New Recommendations to Avoid Sudden Infant Death Syndrome (SIDS)

The American Academy of Pediatrics (AAP) has updated their policy on best sleep practices to avoid sudden infant death syndrome (SIDS).  The policy titled, SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleep Environment, uses new studies to validate their finding, which is that parents and infants should sleep in the same room; however, they should use different surfaces and never on a couch, soft surface, or armchair.

This is the first update to sleep recommendations by the Academy since 2011.

New evidence from studies suggests that sharing a bedroom reduces risk when done for the first six months, at a minimum, and for the first year of life for the most benefit.

The policy statement is set to be released Monday, 10/24, at the American Academy of Pediatrics National Conference and Exhibition, which will be held in San Francisco, CA.  The report was originally published in the journal, Pediatrics, and it cites new evidence that suggests recommendations for bedside and in-bed sleepers, as well as benefits of skin-to-skin contact with newborns.  The article included recommendations for how to make a safe infant sleep environment.

Dr. Rachel Moon, MD, FAAP, lead author of the article, notes that many parents can become overwhelmed with having a newborn at home, so the goal of AAP is to give sound guidance on sleep positions and locations for their infants.  Dr. Moon adds that babies should never be placed on cushioned chairs, sofas, or couches, even if someone is laying with them.  These surfaces can be dangerous for an infant.

SIDS and other sleep-related deaths, like accidental suffocation or strangulation and ill-defined deaths, account for approximately 3500 infant mortalities every year in the United States.  This number has decreased since the 1990s after the AAP initiated their sleep campaign, but the number has plateaued recently.

Recommendations for an infant safe sleep environment include the following, according to the AAP:

  • Use a firm sleep surface like a bassinet or crib with a tight fitted sheet, and place the infant on his or her back.
  • Avoid soft products like extra blankets, pillows, soft toys, and bumpers. Keep the crib bare and free of anything that could wind up over the infant’s face or cause overheating.
  • For the first year of life (or at least the first six months), parents should share a bedroom with their infant, but not the same sleeping surface. Room-sharing has been known to decrease risk of SIDS by 50%.
  • Do not expose the baby to alcohol, drugs, or smoke.

In addition to the above, Dr. Moon and colleagues recommend skin-to-skin contact immediately after the baby is born, regardless of how they were delivered or how they are feeding.  Doing this for the first hour of life helps decrease the risk of SIDS and other sleep-related deaths.

As additional protection against SIDS, the AAP recommends breastfeeding, followed by immediately putting the baby in their sleeping space.

Dr. Lori Feldman-Winter, MD, FAAP, who is a member of the SIDS Task Force and another author of this new policy, reminds parents that if you feel you might fall asleep while feeding your baby, it is better to feed them in bed rather than on a couch or in a chair.  Move the baby to his or her separate sleeping space as soon as you wake up.  The policy frequently mentions that the baby’s sleep environment should be void of anything that could obstruct breathing or cause the infant to overheat.

Current research says that infants are at higher risk of SIDS between the ages of 1 and 4 months; however, newer studies indicate that soft bedding poses additional dangers to babies even after 4 months.

Further AAP sleep environment recommendations include:

  • Make use of a pacifier for bedtime and naptime.
  • Give infants all recommended vaccinations.
  • Do not use any commercial devices marketed to reduce the risk of SIDS, like positioners and wedges.
  • Facilitate infant physical and mental development with daily supervised, awake tummy time play.

The American Academy of Pediatrics recommends that pediatricians and other family physicians have open conversations with parents about sleep hygiene and practices.  The media can help with community education by presenting messages and images that are in line with the above recommendations.

It is important to share this information without frightening the parents; however, it is vital for them to understand the risks of an unsafe sleep space.  Taking precautionary measures is the best way to keep infants safe without spending a ton of money on home devices.


 Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.


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