Protect Baby from Sudden Infant Death Syndrome (SIDS)

What is Sudden Infant Death Syndrome and how common is it in Hong Kong?

  • Sudden Infant Death Syndrome (SIDS) or cot death is the sudden, unexpected and unexplained death of a baby in the first year, usually during sleep, with unknown cause.
  • SIDS most commonly affects babies in the first 6 months with peak at 2 to 3 months of age.
  • SIDS is not common in Hong Kong (affecting 1 to 3 babies out of every 10,000).
  • Experts cannot predict which babies will die from SIDS.

Taking appropriate precautions can reduce the risk of SIDS.

How can I reduce the risk of SIDS?

Back Sleeping

  • Always place your baby on the back to sleep
    • It is six times safer than sleeping on the front and twice as safe as on the side.

Sleeping on the back gives your baby:

  • Best protection from SIDS
  • Best way to breathe easily
  • Best chance to cool when gets too hot
  • Best position to prevent from rolling to the front or slipping under the bed covers

No Smoking

  • Maintain a smoke-free environment
    • The risk of SIDS is increased if mothers smoke during pregnancy.
    • There is some evidence indicating that the exposure of babies to secondhand smoke may increase the risk of SIDS.

Safe sleeping environment

  • Place your baby on a firm sleep surface. Use a firm and well fitted mattress. Never place him to sleep on a quilt, pillow, sheepskin or bean bag etc.
  • Avoid having objects and loose bedding where your baby is sleeping like pillows, fluffy blankets or duvets, pillow-like bumpers, stuffed toys etc.
  • Make sure your baby's face is not being covered during sleep. So when blanketing the baby, leave his arms uncovered. A baby’s face and head are important for breathing and cooling.
  • Avoid letting your baby get too hot. Do not overdress or overheat your baby with the covers. Remember to keep the room well-ventilated with temperature comfortable for a lightly clothed baby.
  • Your baby should sleep with you in the same room. Put your baby in a cot near your bed in your room. If it is not possible to put the cot in your bedroom, you may place the baby on a cradle on your bed to separate him from you. The baby should have his own blanket. Make sure your bedding does not cover his head and face to prevent suffocation.


  • Get your baby fully immunised
    • Recent evidence has shown that immunisation can reduce the risk of SIDS.


  • Breastfeeding is likely to have a direct protective effect against SIDS. We strongly encourage breastfeeding which has many other health benefits for both the baby and the mother.

Should I share a bed with my baby?

Some parents prefer to share a bed with their babies due to different reasons, for example it may be more convenient to breastfeed. However, due to safety concerns, we recommend the baby should be sleeping in his own bed.

Research has shown that sharing a bed with a baby under the following circumstances can be particularly dangerous:

  • The mother smokes during pregnancy or if either parent smokes after the baby is born.
  • Use of soft mattresses, loose bedding or large soft pillows in the bed. These may cover the baby's face or head, particularly when the baby rolls onto his front.
  • The parents' alertness is reduced
    • after drinking alcohol;
    • after taking drugs;
    • when very tired or sick.
  • The baby shares a bed with someone other than his parents (e.g. other children or adults).
  • Sleeping with the baby in the sofa.

I want to bring my baby into my bedroom to facilitate breastfeeding, what should I bear in mind?

Some mothers may need to breastfeed frequently; the best way would be to place the baby’s cot directly next to your own bed. In this way, you can breastfeed the baby whenever he needs either sitting or lying on your bed. Put the baby back to his own cot after he is satisfied. By doing so, it is not only convenient but also brings the following benefits:

  • You can observe the baby’s needs easily and respond readily.
  • You can sleep better and you don’t need to worry about the baby’s safety when he sleeps with you.
  • It can reduce the risk of SIDS by avoiding sharing a bed with the baby.
  • It helps the baby develop a healthy sleeping habit without the need to rely on suckling on the breast to fall asleep.

Does my baby need a baby pillow?

  • Babies usually sleep well without a pillow.
  • Research shows that large soft pillows increase the risk of SIDS and these are not recommended for infants. There is limited evidence as to whether small baby pillows are safe or dangerous.
  • If you need to put your baby in a semi-upright position after a feed, consider putting a pillow under the mattress, so that the mattress itself is elevated.

Should my baby use a dummy to reduce the risk of SIDS?

  • Research has shown that babies who use a dummy have a reduced risk of SIDS.
  • However, dummy use may increase the risk of otitis media.
  • Dummy may affect some babies when they first learn to suckle the breast. So if you are breastfeeding, you may consider giving your baby dummy after he is more than one month old to ensure that breastfeeding is well established.
  • Use dummy only when settling the baby to sleep, and there is no need to put it back once your baby falls asleep and drops the dummy.
  • Should not force your baby to use a dummy.
  • Should not coat the dummy with any sweetened solutions. Clean it often and replace it regularly.

If your baby is unwell, please seek advice from your doctors.

"Points to Note for Keeping Baby Safe during Sleep"

  • Face and hands not covered
  • Place baby on his back to sleep
  • Smoke-free environment
  • Baby sleeps in a cot with you in the same room
  • Use firm mattress
  • No soft objects and loose bedding
  • Comfortable temperature
(Content revised 09/2017)