They are not recommended for children under one year of age, as this risk of suffocation greatly outweighs the risk of head bumping or limbs getting stuck in the bars of the crib.Sharing a bed with parents or siblings increases the risk for SIDS. This risk is greatest in the first three months of life, when the mattress is soft, when one or more persons share the infants bed, especially when the bed partners are using drugs or alcohol or are smoking. The risk remains, however, even in parents who do not smoke or use drugs. The American Academy of Pediatrics thus recommends "room-sharing without bed-sharing", stating that such an arrangement can decrease the risk of SIDS by up to 50%. Furthermore, the academy has recommended against devices marketed to make bed-sharing "safe", such as "in-bed co-sleepers".Room sharing as opposed to solitary sleeping is known to decrease the risk of SIDS. Breastfeeding
Breastfeeding is associated with a lower risk of SIDS. It is not clear if co-sleeping among mothers who breastfeed without any other risk factors increases SIDS risk. Pregnancy and infant factors
SIDS rates decrease with increasing maternal age, with teenage mothers at greatest risk. Delayed or inadequate prenatal care also increases risk. Low birth weight is a significant risk factor. In the United States from 1995 to 1998, the SIDS death rate for infants weighing 1000–1499 g was 2.89/1000, while for a birth weight of 3500–3999 g, it was only 0.51/1000. Premature birth increases the risk of SIDS death roughly fourfold.
From 1995 to 1998, the U.S. SIDS rate for births at 37–39 weeks of gestation was 0.73/1000, while the SIDS rate for births at 28–31 weeks of gestation was 2.39/1000.Anemia has also been linked to SIDS (however, per item 6 in the list of epidemiologic characteristics below, extent of anemia cannot be evaluated at autopsy because an infants total hemoglobin can only be measured during life). SIDS incidence rises from zero at birth, is highest from two to four months of age, and declines toward zero after the infants first year. Genetics
Genetics plays a role, as SIDS is more prevalent in males. There is a consistent 50% male excess in SIDS per 1000 live births of each sex. Given a 5% male excess birth rate, there appears to be 3.15 male SIDS cases per 2 female cases, for a male fraction of 0.61. This value of 61% in the US is an average of 57% black male SIDS, 62.2% white male SIDS and 59.4% for all other races combined. Note that when multiracial parentage is involved, infant race is arbitrarily assigned to one category or the other; most often it is chosen by the mother. The X-linkage hypothesis for SIDS and the male excess in infant mortality have shown that the 50% male excess might be related to a dominant X-linked allele, occurring with a frequency of 1⁄3 that is protective against transient cerebral anoxia. An unprotected male would occur with a frequency of 2⁄3 and an unprotected female would occur with a frequency of 4⁄9.