BOSTON — A baby's risk of dying while he sleeps is reduced when he is vaccinated, breast-fed and has no "bumpers" lining the sides of his crib.
Those are the new recommendations pediatricians made today (Oct. 18) to promote safe sleep for babies and decrease the risk of Sudden Infant Death Syndrome (SIDS), also called crib death.
"Our goal is to ultimately eliminate these deaths completely," said Dr. Rachel Moon, a pediatrician at Children's National Medical Center in Washington, D.C., who worked on the new guidelines.
The new recommendations join longer-held advice, such as keeping all loose bedding — including pillows and blankets — out of the crib and avoiding "bed-sharing," in which an infant sleeps in the same bed as a parent or another child.
"There needs to be more education for health care providers and trainees on how to prevent suffocation deaths and to reduce SIDS and other sleep-related infant deaths," Moon said.
The recommendations were part of a new official policy on SIDS prevention from the American Academy of Pediatrics, released here today at the group's annual meeting.
Beyond 'back to sleep'
In 1992, the AAP recommended all babies should be placed on their backs, rather than their tummies, while they sleep. The public health campaign, known as "Back to Sleep," has reduced the incidence of SIDS by 50 percent since its inception, according to the AAP. SIDS now accounts for about 2,300 deaths a year, according to the CDC. However, sleep-related deaths from other causes, including suffocation and choking, have increased.
To further reduce these deaths, the AAP is updating its safe sleep guidelines for children 1 year old and younger.
Infants should be breast-fed, when possible, and immunized with all their shots, the new guidelines say, because studies have shown both reduce the risk of SIDS. [What to Do (And Not to Do) to Ease Kids’ Vaccination Pains]
The ideal baby bed consists solely of a firm crib mattress covered by a fitted sheet, according to the AAP. There should be no gaps between the mattress and the crib.
While items such as stuffed toys, blankets and bumper pads may make a crib look "cute," these things can be dangerous in an infant's crib, Moon said.
Bumper pads pose a risk of suffocation (if the baby rolls up against the pad and doesn't roll away), and strangulation (if the baby gets tangled in the bumper pad ties.)
"There is no reason to have bumpers," Moon said. "They don’t prevent serious injury," she said. Infants don't have enough muscle strength or motor ability to fling themselves against the sides of their cribs with enough force to cause injuries, she said.
Any soft objects or bedding that isn't tightly tucked in beneath the mattress also present risks of suffocation and entrapment, Moon said
Other recommendations from the AAP include:
- Always place your baby on his or her back for every sleep time.
- The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing). This arrangement reduces the risk of SIDS by 50 percent, research shows.
- Infants should not be fed on couches or in armchairs when there is a high risk that the parent will fall asleep.
- Mothers should not smoke before or after pregnancy, as smoking is a major risk factor for SIDS.
- Offer a pacifier at nap time and bedtime. Researchers aren't sure why, but using a pacifier is linked with a reduced risk of SIDS, even if the pacifier falls out of the baby's mouth during sleep.
- Avoid covering the infant's head or allowing him to overheat.
- Do not use home monitors or commercial devices marketed to reduce the risk of SIDS (there is no evidence such devices are safe, or that they reduce SIDS).
- While awake, infants should spend some supervised time on their stomachs. This "tummy time" avoids putting constant pressure on the back of the skull. It also strengthens the baby's neck muscles, which reduces the risk of head deformities that can occur when the baby's head lies on one spot for too long.
Pass it on: In addition to placing babies on their backs, they should be breast-fed and immunized to reduce the risk of SIDS, according to new guidelines on safe sleep for infants.
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Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.