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:
- 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.
- 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.
- Unless contraindicated, mothers should breastfeed exclusively or feed with expressed milk (ie, not offer any formula or other nonhuman milkbased supplements) for 6 months.
- 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.
- Keep soft objects and loose bedding away from the infant's sleep area.
- Consider offering a pacifier at nap time and bedtime.
- 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.
- Pregnant women should obtain regular prenatal care.
- Infants should be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention.
- Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.
- Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
- Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly.
- There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.
- Health care professionals, staff in newborn nurseries and NICUs, and child care providers should endorse and model the SIDS riskreduction recommendations from birth.
- Media and manufacturers should follow safe sleep guidelines in their messaging and advertising.
- 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.
- 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.