American Academy of Pediatrics and New Safe Sleep Guidelines

The American Academy of Pediatrics (AAP) has newly released guidelines for reducing the risk of SIDS and other sleep-related infant deaths. One of the most prominent changes involves encouraging parents to keep their baby in their room (but on a separate surface designed for infants) for the first year of life, but at least for the first 6 months. According to the AAP report, there is evidence that this practice decreases the risk of SIDS by as much as 50%. That is great news!Along with these new guidelines, for a safe sleep environment the AAP also recommends: putting infants down on their back to sleep every time, the use of a firm sleep surface, and avoiding soft-bedding and overheating.

Back to sleep, for every sleep...

To reduce the risk of SIDS, infants should be placed for sleep in a supine (wholly on the back) position for every sleep by every caregiver until the child reaches 1 year of age. Side sleeping is not safe and is not advised.

• Contrary to one school of thought among caregivers, sleeping on their back does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux, because infants have airway anatomy and mechanisms that protect against aspiration.

Use a firm sleep surface...

Infants should be placed on a firm sleep surface (if you can squeeze more than two fingers between the mattress and the safety-approved crib, the mattress is too small) covered by a fitted sheet with no other bedding or soft object to reduce the risk of SIDS and suffocation.

• Soft mattresses, including those made from memory foam, could create a pocket or indentation and increases the chance of rebreathing or suffocation if the infant is placed in or rolls over to the prone position. Always check for recalls on cribs, mattresses and other products.

Breastfeeding is recommended...

Breastfeeding is associated with a reduced risk of SIDS. Although the AAP recommends exclusively breastfeeding infants, with the reality that this is not always possible, they add that any breastfeeding has been shown to be more protective against SIDS than no breastfeeding.

• My Girl Friday has also read a lot about local moms who are willing to share their breast milk with other parents in the community. http://www.wakemed.org/landing.cfm?id=135

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.

There is evidence that sleeping in the parents’ room but on a separate surface decreases the risk of SIDS by as much as 50%. In addition, this arrangement is most likely to prevent suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed.

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.

Although the mechanism is yet unclear, studies have reported a protective effect of pacifiers on the incident of SIDS. The protective effect of the pacifier is observed even if the pacifier falls out of the infant’s mouth.

• The infant should not be forced to take the pacifier if they do not want it, and it should be noted that pacifier introduction should be delayed until breastfeeding is firmly established.

Avoid the use of commercial devices that are inconsistent with safe sleep recommendations.

It's an amazing world out there and consumer products keep getting cooler and cooler. Be careful when purchasing a new "trendy" device. First generation models of any piece of technology will have some issues and kinks that need to be worked out.

• For example: wedges, positioners, and other devices placed in the adult bed for the purpose of positioning or separating the infant from others in the bed- as these do not follow safe-sleep practices recommended by the AAP.

Supervised, awake tummy time is recommended to facilitate healthy muscle development.

While it is important to place your baby on his back for sleep, it’s also important to make sure that as he/she gets older, he/she gets some tummy time. Tummy time should take place when your infant is awake and alert. Place your baby on their tummy on a solid surface such as the floor. Place a toy in front of him and engage him in play. Doing this regularly will help strengthen the muscles in his neck.

There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.

If infants are swaddled, they should always be placed on the back. Swaddling should be snug around the chest but allow for ample room at the hips and knees. When an infant shows signs of attempting to roll, swaddling should no longer be used.

For the complete list of guidelines and more specifics on each of the guidelines listed above, please visit the AAP News & Journals Gateway.

By: Leanne Powell, 2016