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Babies slipping beneath their bedding may be a cause of cot deaths, a New Zealand study has found.
This has long been suspected but never proven.
One of the researchers is advocating a kind of Dutch baby sleeping bag to avoid the risk.
The researchers from Auckland and Germany found that 15.6 cent of sudden infant death syndrome (SIDS) cases in a New Zealand study and 28 per cent in a German study involved the baby's head being covered.
These babies were very sweaty when found, suggesting the covering of their heads preceded death and may have been causally linked to the death.
Auckland University's professor of child health research, Ed Mitchell, one of the authors of the paper published this week in the American journal Pediatrics, said yesterday that the study helped to answer the debate over whether head covering was a causal factor in SIDS.
"There have been a number of studies that have looked [at the question] that have noted head covering occurs in about 30 per cent of deaths.
"The question is, does that cause the death or is it just that the babies are found underneath the bedclothes whereas live babies kicked the bedclothes off?
"If you ask parents, have they ever found their baby with the head covered, most infants will have done that at some stage."
Suffocation or being too hot were the potential mechanisms of death. The face and hands are the most important parts of a baby's body for losing heat.
"The advance we've made is that we've shown convincingly for the first time that [being covered] is part of the causal pathway for some deaths, not all deaths," Professor Mitchell said.
"There are a lot of people that have believed it is part of the causal pathway. The Dutch have included avoidance of head covering as part of their SIDS advice."
Parents in the Netherlands commonly put their babies to sleep in a kind of sleeping bag with shoulder straps to keep the arms out and prevent the head becoming covered, Professor Mitchell said. "I think they are quite good really."
The Health Ministry's chief adviser on child and youth health, Pat Tuohy, said the new findings supported the ministry's longstanding advice that a cot's bedding should be made up and the baby placed so that any spare space was between the baby's head and the head of the cot; the baby's feet should be placed right at the foot of the cot to minimise the risk of becoming covered.
