Abstract
AIM: This paper describes sudden infant death syndrome (SIDS) from a medical historical perspective and explores how risk-reducing advice was developed. A particular focus is the dramatic reduction in the incidence of SIDS in Sweden. METHODS: A mini review of the literature was carried out. RESULTS: Sudden unexpected deaths in infants have been recognised since biblical times and were attributed to overlaying. These are assumed to equate to modern-day SIDS cases. SIDS became an established entity in the late 1960s, and the incidence increased in Sweden in the 1970s and the 1980s, when prone sleeping was the norm. However, case-control studies from New Zealand and England showed that prone sleeping, maternal smoking, not breastfeeding and over-heating, were over-represented in SIDS. Advice in the early 1990s focused on supine sleeping and tackled these other key issues. This led to a drastic reduction in SIDS in Sweden, where the incidence fell sharply from 1.1 to 1.2 per 1000 live births. Since 2017 the incidence has been stable at around 0.1 per 1000. Abandoning prone sleeping for infants was the most important change. CONCLUSION: The development of effective advice to reduce the risk of SIDS has been a major pediatric accomplishment.