The American Academy of Pediatrics (AAP) issued new guidelines today concerning Sudden Infant Death Syndrome (SIDS). SIDS is the sudden death of an infant under 1 year of age which remains unexplained after a thorough investigation.
According to the Academy, Sudden Infant Death Syndrome continues to be responsible for more infant deaths in the United States than any other cause of death during infancy. The occurrence of SIDS is rare during the first months of life, increases to a peak between 2 and 3 months of age, and then decreases. The primary risk factors for SIDS are:
• Prone sleep position
• Sleeping on a soft surface
• Maternal smoking during pregnancy
• Late or no prenatal care
• Young maternal age
• Preterm birth and/or low birth weight
• Male gender
Consistently higher rates are found in black and American Indian/Alaska Native children – 2 to 3 times the national average.
In 1992, the American Academy of Pediatrics released a recommendation that infants be placed down for sleep in a non-prone position. Both side sleeping and back sleeping were recommended. Campaigns to encourage parents to put babies to sleep on their sides or back resulted in a consistent decrease in the SIDS rate.
After further study, AAP no longer recognizes side sleeping as a reasonable alternative to back sleeping. Studies have found that the side sleep position is unstable and increases the chances of the infant rolling onto his or her stomach. The Academy now recommends that parents use the back sleep position during every sleep period.
Research into SIDS has shown an interesting relationship between pacifiers and SIDS, with several studies reporting a protective effect of pacifiers. The Academy now recommends the use of pacifiers at nap time and bedtime throughout the first year of life.
The new guidelines issued by the American Academy of Pediatrics include the following:
• Infants should be placed on their back for every sleep.
• A firm crib mattress, covered by a sheet, is the recommended sleeping surface.
• Keep soft objects and loose bedding out of the crib.
• Do not smoke during pregnancy and avoid exposing infants to second hand smoke.
• Bed sharing during sleep is not recommended. A separate but close sleeping environment is recommended such as a separate crib in the parent’s bedroom.
• Consider offering a pacifier at nap time and bedtime. The pacifier should be used when placing the infant down for sleep and should not be reinserted once the infant falls asleep.
• The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable.
• Assure that everyone caring for the infant is aware of the recommendations.