SIDS Program Manual SIDS & Infant Death Program Manual and Trainer's Guide Trainer's Guide

What is SIDS?

Non-Modifiable Risk Factors

Risk Factors

Low Birth Weight and Prematurity

A low birth weight (LBW) infant is an infant who weighs less than 2,500 grams (5.5 pounds) at birth. LBW infants may be premature (born before the completion of the 37th week of pregnancy) or full-term. LBW affects about 7.6 percent of infants born each year in the United States. About half of all cases of LBW are related to teenage pregnancy, cigarette smoking during pregnancy, poor nutrition before and during pregnancy and poor health of the mother.

The incidence of LBW continues to grow and has become a major public health issue in the United States. LBW and prematurity are major risk factors for overall infant mortality, including a three to six times greater risk of SIDS in comparison to normal birth weight and gestational period infants.63,64 The latest infant mortality statistics reveal that in contrast to infant mortality, the last decade saw no significant drop in the rate of LBW and, in fact, LBW now appears to be on the rise.

There are unique challenges to working with LBW and premature infants because neonatal intensive care units (NICU) often place these infants in the prone position. Very low birth weight (VLBW) infants suffer from a higher prevalence of certain medical conditions, such as gastrointestinal reflux and upper airway problems, that lead some medical professionals to recommend the prone sleep position. It is also possible that physicians, NICU nurses and other medical professionals remain uncomfortable recommending non-prone sleeping for VLBW infants, despite the AAP’s recommendations and the physiologic data that support it.65

Research shows that parents of VLBW infants are more influenced by both the recommendations of a physician, and the practices of the nursery more than parents of normal birth weight infants. Prior to discharge, VLBW, LBW and preterm infants should be transitioned to the supine position and infant sleep position should be discussed with the parents.66