The ABCs of Infant Safe Sleep

By: Dr. Nicole Baumann-Blackmore, Pediatric Hospital Medicine

Sudden infant death syndrome (SIDS), defined as the sudden death of an infant less than one year of age that cannot be explained after a thorough investigation, is the leading cause of death among infants aged 1 to 12 months in the United States. This staggering statistic, along with the infant deaths that are able to be attributed to accidental strangulation or suffocation in bed, demonstrate the continued need to provide safe sleep information to parents and caregivers of infants. In 2011, the American Academy of Pediatrics (AAP) updated its recommendations for a safe sleep environment for infants. Here are some of the key recommendations that should be used consistently for all infants up to 12 months of age:

1.) Back to sleep for every sleep – Infants should be placed in the supine position (completely on their back) for every sleep by every caregiver until 12 months of age. Once a baby is able to roll over, they should still be placed to sleep on their back but then allowed to stay in whatever position they assume during sleep.
2.) Use a firm sleep surface – A firm crib mattress, covered with a fitted sheet, is the preferred sleeping surface. All cribs, bassinets or portable cribs used should conform to the safety standards of the Consumer Product Safety Commission.
3.) Room-sharing without bed-sharing – Some studies have shown that this sleep arrangement may decrease the risk of SIDS by up to 50%, and it makes nighttime feedings and diaper changes more convenient!
4.) Keep soft objects and loose bedding out of the crib – No pillows, stuffed animals, toys, bumper pads, sleep positioning devices, etc.
5.) Avoid smoking, alcohol use and illicit drug use both during pregnancy and after birth. Avoiding second hand smoke exposure is also important.
6.) Breastfeeding is recommended. If possible, mothers should exclusively breastfeed or feed expressed breast milk until 6 months of age. The protective effect of breastfeeding increases with exclusivity. However, any breastfeeding has been shown to be more protective against SIDS than no breastfeeding.
7.) Consider offering a pacifier at naptime and bedtime once breastfeeding has been well established, usually 3-4 weeks. The pacifier does not need to be replaced if it falls out. Do not attach the pacifier to the baby’s clothing, hang it around their neck or attach it to a stuffed toy.
8.) Avoid overheating – Infants should be dressed appropriately for their environment with no more than one layer more than an adult would wear to be comfortable in that environment.

These are just some of the important recommendations provided by the AAP. To learn more, speak with your child’s primary care physician or visit any of the following websites:

Please help keep your baby safe and reduce the incidence of infant death due to unsafe sleep environments. Follow and teach others the ABCs of safe sleep!

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