What is the major modifiable risk factor associated with cot death?

The major modifiable risk factor associated with cot death, also known as sudden infant death syndrome (SIDS), is prone sleeping. Research has shown that placing an infant on their stomach or side to sleep significantly increases the risk of SIDS. When infants are positioned in this manner, it can lead to difficulties in breathing and an increased likelihood of rebreathing carbon dioxide, both of which can contribute to this tragic outcome.

Public health campaigns have effectively educated parents and caregivers about the dangers of prone sleeping, promoting safe sleep practices that recommend placing infants on their backs during sleep. This change in sleeping position has been associated with a marked decline in SIDS rates in many countries.

While low birth weight, parental smoking, and infrequent feeding are also risk factors associated with SIDS, they are not modifiable in the same direct way as sleeping position. For instance, while addressing parental smoking can reduce risk, it is not as universally actionable as simply ensuring that an infant sleeps on their back. Thus, the emphasis on sleeping position is critical for preventing cot death.