The American Academy of Pediatrics (AAP) recently updated their safe sleep recommendations for infants. Several recommendations remain the same. For example, babies younger than one-year-old are safest when placed on their backs on a firm flat surface without any pillows, blankets, bumpers, other soft bedding, or toys in the sleep environment. Other recommendations, such as how long a baby should share a room with her parents, have changed a bit. The full set of recommendations contains complete explanations of why these recommendations are made and how they relate to protecting against Sudden Infant Death Syndrome (SIDS), suffocation, strangulation, or other unexplained infant death during sleep. Below is an abbreviated list of recommendations:
- Put your baby on her back to sleep for every sleep.
- Use a firm, flat sleep surface. Couches and armchairs are particularly problematic, as are other soft surfaces such as memory foam.
- Breastfeeding is recommended – exclusive is best, and some is better than none.
- Room-sharing – It is recommended that infants sleep in the parents’ or caregivers’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.
- Keep soft objects and loose bedding away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation.
- Consider offering a pacifier at nap time and bedtime – it’s protective against SIDS. Be sure the pacifiers are not attached to clothing or have anything hanging from them. There is not enough evidence to say that finger sucking does the same thing.
- Avoid smoke exposure during pregnancy and after birth.
- Avoid alcohol and illicit drug use during pregnancy and after birth.
- Avoid overheating and head covering in infants. Overheating is a risk for SIDS. Dress your baby in no more than one layer more than you (an adult) would wear in the environment.
- Pregnant women should obtain regular prenatal care. Having regular prenatal care is protective against SIDS.
- Infants should be immunized in accordance with recommendations by the AAP and Centers for Disease Control and Prevention. Immunizations do not cause SIDS and in fact may protect against it.
- Avoid the use of commercial devices that are inconsistent with safe sleep recommendations – particularly ones that claim to reduce the risk of SIDS such as devices that are placed in the adult bed that claim to make bed-sharing safe. Also, there are no safety standards for in-bed sleepers, but there are safety standards for sleepers that attach to the bed.
- Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
- Supervised, awake tummy time is recommended to promote development and to minimize positional plagiocephaly (flat back of head).
- There is no evidence that swaddling reduces the risk of SIDS.
The complete set of AAP recommendations can be found here.