Sleep Position/Environment and Sudden Infant Death Syndrome (SIDS)

SIDS is the leading cause of infant death beyond the neonatal period.  Since 1992 when the American Academy of Pediatrics recommended that babies be positioned on their backs while sleeping, the SIDS rate in the United States has decreased by greater than forty percent.  The AAP has made the following recommendations concerning infant sleep:

  • Infants should be placed for sleep on their back.  Supine (wholly on the back) confers the lowest risk and is preferred.
  • Only allow your baby to sleep in a crib that conforms to the safety standards of the Consumer Product Safety Commission and the American Society for Testing and Materials.
  • Infants should not be put to sleep on waterbeds, sofas, soft mattresses, or other soft surfaces.
  • Avoid soft materials in the infant’s sleeping environment (plush blankets, stuffed animals, or pillows).
  • Bed sharing or co-sleeping may be hazardous as well.
  • Overheating should be avoided.  The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult.  Over bundling should be avoided, and the infant should not feel hot to the touch.
  • A certain amount of tummy time while the infant is awake and observed is recommended for developmental reasons and to help prevent flat spots on the head.  Consider alternating the side of the head the infant sleeps on weekly or daily.
  • Sleep positioning devices are not recommended.
  • There is no evidence that home apnea monitors decrease the incidence of SIDS.
  • A pacifier used during sleep time can decrease the risk of SIDS, however for dental reasons, all pacifier use should be discontinued after the first birthday.