As a new mom, University of North Texas educational psychology associate professor Wendy Middlemiss was dissatisfied with information on safe infant sleep. She made infant sleep research a priority and dedicated years of study to best practices for parents when it comes to bedtime for babies.

Each year, the CDC estimates there are 3,500 sleep-related deaths among babies in the U.S. October is National Sudden Infant Death Syndrome Awareness Month, that shines a light on the unexplained death of children under 1. Middlemiss, who has researched the impact of health messaging related to safe infant sleep, says there’s room for improvement when it comes to SIDS awareness.

“In regard to SIDS in the U.S. and globally, safe sleep campaigns and SIDS-related policies and advice are very often not effective,” Middlemiss said. “We have lots of documentation that what we’re doing works for some and doesn’t work for many. There are a lot of disparities.”

Middlemiss said instead of merely telling parents what they shouldn’t do, communications should explain what is a risk factor and equip parents with the knowledge of what the child needs to keep them healthy and reduce the risk of SIDS. She collaborated with other researchers across the globe in developing an educational video on safe infant sleep practices, that will soon be distributed in official health messaging campaigns.

So, what are some SIDS risk factors? Here’s what Middlemiss said: 

Many parents do not put their babies on their back because they’re afraid the infant will spit-up in the night and choke. But, having babies sleep on their backs is an important protection against SIDS. When an infant is placed on its back, the baby’s windpipe is kept open and straight posing less risk of choking.

One very significant risk is to have blankets or soft toys in a baby’s sleep space. In a research study we did on perceptions of infant sleep spaces, parents didn’t recognize these objects as risk factors. Babies can get tangled in blankets and toys or they can put them over their faces hindering their ability to breathe.

If a baby is overheated, then their risk of a weakened arousal response increases. A weakened arousal response means a baby is less likely to wake up and change their position to increase their oxygen intake. If the arousal signal isn’t strong enough to wake the baby up, then their risk of SIDS increases.