Have you been told that co-sleeping is best for your new baby? Or that placing babies on an incline is better than having them sleep on a flat mattress?
The American Academy of Pediatrics (AAP) disagrees!
The AAP, an organization of 67,000 pediatricians dedicated to all aspects of children’s health from infancy to young adulthood, recently updated their safe-sleep guidelines for the first time since 2016. At the top of their list—their “A-level recommendations”—is keeping babies on their backs on firm, flat surfaces near (but separate from) their caregivers.
SIDS (sudden infant death syndrome), also known as SUID (sudden unexpected infant death) or “crib death,” is the leading cause of death among babies between 1 month and 1 year of age. And it can even happen to healthy infants.
While the exact cause of SIDS/SUID is still unknown, there are several factors that put babies at a higher risk. According to Jill Lucas Drakeford, a safe sleep expert and health educator with Carilion Children’s, babies are at a higher risk for SIDS if they:
- Sleep on their stomachs
- Sleep on or under soft or loose bedding
- Get too hot during sleep
- Sleep on soft surfaces, such as an adult mattress, couch or chair
- Are exposed to cigarette smoke in the womb or in their environment
- Sleep in an adult bed with parents, other children or pets
Read on for guidance on how best to protect your baby from SIDS/SUID.
- Always place babies on their backs to sleep.
- Use a firm, flat, noninclined sleep surface to reduce the risk of suffocation or wedging/entrapment.
- When infants fall asleep in a sitting device, remove them from the product and move them to a crib or other appropriate flat surface. Sitting devices are items such as car seats, strollers, swings, infant carriers and infant slings or bouncy seats.
- Feed babies with human milk because it is associated with a reduced risk of SIDS.
- Have infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for at least the first 6 months.
- Keep soft objects, such as pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like materials and loose bedding, such as blankets and nonfitted sheets, away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment/wedging and strangulation.
- Offer a pacifier at naptime and bedtime to reduce the risk of SIDS.
- Avoid smoke and nicotine exposure during pregnancy and after birth.
- Avoid alcohol, marijuana, opioids and illicit drug use during pregnancy and after birth.
- Avoid overheating/overbundling and head covering.
- Obtain regular prenatal care when pregnant.
- Immunize infants in accordance with guidelines from the AAP and U.S. Centers for Disease Control and Prevention.
- Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.
- Use supervised, awake tummy time to help your child develop and to minimize the risk of positional plagiocephaly. Do this for short periods of time beginning soon after hospital discharge, slowly increasing to at least 15-30 minutes total daily by age seven weeks.
The AAP also notes that there is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS. When an infant exhibits signs of attempting to roll (which usually occurs at age three to four months but may occur earlier), swaddling is no longer appropriate.
While many of these recommendations look like common sense, some of them differ from the advice parents, grandparents and other well-meaning people received when their children were young.
If you have any questions about how to care for your baby—awake or asleep—contact your family’s pediatrician.