Room sharing. Three of 4 studies found that infants sleeping in separate rooms from their caregivers had a 3-fold increased risk of SIDS,5,6,11 while the fourth study found a 10-fold increased risk.8 One study found the risk was present in infants less than 20 weeks, but was inconclusive for those greater than 20 weeks.11
Sleep surface. All 4 studies evaluating sleep surface found a significantly increased risk of SIDS for infants sleeping on sofas or armchairs compared with infants sleeping in beds or cribs. Fifty-five of 772 total cases (7.1%) from the 4 studies slept on a non-bed surface compared with 8 of 1854 controls (0.4%).4-6,9
Bedding accessories. Two of 3 studies found pillow use unrelated to SIDS.4,7,9 The larger of 2 studies on duvet use found it to be a risk factor for SIDS (OR=1.82).8
Recommendations from others
The American Academy of Pediatrics recommends that infants should sleep supine in the same room, but not the same bed, as their caregivers, while on a firm surface without bedding accessories. They should never sleep on a couch or armchair. Infants may be brought into bed briefly for feeding or comforting. Parents should be encouraged to quit smoking.10