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Am Fam Physician. 2025;111(2):164-170

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Sudden unexpected infant death is an umbrella term that describes death that occurs in infants younger than 12 months that does not have an immediately obvious cause. Sudden infant death syndrome (SIDS) is diagnosed when there is no other explanation for the death after a detailed investigation. Despite a decrease in the incidence of SIDS after instituting the Back to Sleep campaign in 1992, sudden unexpected infant death remains a leading cause of infant death, and rates have plateaued. Although there has been a decrease in the incidence of SIDS, these numbers likely reflect improved investigations because rates of sudden unexpected infant death have remained stable. Recommended risk reduction strategies include promotion of a supine sleep position, safe sleep surfaces, room sharing, breast milk feeding, and pacifier use. Families should be counseled to avoid sharing sleep surfaces, overheating, loose bedding and inclined surfaces, and parental use of tobacco or alcohol. Infant swaddling without hats is recommended until they are attempting to roll over, after which appropriate clothing or wearable blankets can be worn. Family physicians should prioritize early education and consistent messaging to promote SIDS risk reduction.

Approximately 3,400 infants die of sudden unexpected infant death in the United States annually, and 1,400 of these deaths are diagnosed as sudden infant death syndrome (SIDS).1 SIDS requires a full investigation without alternative findings, whereas sudden unexpected infant death is a larger category of unexplained infant deaths that includes SIDS. Although talking about infant death can be difficult for families and physicians, early introduction and consistent messaging allow parents to reduce the risk of SIDS.2 This article reviews common questions about SIDS and presents evidence-based answers.

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