ISPID - International Society for the Study and Prevention of Perinatal and Infant Death
ISPID - International Society for the Study and Prevention of Perinatal and Infant Death

International Society for the Study and Prevention of Perinatal and Infant Death

AAP Recommendations on SIDS & Sleep Related Deaths

In 2016, the American Academy of Pediatrics updated their recommendations on SIDS and Sleep Related Deaths.

The updated 2016 Policy Statement includes the following recommendations:

  1. Infants should be placed for sleep in a supine position (wholly on the back) for every sleep by every caregiver until the child reaches 1 year of age.
  2. Infants should be placed on a firm sleep surface (eg, mattress in a safety-approved crib) covered by a fitted sheet with no other bedding or soft objects.
  3. Unless contraindicated, mothers should breastfeed exclusively or feed with expressed milk (ie, not offer any formula or other nonhuman milkbased supplements) for 6 months.
  4. It is recommended that infants sleep in the parents' 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.
  5. Keep soft objects and loose bedding away from the infant's sleep area.
  6. Consider offering a pacifier at nap time and bedtime.
  7. Avoid smoke exposure during pregnancy and after birth.
  8. Avoid alcohol and illicit drug use during pregnancy and after birth.
  9. Avoid overheating and head covering in infants.
  10. Pregnant women should obtain regular prenatal care.
  11. Infants should be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention.
  12. Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.
  13. Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
  14. Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly.
  15. There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.
  16. Health care professionals, staff in newborn nurseries and NICUs, and child care providers should endorse and model the SIDS riskreduction recommendations from birth.
  17. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising.
  18. 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.
  19. Continue research and surveillance on the risk factors, causes, and pathophysiologic mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths altogether.

The rationale for these updated recommendations is discussed in detail in the 2016 Technical Report.

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