultation.

Professor Mark Baker, NICE's clinical practice director, said: "Falling asleep with a baby, whether that's in a bed or on a sofa or chair, is risky.

"It's imperative that all parents and carers know about the association between sudden infant death syndrome and falling asleep with a child under the age of one. This is especially important if parents drink alcohol, take drugs or expose their baby to tobacco smoke."

The updated draft recommendations - which are relevant for infants from birth until 1 year of age[2] - say that midwives, GPs and health visitors should ensure parents and carers are told of the link between co-sleeping (falling asleep with a baby in a bed, or on a sofa or armchair) and SIDS. They also ask healthcare professionals to:

  • advise parents and carers that the association between co-sleeping and SIDS is likely to be greater when they, or their partner, smoke
  • inform parents and carers that the association between co-sleeping and SIDS potentially increases if they have used drugs and/or recently drunk alcohol
  • tell parents and carers that the association between co-sleeping and SIDS potentially increases if their child had a low birth weight or was born prematurely
  • NICE is updating its guidance after the Department of Health asked it to review its recommendations last year. This request followed new research which suggested sharing a bed with a baby could increase the risk of SIDS, even among non-smokers.

Professor Baker says the updated recommendations aim to provide further evidence-based clarity to the risk factors associated with co-sleeping and SIDS: "There is no universal agreement on the causes of sudden infant death syndrome.

"We know there is a link between SIDS and falling asleep with a baby in a bed or on a sofa or chair, but studies into why this happens can often give conflicting results. And other factors are likely to play a part in increasing the risk to the infant.

"We recognise that some parents may choose to share a bed with their baby because it could make breastfeeding easier, or for cultural reasons. Or they may be forced to co-sleep because they may not have the space or money for a cot.

"This is why it's so important for parents to understand what the risks are. The recommendations we are developing aim to help healthcare professionals inform parents and carers of the likely risks associated with co-sleeping, according to the best available evidence."

The public consultation on these draft recommendations will run until Thursday 31 July 2014. The committee will then consider all comments and the final recommendations will be developed.

Once published, these recommendations will replace some, but not all parts of NICE's 2006 postnatal care guidance.

Responding to the draft NICE recommendations to tackle SIDs, Dr Simon Newell, Consultant Neonatologist and Vice President for the Royal College of Paediatrics and Child Health said:

"Over half of deaths in childhood occur during the first year of a child's life. In 2012 over 3000 babies died before age one and the RCPCH's Why Children Die report highlights the contribution Sudden Infant Death Syndrome (SIDS) played to this figure.

"Every case of unexplained infant death is an absolute tragedy for a family, and although rare, still claims the lives of around five babies each week - that's still five cases too many.
"Most of the time co-sleeping is safe but the risk increases when an adult is very tired, drunk alcohol, used drugs or when they have taken medication which might sedate.
"To address this, we need to help ensure that all families have access to safe sleeping guidance and resources. And because we know that vulnerable families are especially at risk of SIDS, we need a targeted campaign to promote safe sleeping habits.

"We hope these updated recommendations from NICE will raise awareness of SIDS and remind us all that more can be done to prevent deaths in future."