Thursday , 18 January 2018

AAP Expands Guidelines for Infant Sleep Safety and SIDS Risk Reduction

The American Academy of Pediatrics just updated its recommendations on how to create safe sleeping conditions for infants, and not only are they easy to follow, they could also save new parents money and time. While much of the advice is consistent with the AAP’s previous set of recommendations, released in 2011, the latest includes new thinking on the ideal sleep environment for infants.


Currently, around 3,500 babies die in America each year of SIDS and sleep-related accidents, including strangulation and suffocation. SIDS is different from the latter, because it involves some internal mechanism, or combination of mechanisms, which stops children from breathing, as opposed to their breathing being obstructed by another object. Experts believe that by putting infants to sleep in environments that make it as easy as possible to breathe, these mechanisms are less likely to be triggered. The rate of SIDS dropped sharply in the 1990s, when pediatricians began recommending that infants sleep on their backs, but in recent years, progress in reducing sleep-related infant deaths has stalled.

“The whole phenomenon of SIDS implies that we don’t know 100% what is responsible for the death, but we have theories,” said Dr. Lori Feldman-Winter, member of the Task Force on SIDS and co-author of the report.

The AAP now recommends that babies sleep in the same room, but not the same bed, as their parents, up to the age of 1. Doing so can decrease the risk of SIDS by as much as 50 percent compared with the current rate, making it safer than bed-sharing, or having the infant sleep in another room. Also, room-sharing, compared to bed-sharing, is less likely to lead to other causes of death— including suffocation, strangulation, and entrapment—while still allowing for the regular monitoring of the infant. While the AAP has found that room-sharing improves outcomes up to age of 1, they encourage parents to do it for at least for the first six months of a child’s life, when SIDS is most likely to occur.

“A baby that is within reach of their mother may have more comfort, or physical stimulation form being in an environment with another person,” said Winter, adding that mothers being near their babies also facilitates breastfeeding, which in itself has been shown to reduce the risk of SIDS by 70%.

Other recommendations in the report, many of which are not new, include a ban on anything else in the crib, bassinet, or playpen, besides the child and a firm mattress. This means no bumpers, stuffed animals, pillows, or blankets. Children should always sleep supine, or on their backs. This makes them more likely to arouse, which, while not ideal for their zombie-eyed parents, “is an important protective physiologic response to stressors during sleep.” Once an infant can roll over to her stomach, she can be allowed to stay that way, though her parents should still put her to sleep on her back. Pacifier use can substantially reduce the risk of SIDS, ranging from 50 percent to 90 percent, and should be offered at naptime and bedtime. Lastly, children shouldn’t be left to sleep in car seats, bouncers, swings, strollers, or slings.

One comment

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