American Academy of Pediatrics Revises Recommendations to Reduce the Incidence of Infant Death

Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS; International Classification of Diseases, 10th Revision [ICD-10], R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After an initial decrease in the 1990s, the overall death rate attributable to sleep-related infant deaths has not declined in more recent years. Many of the modifiable and non-modifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths.

Recommendations for a safe sleep environment include:

  • Supine positioning
  • The use of a firm sleep surface
  • Room-sharing without bed-sharing
  • The avoidance of soft bedding and overheating

Additional recommendations for SID reduction include:

  • The avoidance of exposure to smoke, alcohol and illicit drugs
  • Breastfeeding
  • Routine Immunization
  • Use of a pacifier

New evidence is presented for skin-to-skin care for newborn infants, use of bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. The recommendations and strength of evidence for each recommendation are included in this policy statement. The rationale for these recommendations is discussed in detail in the accompanying technical report

Research Briefs

Preterm Delivery and Age of SIDS Death
Purpose: The aim of the study is to (1) reexamine risk factors for sudden infant death syndrome (SIDS). Conclusions: Preterm birth continues to be a strong risk factor for SIDS after controlling for fetal growth. With increasing gestational age, mean age of SIDS death decreases considerably, with the postnatal age of death of very preterm infants, 6 weeks later than that of term infants.

Second-Trimester Maternal Serum Levels of Alpha-Fetoprotein and the Subsequent Risk of Sudden Infant Death Syndrome
This study investigates whether second-trimester maternal alpha-fetoprotein levels are associated with the future risk of sudden infant death syndrome (SIDS) and stillbirth. Researchers conducted this study in Scotland by linking a prenatal screening database for women with databases of maternity, perinatal death, and birth and death certifications of assess the association. The results of the study indicate that there is a direct association between second-trimester maternal serum alpha-fetoprotein levels and the risk of SIDS, which may be mediated in part through impaired fetal growth and preterm birth.

Related Research/Topics

The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk

Influence of Sleep Position Experience on Ability of Prone-Sleeping Infants to Escape From Asphyxiating Microenvironments by Changing Head Position

Study Confirms Safety of Placing Infants to Sleep on their Backs Infant Who Sleep on Back Have Fewer Fevers and Ear Infections

Heat Stress and Sudden Infant Death Syndrome Incidence: A United States Population Epidemiologic Study

Sleep Position of Low Birth Weight Infants

Effect of Prone Sleeping on Circulatory Control in Infants

Changing Infants' Sleep Position Increases Risk of Sudden Infant Death Syndrome (unaccustomed prone sleeping)

Potential to Prevent Carbon Dioxide Rebreathing of Commercial Products Marketed to Reduce Sudden Infant Death Syndrome Risk

SIDS and Other Sleep-Related Infant Deaths: Updated Recommendations for a Safe Sleep Environment
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