The long awaited American Academy of Pediatrics guidelines on reducing the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths were presented yesterday at the AAP national conference in Boston. Judy Kimmitt Rainey, director of National and Legislative Affairs for Cribs for Kids, summarized the new guidelines.
New SIDS Guidelines
- Epidemiologic studies have not demonstrated any bed-sharing situations that are protective against SIDS or suffocation. Specific circumstances substantially increase the risk of SIDS or suffocation while bedsharing. One example: Never bedshare with infants under 3 months of age, even if the parents are non-smokers.
- There is no evidence that bumper pads prevent injury in young infants, but they do increase risk of suffocation; therefore the AAP does not recommend their use.
- Breastfeeding, if exclusive, is protective against SIDS, but any breastfeeding is better than none, and is encouraged.
- Sitting devices, such as car seats, strollers, infant swings, infant carriers, and infant slings, are not recommended for routine sleep in the hospital or at home. Infants younger than 4 months are particularly at risk for suffocation or air-way obstruction.
- There is insufficient evidence to recommend the use of a fan as a SIDS risk-reduction strategy.
Expand the national Back to Sleep campaign to include recommendations on how to prevent deaths due to suffocation and other accidental deaths during sleep.
The new guidelines are made easier to understand by answering frequently asked questions about SIDS and safe sleep. Below is a summary of all recommendations from the AAP Task Force on Sudden Infant Death Syndrome.
Level A Recommendations
- Back to sleep for every sleep.
- Use firm sleep surface.
- Room-sharing without bed-sharing is recommended.
- Keep soft objects and loose bedding out of the crib.
- Pregnant women should receive regular pre-natal care.
- Avoid alcohol and illicit drug use during pregnancy and after birth.
- Breastfeeding is recommended.
- Consider offering a pacifier at nap time and bedtime.
- Avoid overheating.
- Do not use home cardio-respiratory monitors as a strategy for reducing the risk of SIDS.
- Expand the national campaign to reduce the risk of SIDS to include a major focus on the safe sleep environment and ways to reduce the risks of all sleep-related infant deaths, including SIDS, suffocation, and other accidental deaths; pediatricians, family physicians, and other primary care providers should actively participate in this campaign.
Level B Recommendations
- Infants should be immunized in accordance with recommendations of the AAP and the Centers for Disease Control and Prevention.
- Avoid commercial devices marketed to reduce the risk of SIDS.
- Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly.
Level C Recommendations
- Health care professionals, staff in newborn nurseries and NICUs, and child care providers should endorse the SIDS risk-reduction recommendations from birth.
- Media and manufacturers should follow safe-sleep guidelines in their messaging and advertising.
- Continue research and surveillance on the risk factors, causes, and pathophysiological mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths entirely.
The complete guidelines will be published in the November issue of Pediatrics. Additionally, the AAP will post this information on the Academy’s Healthy Children website, healthychildren.or