Smoking during pregnancy is linked to numerous health problems for the baby and the mother – but research also says babies born from mothers who smoked while expecting have a higher incidence of sudden infant death syndrome (SIDS). Infants born to smoking mothers may have a risk for SIDS that is double – even five times greater – than babies born to non-smoking mothers.

A research review conducted by Cincinnati Children’s Hospital, led by Hemant Sawnani, points to changes in the areas of brain development that control breathing in mothers who used nicotine. Babies born to smoking mothers showed a greater number of short stops in breathing, or pauses known as infant apnea, and were less equipped to awaken when sleeping when their oxygen level dropped too low.

Published in the journal Pediatric Allergy, Immunology and Pulmonology, editor Dr. Harold Farber said the research conclusions draw more attention to the value of public health strategies that are aimed at preventing tobacco usage among teen girls. Farber also said the study points to a greater need to stop womens’ nicotine addiction and dependence before they become pregnant.

Additional research from the University of Arizona says that the breathing ability and response of animals with gestational nicotine exposure was lower than animals who did not receive nicotine exposure. When the newborn animals experienced lower levels of blood oxygen, the ones who had been exposed to nicotine were not as able to respond and begin breathing again as animals that had not been exposed. Experts say the ability to begin breathing again following a pause, or apnea, is a critical element in the study of SIDS.

In combination with reduced levels of blood oxygen, infants can experience higher rates of SIDS when levels of carbon dioxide climb. If this occurs with apnea over a period of time, the baby may experience a sharp decline in blood oxygen levels and eventually fatal cardiovascular arrest.

It is still not understood what causes SIDS, but the American SIDS Institute says regular prenatal care and doctor’s visits can help, along with eating healthy – factors which can help prevent premature delivery, one of the elements of higher risk for incidences of SIDS. Women who wait until they are adults, instead of teenagers, to have a child also have a lower risk of SIDS.

The SIDS Institute says using cocaine, heroin and tobacco causes the baby to have a higher chance for SIDS. In addition, the Institute says that even exposure to second-hand tobacco smoke increases the risk of SIDS, and babies should not be in a home or a vehicle with a smoker.

Quitting smoking can be one of the most challenging addictions to break – but evidence pointing toward the acute health risks for both mother and baby make the challenge worth the effort. The best approach is to quit before pregnancy, but a combination of counseling, medications – if approved and monitored by a doctor – and family or group support can be options for pregnant mothers who are kicking the smoking habit.