SIDS Update: Changes to Know About

Since 1992, when the American Academy of Pediatrics recommended that all babies be placed on their backs to sleep, deaths from SIDS have declined dramatically. However, sleep-related deaths from other causes, including suffocation, entrapment and asphyxia, have increased.

A new, updated policy has recently been issued and includes 3 important changes:

First (and this is big), since 2005 there has been a lot of research showing that breastfeeding protects against SIDS. So add the prevention of SIDS deaths to all the other significant benefits of nursing for at least the first 6-12 months.

The second change is an emphasis on immunization.

There’s been a lot of press about how immunizations may contribute to SIDS deaths. Again, there’s been conclusive research that shows this is absolutely not the case. In fact, if infants are immunized the risk of SIDS drops by 50%.

The third big change is the recommendation against using bumper pads in cribs, which can prevent accidental smothering.

The recommendations in the policy statement have been expanded to focus not only on SIDS, but on other crib-related deaths that can occur. The AAP is recommending against the cushions that go along the sides of the crib because babies can be suffocated by them.

Other key recommendations are:

• Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
• The baby may sleep in the same room as the parents, but not in the same bed (room sharing without bed sharing).
• Keep soft objects or loose bedding out of the crib.
• Avoid the use of wedges and positioners.
• Offer a pacifier at nap time and bedtime.
• Do not cover the infant’s head or overdress him, which could cause overheating.
• Stay away from home monitors or commercial devices marketed to reduce the risk for SIDS as they are not effective.
• Provide supervised, awake tummy time to promote development and minimize flat heads.

Eve R. Colson, MD, from the Yale University School of Medicine, New Haven, Connecticut is very happy to see this focus on preventing accidental deaths.

“As a director of our nursery and somebody who is really into medical education of families and of staff, I am glad to see this because we have seen lots of accidental deaths,” Dr. Colson, who was not a member of the policy statement task force, said.

“We, at Yale, have been so upset by the increased number of deaths in beds. The adult bed is not a safe place and I’m glad they’ve come out with this recommendation. We get SIDS deaths in our emergency room, but we also get babies who have suffocated because somebody rolled on them or they have ended up underneath a pillow or got trapped between the mattress and the wall. This is what we have seen and we want to prevent that.”