Four Ways Attachment Parenting Can Reduce the Risk of S.I.D.S.

The most plausible explanation for SIDS, in most babies, is a defect in cardiorespiratory control and arousability during sleep. Also, research suggests that some infants at risk for SIDS have less-organized physiological control mechanisms. So, any parenting style that can enhance the development of a baby’s physiological control systems and increase mother’s awareness to subtle changes in her baby’s physiology, would lower the risk of SIDS. Attachment parenting does this.

1. Attachment parenting organizes an infant’s physiological control systems.

New thinking is that some SIDS babies may not have been as physiologically normal as they appeared to be before they died. Findings of higher heartrates and less adaptable heartrate variability in babies at risk for SIDS suggests these infants are less able to adjust their physiology to changing biological conditions. Also, several studies of high risk infants and babies who died of SIDS suggests that some of these babies had temperaments and behavioral qualities that lessened their ability to protest life-threatening circumstances. Summing up this complicated and shaky research that attempts to correlate infant temperament and SIDS, it seems that in some infants the drive to survive is weak. Some infants are physiologically disadvantaged to protect themselves from SIDS.

A baby who spends a lot of time in mother’s arms, at mother’s breasts, and in mother’s bed becomes more physiologically organized. Therefore, I believe a baby whose overall physiology is more organized has a lower risk of succumbing to SIDS. Pure speculation, researchers would claim! Read on. Over a period of fifteen years I gathered hundreds of articles on attachment research — studies that conclude: the closer the infant and mother are, the better the baby’s physiology works, especially during the early months when infants are at highest risk of SIDS. What a pity that most of this useful research lies buried in obscure journals or shared at scientific meetings, but little is translated into practical information to help new parents develop a style of infant care that could reduce the risk of SIDS.

Circulating throughout the bloodstream of every person, even tiny babies, is an adrenal hormone called “cortisol.”Produced by the adrenal glands, this hormone helps major systems of the body function normally. The body needs just the right amount of cortisol at the right times. Too much or too little, and the body is not in tune, sort of like an engine trying to run with the wrong mix of gasoline and air. Adrenal hormones are also known as stress hormones. Levels rise quickly to help a person react to a threat. Although stress hormones are needed in times of danger, if they remain too high for too long, the body becomes overstressed and certain systems, such as the immune system, can’t function as well. Experiments on both human infants and infant experimental animals showed these fascinating results about attachment research. :

  • Human infants with the most secure attachment to their mothers had the best cortisol balance.

  • The longer infant animals were separated from their mothers, the higher the cortisol levels, suggesting that these babies could be chronically stressed. The mothers also experienced elevated cortisol levels when separated from their babies.

  • Prolonged cortisol elevations may diminish growth.

  • Prolonged cortisol elevations may suppress the immune system.

  • Infant animals separated from their mothers showed imbalances in the autonomic nervous system — the master control system of the physiology. They didn’t show the usual increases and decreases in heart rate and body temperature, had abnormal heartbeats (called “arrhythmia”), and showed disturbances in sleep patterns, such as a decrease in REM sleep (the stage of sleep in which an infant is most arousable in response to a life-threatening event). Similar physiological changes were measured in preschool children separated from their parents

  • In addition to the agitation caused by prolonged elevation of adrenal hormones, separation sometimes caused the opposite physiological effect: withdrawn, depressed infants who had low cortisol levels.

  • Separated infants showed more irregular heart rates.

  • Infants separated from their mothers were less able to maintain a stable body temperature.

  • Infant animals who stayed close to their mothers had higher levels of growth hormones and enzymes essential for brain and heart growth. Separation from their mothers, or lack of interaction with their mothers when they were close by, caused the levels of these growth-promoting substances to fall.

Clearly, the continued presence of a nurturing mother is important for the infant’s physiological and emotional well-being. A secure mother-infant attachment helps an infant’s physiological systems work better. Attachment organizes a baby’s overall physiological systems; separation disorganizes them. And a baby with a disorganized physiology or disorganized biorhythms can be at increased risk of SIDS.

Attachment researchers use the two physiological parameters of heartrate and heartrate variability (how well the heart changes in response to changing physiological needs) as a sort of efficiency indicator of an infant’s physiological well-being. Studies showed that breastfeeding newborns had lower heartrates, more heartrate variability, improved behavioral organization, and more active sleep than bottlefeeding newborns. Also, the investigators concluded that breastfeeding newborns show a more energy efficient behavioral organization than that of bottlefed newborns. These studies suggest the physiology of a bottlefeeding baby may be like an automobile engine that is not tuned up.

2. Attachment parenting helps babies thrive

If, as we have seen, an in-arms baby cries less and is less anxious, and therefore consumes less energy, I conclude that the infant has more “free time” to divert that energy that would have been wasted worrying and fussing into thriving. To thrive means more than just growing bigger; it means an infant grows to her fullest potential, physically, intellectually, and physiologically.

