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Using a fan while an infant is sleeping in a room with inadequate
ventilation can decrease the risk of that infant dying of sudden
infant death syndrome (SIDS), according to a report released on October
6, 2008 in Archives of Pediatrics & Adolescent
Medicine, one of the JAMA/Archives journals.

Sudden infant death syndrome, sometimes called cot death or crib death,
describes the unexpected, unexplained death of an apparently health
infant. In the United States, between the years of 1992 and 2003, the
incidence of SIDS decreased by 56%, according to this article. Largely,
experts attribute this to the increased employment of the supine
sleeping position, with the infant sleeping on its back with its head
facing up, following the introduction of the “Back to Sleep” campaign
in 1994. This decrease has become less pronounced in recent years. The
authors note that this indicates a need for further research in SIDS
prevention: “Although caretakers should continue to be encouraged to
place infants
on their backs to sleep, other potentially modifiable risk factors in
the sleep environment should be examined to promote further decline in
the rate of SIDS.”

Room ventilation has been associated with SIDS in previous studies, but
thsi factor has not been paid significant attention in research. By
limiting ventilation, carbon dioxide might pool around the infant’s
nose and mouth, and this would increase the likelihood of rebreathing.
It is possible that allowing air to move in the room could potentially
reduce SIDS risk.

To investigate this association further, Kimberly Coleman-Phox, M.P.H.,
and colleagues at Kaiser Permanente’s Division of Research in
Oakland, CA, investigated information taken from interviews with
mothers of 185 infants who has died of SIDS, and the mothers of 312
randomly selected infants from the same county, with the same maternal
race/ethnicity, and age. In the interviews, mothers answered questions
about fan use, pacifier use, the status of nearby windows on the night
of the infant’s last sleep, location of the room, sleep location,
number and type of covers, the bedding used , and the temperature of
the room.

Several trends were identified in the infants who died from SIDS in
comparison with infants who do not. For example, more were placed on
their stomachs or sides to sleep, more did not use a pacifier, more
were found with bedding or clothing covering the head, more slept on a
soft surface, and more shared the bed with someone who was not a
parent. For both groups of children, the use of soft bedding underneath
the infant and the room temperature were similar.

Notably, having a fan running during the sleep was associated with a
72% decrease in SIDS deaths in comparison to sleeping in a room without
a fan. This was especially true for the use of fans when the room
temperature was higher, and when the room was about 69°
Fahrenheit (21° Celsius), fan use decreased SIDS deaths by
94%. This was also true for infants who slept on their sides, shared a
bed with someone other than their parents, or did not use a pacifier.

There is still room for improvement, and even though placing infants on
their backs is extremely effective against SIDS, some one-quarter of
child care providers do not follow this practice regularly. The authors
conclude that this is still an important risk factor for prevention of
SIDS. “Use of the prone sleep
position [lying with the front or face downward] remains highest in
care providers who are young, black or of low income or who have low
educational attainment,” they say.. “In
this study, the frequency of fan use was similar in young and less
educated women as in other women; thus, fan use can be easily adopted
by these populations.”

They finish, advocating for a combined approach: 
“Although improving the methods used to convey the importance
of the supine sleep position remains paramount, use of a fan in the
room of a sleeping infant may be an easily available means of further
reducing SIDS risk that can be readily accepted by care providers from
a variety of social and cultural backgrounds.”

Use of a Fan During Sleep and the Risk of Sudden Infant Death
Syndrome
Kimberly Coleman-Phox; Roxana Odouli; De-Kun Li
Arch Pediatr Adolesc Med. 2008;162(10):963-968.
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Written by Anna Sophia McKenney

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