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Guidelines for Safe Infant Sleeping Environment
Pediatrics; ePub 2016 Oct 24; AAP Task Force on SIDS
The American Academy of Pediatrics (AAP) has issued a policy statement with its updated 2016 recommendations for a safe infant sleeping environment, covering sudden infant death syndrome (SIDS) and other sleep-related infant deaths. AAP recommendations (Level A) for a safe sleep environment as outlined in the updated recommendations include:
- Back to sleep for every sleep.
- Use a firm sleep surface.
- Breastfeeding is recommended.
- Room-sharing with the infant on a separate sleep surface is recommended.
- Keep soft objects and loose bedding away from the infant’s sleep area.
- Consider offering a pacifier at naptime and bedtime.
- Avoid smoke exposure during pregnancy and after birth.
- Avoid alcohol and illicit drug use during pregnancy and after birth.
- Avoid overheating.
- Pregnant women should seek and obtain regular prenatal care.
- Infants should be immunized in accordance with AAP and CDC recommendations.
- Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
- Health care providers, staff in newborn nurseries and NICUs, and child care providers should endorse and model the SIDS risk-reduction recommendations from birth.
- Continue the “Safe to Sleep” campaign, focusing on ways to reduce the risk of all sleep-related infant deaths, including SIDS, suffocation, and other unintentional deaths. Pediatricians and other primary care providers should actively participate in this campaign.
Citation:
AAP Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a safe infant sleeping environment. [Published online ahead of print October 24, 2016]. Pediatrics. doi:10.1542/peds.2016-2938.
Approximately 3,500 infants die annually in the US from sleep-related infant deaths. Sudden unexpected infant death (SUID) describes any sudden and unexpected death, of which sudden infant death syndrome (SIDS) is one cause. Since 1992 the rate of SIDS has declined from 120 deaths per 100,000 live births in 1992, to 54 per 100,000 live births in 2009, to 40 per 100,000 live births in 2013. The greatest rate of decline occurred shortly after the first supine sleep position recommendations. SIDS remains the most common cause of death in infants from 1 month to 12 months of age. The recommendations above reinforce the importance of a consistent approach to decreasing SUID. While the above recommendations are clear, infants between 4 to 6 months of age often begin to roll over from supine to a prone position. The American Academy of Pediatrics recommends, “all infants continue to be placed supine until 1 year of age. If the infant can roll from supine to prone and from prone to supine, the infant can then be allowed to remain in the sleep position that he or she assumes.”1 —Neil Skolnik, MD