Attachment-parented babies feed more frequently, an interaction that itself improves growth and overall behavioral organization. One of the oldest recipes for the failing to thrive baby is “take your baby to bed and nurse.” As previously discussed, attachment promotes growth hormones and enzymes that enhance brain growth in experimental animals. Growth hormone is secreted primarily during sleep. Endocrinologists have discovered that human infants deprived of sufficient attachment have lower growth hormones and fail to thrive — a malady called psychosocial deprivation. From these studies can we infer that attachment-parented babies have higher levels of growth-promoting hormones? Someday, I predict, research will confirm what I have long suspected: attachment-parented infants have higher levels of substances that enhance their overall physiological well-being, and boost a baby’s self-protective abilities as well. So, it seems that mother, by attachment parenting, could act as a regulator of her infant’s physiology, especially during the “developmental dip,” the crucial 2-4 months when an infant is physiologically disadvantaged and at highest risk of SIDS.

If attachment parenting puts an infant at a physiological advantage to survive the vulnerable period for SIDS, does that imply a baby who receives a more distant style of parenting is at a physiological disadvantage? I believe it does. During my 30 years as a pediatrician I have cared for infants called failure to thrive babies — infants who aren’t developing to their physical and psychological potential. And, often unintentionally, this condition can be due to poor quality of mother-infant attachment. For the past 30 years pediatric textbooks have documented cases of “failure to thrive” secondary to poor attachment. Simply put, a baby who feels right, grows right; but an infant who receives less attachment than he needs to thrive feels psychologically unright, and this feeling translates into being physiologically unright.

3. Attachment parenting makes you an expert on your baby.

Besides doing good things for babies, attachment parenting helps mothers too. One of the pieces of advice I give new parents during their first well-baby checkup is: “You don’t have to become an expert on parenting, but you must become an expert on your baby, because no one else will.” While it is true that many babies dying of SIDS give no warning signs that their last breath is imminent, some babies do give clues that something is not quite right. Attachment parenting can also boost your sensitivity, helping you monitor your baby appropriately. Studies have shown that improving mothering skills can lower SIDS rates. The Sheffield, England, study showed that high risk families who received special parenting-skill education had a SIDS rate of 3.2 per thousand compared with 10.6 per thousand who received no special attention. While this extra education did not specifically mention “attachment parenting” the mother’s were encouraged to breastfeed, and it seems that the closer the mothers got to their babies the more they were able to recognize subtle signs of illness and respond intuitively with a level of care that improved their baby’s well-being.

Attachment parenting is especially valuable for babies born prematurely. By breastfeeding, sleeping with her baby, and wearing her baby, mother provides a backup system for baby’s immaturity. Little things mean a lot for infants at risk for SIDS. Attachment parenting makes you more likely to pick up on subtle changes in your baby, and because you know so much about him, you know when and how you need to intervene. You know where and in what position baby sleeps best, how to heat baby’s room, when to seek medical attention, even when to clean out his stuffy nose. You are able to spot changes — for the better and for the worse. The self-training of an attached mother reminds me very much of how the U.S. Department of Treasury trains people to spot counterfeit money. The spotters spend a long time learning what real money is like. They get a feel for real money. As a result, as soon as a counterfeit piece comes along, it triggers a “not right” alarm inside them, and they spot it. (See and )

4. There is a mutual giving in attachment parenting that can be lifesaving.

Mother acts as a regulator of her infant’s physiology, and her infant helps her develop a keen sensitivity. True, the infant is a remarkably sturdy little person, able to adjust and grow in a wide variety of parenting situations. But perhaps some need extra help. Could SIDS in some babies be a disease of physiological disorganization? Could attachment parenting help to counteract this disorganization by decreasing stress and providing an environment that makes up for the baby’s inability to regulate himself? Could attachment parenting aid in the maturation of the respiratory control system so that an infant is able to survive threats to his breathing? These are unanswered, perhaps unanswerable, questions, yet I believe the available evidence, plus a dose of common sense, makes a good case for the idea that a mother, because of the organizing effect she has on her infant’s physiology, provides protection against SIDS.

Suggesting a relationship between parenting styles and SIDS is bound to draw fire from critics who still think that parenting practices play no role in SIDS, or who do not wish to place so much emphasis on the importance of the mother-baby relationship. I wonder if modern parenting focuses on too much “stuff” and not enough touch, and if modern baby-care practices are a trade-off of increased convenience for increased risk. It may be considered politically incorrect to speculate on this kind of life-or-death role for a mother; yet for a few infants it may be physiologically correct. Over the past twenty years the importance of the mother to her infant’s well-being has been diluted by social and economic changes to the extent that the modern view of attachment parenting is that it is nice but not necessary. I challenge that view. As soon as we open our eyes to the time-honored fact that mothering matters, the better off — and perhaps safer — babies will be. My wish is that you practice attachment parenting, not just to prevent SIDS, but because you believe it is the best for you and your baby. By receiving the gift of attachment parenting, more babies will thrive — and survive.


(excerpted from