Prof Ndu Explains Myths, Causes, Solutions to Sudden Infant Death Syndrome
Each year, thousands of babies around the world die suddenly and unexpectedly in their sleep, leaving families heartbroken and searching for answers. Yet many of these deaths can be prevented through simple awareness and safe sleep practices. In this article, Professor Ikenna Kingsley Ndu of the College of Medicine, Enugu State University of Science and Technology (ESUT), explains what every parent and caregiver should know about Sudden Infant Death Syndrome (SIDS) — how it happens, the myths surrounding it, and how knowledge can help protect the youngest members of our families.
Sudden Infant Death Syndrome (SIDS): Questions Parents Are Asking
Based on insights from Dr. Ikenna Kingsley Ndu, Professor of Paediatrics, College of Medicine, Enugu State University of Science and Technology (ESUT), Enugu, Nigeria
Introduction
Every parent dreams of watching their baby grow and thrive. That’s why nothing is more devastating than losing a healthy child suddenly and without warning. Around the world, thousands of families each year face this heartbreak through Sudden Infant Death Syndrome (SIDS)—the unexpected and unexplained death of an apparently healthy baby, usually during sleep.
In this article, we answer common questions about SIDS—what it is, how it happens, and, most importantly, how parents and caregivers can help prevent it.
What exactly is SIDS?
Sudden Infant Death Syndrome, often called SIDS (previously referred to as ‘cot death’ in older literature, a term now avoided because it can be imprecise and outdated), refers to the sudden and unexplained death of a baby under one year of age, usually during sleep. Even after detailed medical checks, a review of the circumstances, and an autopsy, no clear cause is found.
It falls under a broader term called Sudden Unexpected Death in Infancy (SUDI), which includes both explained and unexplained sudden infant deaths. SIDS represents the unexplained group and remains one of the most heartbreaking challenges in child health.
How common is it?
Globally, around 30,600 babies died from SIDS in 2021. While this number sounds high, it represents a significant decline from the early 1990s, when nearly 75,000 babies were lost each year. Safe sleep campaigns and greater awareness have helped reduce SIDS deaths worldwide.
In the United States, SIDS remains one of the top three causes of infant death, claiming about 1,500 babies in 2022. Most cases occur when babies are between 2 and 4 months old, and about 9 in 10 happen before 6 months. Boys are affected slightly more than girls.
In Nigeria, reliable figures are hard to find. Few studies exist, and cultural beliefs or lack of autopsies mean many deaths go unrecorded. Some parents may attribute such deaths to spiritual attacks by enemies, the ogbanje phenomenon, or other mystical causes, while others never report them to hospitals. This underreporting makes it difficult to know how many Nigerian infants die from SIDS each year—but doctors believe the number is significant given the country’s high infant mortality rate overall.
What are the risk factors?
Some risks are beyond a parent’s control, while others can be changed.
- Unavoidable factors: low birth weight, premature birth, recent infections, and poverty.
- Modifiable factors: sleeping face-down or on the side, exposure to cigarette smoke, overheating from heavy bedding, and bed-sharing with adults.
On the positive side, breastfeeding, keeping up with vaccinations, and allowing babies to sleep in the same room (but not the same bed) as their parents have all been shown to lower the risk.
Why is SIDS less recognised in Nigeria and other developing countries?
- Few autopsies are done: Families often refuse post-mortems due to cultural or religious beliefs.
- Cultural explanations: Some parents believe the child’s death is due to spiritual attacks by enemies or the ogbanje phenomenon, which are seen as supernatural rather than medical events.
- Poor reporting: Many cases are recorded as “Brought in dead” or “dead on arrival,” and further investigations are not carried out.
- Low awareness: Unlike developed countries, Nigeria lacks national “Safe Sleep” education campaigns.
Because of these barriers, SIDS remains hidden and under-discussed, even though many of these deaths are preventable.
What can parents and caregivers do to reduce the risk?
Simple changes save lives:
- Always place babies on their backs to sleep.
- Use a firm mattress—no pillows, soft toys, or heavy blankets.
- Keep the baby’s sleep area cool and uncluttered.
- Avoid smoking during and after pregnancy.
- Let the baby sleep in the same room as you, but not in the same bed.
- Support breastfeeding and routine immunization.
These steps are simple, safe, and effective.
Why is it important to talk about SIDS now?
Nigeria’s infant mortality rate is still among the highest in the world. Talking openly about SIDS can:
- Replace fear and superstition with knowledge.
- Help grieving parents find understanding and support.
- Encourage safe baby-care practices in every home.
When families know how to create safer sleep environments, many of these tragedies can be prevented.
What is the way forward?
Nigeria needs to build awareness, strengthen hospital reporting, and educate families through health centres, antenatal clinic (ANC) health talks, churches, mosques, and the media. Every caregiver should know how to create a safe sleep space.
By incorporating SIDS education into ANC visits, mothers and caregivers can receive timely guidance on safe sleep practices even before the baby is born. With stronger community education and compassionate health care, we can reduce infant deaths and give more babies a chance to thrive
A Mother’s Story: “I Thought I Was Being Careful
“My daughter Ada was only three months old. One night, I let her sleep beside me because she had been crying, in order to console her and monitor her body temperature in case she developed a fever. Usually, my other children develop fever after crying like that.
I woke up in the morning and she wasn’t breathing. I had never heard about the dangers of bed-sharing. I blamed myself for months. Now I share my story to tell other mothers—please, always let your baby sleep on their back and in their own space.”
— Ngozi, mother from Enugu
(Story shared with permission, name changed for privacy. While the exact cause was never confirmed, this tragic event highlights the risks of unsafe sleep environments that can lead to SUDI, including SIDS. Such losses can also place enormous emotional strain on families—especially when a grieving mother faces blame or misunderstanding from her spouse or relatives. Compassionate counselling and family support are crucial in the healing process.)
Safe Sleep Checklist for Every Parent
Do’s:
- Place your baby on their back for every sleep.
- Use a firm mattress and keep it flat.
- Keep the crib or cot clear of pillows, toys, or loose bedding.
- Share your room—but not your bed—for at least the first six months.
- Breastfeed if possible—it helps lower SIDS risk.
- Immunize on schedule—healthy babies sleep safer.
Don’ts:
- Don’t put your baby to sleep on their stomach or side.
- Don’t overheat your baby—avoid heavy blankets or head coverings.
- Don’t smoke or let anyone smoke near your baby.
- Don’t let your baby sleep on a couch, sofa, or armchair.
In Conclusion
SIDS may be rare, but for the families it touches, the pain is immeasurable.
Awareness and simple preventive steps can make the difference between tragedy and safety. Every conversation, every campus seminar, every clinic visit that spreads this message can save a child’s life.
Together, we can make our university community and Nigeria a place where every baby sleeps safely and wakes up smiling.
Dr. Ndu is a Professor of Paediatrics at the College of Medicine, Enugu State University of Science and Technology (ESUT), Enugu, Nigeria.
He is passionate about promoting evidence-based parenting and creating safer environments for children across Nigeria.
