Cot death (sudden infant death syndrome) - Cot death

Cot death is the sudden and unexpected death of a baby who seems healthy during sleep. It is also called sudden infant death syndrome (SIDS).

It can happen anywhere a baby is sleeping. This includes a cot, pram, bed, car seat or baby seat.

Cot death is one of the main causes of death in babies from 4 weeks to 12 months of age. It is most common between 2 and 4 months of age. It can also happen to older babies.

Immediate action required: Call 999 or 112 if:

  • your child is unresponsive, hard to wake, or you think they need emergency care.

Trust your instincts. Contact your GP or GP out of hours if your child is very unwell but responsive.

Reducing the risk

Because the cause of cot death is not known, it cannot be completely prevented. But research has shown that you can take steps to reduce the risk.

Do:

  • place your baby on their back to sleep in their own cot

  • point their feet towards the foot of the cot

  • keep their head uncovered and do not use too many clothes

  • use only blankets or a sleeveless sleeping bag in the cot

  • keep the cot in your room for the first 6 months

  • make sure the room temperature is between 16 and 20 degrees Celsius

  • avoid bed-sharing in the first 3 months, particularly if your baby was born prematurely or had a low birth weight

Don't:

  • do not smoke and keep your baby away from smoking

  • do not have pillows, cushions, sleep positioners or any other item in the cot

  • do not share a bed with your baby when you have recently taken alcohol or drugs - including medicine that may make you drowsy

Apnoea or breathing monitors cannot prevent cot death. These monitors alert parents and carers to apnoea (stopped breathing) or an apparent life-threatening event.

Babies who die from cot death cannot be successfully resuscitated. Babies who have an apnoea can be.

Important

Cot death is not caused by vaccines, vomiting, choking or suffocation.

Safe sleep position for your baby

Babies who sleep on their tummies have a higher risk of cot death. It is not safe to place your baby on their side because they may roll onto their tummy.

You should always:

  • lay your baby on their back, with their feet touching the end of the cot - they should lie on their back every time they are put to sleep, during the day and night
  • place your baby to sleep with their feet to the foot of the cot - this means they cannot wriggle down under the covers and suffocate
  • tuck blankets in loosely but securely, no higher than your baby’s shoulders
  • check regularly to make sure your baby’s face and head stays uncovered - there is a higher risk of overheating or suffocation if blankets slip over their face and head
  • keep their head uncovered and do not use too many clothes
  • use only blankets or a sleeveless sleeping bag in the cot
A safe sleep position

Where your baby should sleep

Your baby should sleep in a cot in the same room as you for at least the first 6 months.

The risk of cot death is higher for babies who sleep in a separate room.

Bed sharing or co-sleeping in the same bed can be dangerous. It can increase your baby’s risk of suffocation and cot death.

Preparing your baby's cot

Make sure the cot is in good condition. The mattress should be clean, firm and flat with no tears. It should fit neatly inside the cot. Make sure there are no gaps between the mattress and the edge of the cot where your baby might get trapped.

Keep the cot clear of all objects. Putting objects in the cot can increase your baby's risk of suffocation.

Objects you should never put in your baby's cot include:

  • pillows and cushions
  • sleep positioners or other similar products such as 'nests', 'cocoons', 'pods' or 'wedges'
  • any soft objects and anything loose or fluffy - for example, cot bumpers, comforters, duvets, toys, teddies, wedges and bedding rolls

These objects can suffocate your baby.

When your baby is not in their cot

Never fall asleep while holding your baby on a sofa, couch, armchair or beanbag. This significantly increases the risk of cot death.

Never leave your baby unsupervised in a sitting device. This includes car seats, baby seats, slings, carriers or similar products. Sleeping in a sitting position can make it more difficult for your baby to breathe.

Read more about where your baby should sleep

Your baby's sleep temperature

Overheating can increase your baby's risk of cot death.

Do not overdress your baby for sleep. A nappy, vest and babygrow are enough. Do not use a hat, unless your GP or midwife tells you to. Use less clothing in warmer weather.

Make sure the room your baby sleeps in has a comfortable temperature - not too warm or too cold. Room temperature should range from 16 to 20 degrees Celsius. Use a room thermometer to check the temperature.

Important

Never place your baby to sleep next to a radiator, heater, fire or in direct sunlight

Creating a smoke-free zone

Your baby's risk of cot death increases with every cigarette you smoke. The more you or other people smoke in your home, the higher the risk to your baby.

Do not allow anyone to smoke in your home, car or around your baby. When you go out, do not bring your baby into smoky places.

Bed-sharing and smoking

If you or your partner smoke, you should not share a bed with your baby. This greatly increases the risk of cot death. It does not matter where you smoke or if you never smoke in bed.

Smoking during pregnancy

Smoking during pregnancy increases your baby's risk of cot death. If you smoke during pregnancy, your baby is more likely to be born prematurely or have a low birth weight.

Babies who are premature and have a low birth weight have a higher risk of cot death.

Getting help to quit

Contact the HSE's QUIT team for help giving up smoking. QUIT provides free advice and support for people who want to quit smoking. This is non-judgemental.

QUIT’s team of helpers are available by phone, Facebook, LIVE chat or Freetext. You can also sign up for a daily email or SMS support.

HSE's QUIT team

Freephone 1800 201 203
Freetext QUIT to 50100
Get started on www.QUIT.ie
Find local HSE QUIT support groups
Tweet the QUIT team @hseQUITteam
Join our Facebook page www.facebook.com/HSEquit

Other ways to reduce the risk of cot death

Breastfeed your baby

Breastfeeding your baby reduces the risk of cot death. Aim to breastfeed your baby for as long as you can.

Some mothers like to breastfeed their baby in bed. It is safe to feed your baby in bed as long as you put them back in their own cot to sleep.

Soothers

Some research shows using a soother (dummy) at the start of sleep may reduce the risk of cot death.

If you choose to give your baby a soother
  • offer the soother to your baby every time they are going to sleep
  • do not force your baby to use a soother if they do not like it
  • do not worry if the soother falls out while your baby is asleep
  • if you are breastfeeding, wait until they are used to breastfeeding before introducing a soother
  • do not use clips or chains to attach soother to clothing as this is a choking risk
  • keep soothers clean and never dip them in sugar, honey or other food and drinks

More information and support

If your baby has died of cot death or you are supporting parents who have suffered the loss of their baby, contact the support service FirstLight

Call 0872423777 (7 days a week) or email support@firstlight.ie

If you would like more information on cot death, contact:

National Paediatric Mortality Register,
National Office of Clinical Audit, 2nd Floor,
Ardilaun House, 111, St. Stephen's Green,
Dublin 2, Dublin DO2 VN51

Freephone: 01 878 8455 or email npmr@cuh.ie

National Paediatric Mortality Register - sidsireland.ie

Page last reviewed: 15 September 2022
Next review due: 15 September 2025