Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada

Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada

The following was adapted from the “Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada.” This statement was a collaboration between the Canadian Paediatric Society, the Canadian Foundation for the Study of Infant Deaths, the Canadian Institute of Child Health, Health Canada, and the Public Health Agency of Canada. Please see the original document for a complete list of recommendations on this topic.


Give health care providers evidence-based information on safe sleeping practices and SIDS prevention in infants, so that they can provide caregivers with accurate and consistent advice.


Sudden Infant Death Syndrome (SIDS) is the sudden and unexpected death of an infant younger than 1 year old. In these cases, there is no obvious cause of death despite thorough investigation including clinical history, autopsy, and death scene investigation.


  • SIDS can occur anytime between the ages of 0-1 year
  • More common between 2-4 months of age
  • Risk decreases after 6 months of age


  • Exact cause of SIDS is unknown
  • Currently, it is considered a complex multifactorial disorder
  • SIDS is thought to arise from interaction between certain genetic, metabolic, and environmental factors

Risk factors: 

  • Non-modifiable: male, premature, low birth weight, Aboriginal heritage, socioeconomically disadvantaged background
  • Modifiable: sleeping prone, maternal smoking during pregnancy
  • Risk factors for both SIDS and unintentional suffocation while sleeping:
    • Sleeping surface shared with another person
    • Presence of soft bedding

Prevention: Based on the modifiable risk factors listed above, the following recommendations have been made to prevent SIDS and promote safe sleeping practices:

  • Limit exposure to tobacco smoke before and after birth
  • Encourage room sharing
    • During the first 6 months of life (when SIDS risk is highest) infants should sleep in the same room as their caregivers
    • It is important to differentiate between room sharing and bed sharing
    • Bed sharing is where the infant sleeps on the same surface as another person
      • It is linked to SIDS and unintentional death from entrapment, overheating, overlaying, and suffocation, and therefore is strongly discouraged
  • Create an appropriate sleeping environment  for the infant
    • Infants should have their own bassinet, crib or cradle that meets current safety regulations
    • Only a firm mattress and fitted sheet are needed
    • Extra items such as bumper pads and other bedding actually pose a suffocation risk
    • Have the infant sleep in one-piece sleepwear. Avoid excess clothing or blankets which could cause them to overheat
  • Always place infants on their back to sleep
    • Sleep positioning devices should not be used to keep infants supine as there is a possibility of suffocation
    • Encourage tummy time during the day. It helps strengthen muscles and can prevent plagiocephaly from back sleeping
  • Breastfeed infants
    • Any amount of breastfeeding protects against SIDS, but exclusive breastfeeding is most beneficial
    • Pacifiers also seem to reduce the risk of SIDS



Public Health Agency of Canada. (2011). Joint statement on safe sleep: Preventing sudden infant deaths in Canada. Retrieved from:

Physiologic System: 
Clinical Presentation: