Safe sleeping guidelines go beyond 'Back to sleep'

Last week the American Academy of Pediatrics refined its infant sleep guidelines. By encouraging infants to sleep on their backs exclusively, SIDS rates have declined significantly but preventable infant deaths still occur. Most infant deaths now are the result of suffocation, asphyxia and entrapment and as such the guidelines have been revised.

In addition to placing infants on their backs to sleep, the AAP recommends that parents who want to have infants nearby, have the infant sleep in his own bed with a firm mattress and no blankets, stuffed toys or bumpers. Co-sleeping is popular for some families but confers risks of suffocation or asphyxiation either due to soft bedding or by laying too close to a sleeping parent and as such it is not as safe as infants sleeping in their own beds.

Other things parents can do to decrease infant deaths while sleeping include breastfeeding, preventing all smoke exposure, having your baby use a pacifier and not over dressing your baby at bedtime. Infants who are overheated are at greater risk of dying. Even without a blanket, if you have your baby in a onesie and a sleeper, the ambient room temperature should only be 67-70 degrees for the safest sleep environment. Circulating the air in the room by having a window open when weather permits or using a fan also decreases the risk of infant death.

Another interesting association highlighted in the new guidlelines is that infants receiving vaccines on the routine schedule also have lower rates of sleep related deaths than infants who are undervaccinated. Getting vaccinated makes sense.

For parents concerned about babies getting legs or arms stuck in the crib rails, mesh bumpers can do the job without any of the increased risk associated with traditional bumper pads.

All in all, the ‘Back to sleep’ campaign has worked well to substantially reduce the risk of infant death while sleeping and with a few more interventions the risk can be decreased even more.