Placing infants on their backs, breastfeeding and immunizations are among the recommendations in the new guidelines issued by the American Academy of Pediatrics (AAP) for better sleep and minimizing the risk of SIDS (Sudden Infant Death Syndrome), also known as crib death and cot death. At the National Academy of Pediatrics National Conference & Exhibition 2011, Boston, Mass., Rachel Moon, MD, FAAP said pediatricians have received a bit of scientific support from the AAP when they coach new parents on how to put infants down to sleep.
The recommendations have been published in this week’s issue of the journal Pediatrics.
Dr. Moon presented “Safe Sleep for Infants” in the conference on Monday 17th October. Dr. Moon said:
“This is an important issue because we still need to get the word out to many families about what the recommendations are and, more importantly, we need to educate our physicians about why people make the decisions they do. For instance, why do parents put babies on their stomachs?
We want to help pediatricians better explain the recommendations to parents, and if doctors have a better sense of the barriers they’ll encounter, they can proactively address them. These new recommendations are more helpful and should make it easier (for pediatricians) to coach parents through any issues they may have.
Dr. Moon informs that several sleep-related deaths among infants are linked to factors in their sleep environment. In her presentation she reviewed the epidemiological evidence on sleep-related infant death, including SIDS (Sudden Infant Death Syndrome), strangulation and suffocation.
Placing baby on his back to sleep reduces risk of SIDS
Dr. Moon said:
“One of the issues we covered in the new document is breastfeeding. In the past, there was not enough evidence to say breastfeeding reduced the risk of SIDS. However, newer research supports that statement, and pediatricians need to let parents know that this is one more great reason to breastfeed your baby.”
Pacifiers have also been shown to reduce the risk of SIDS. The AAP suggests parents offer pacifiers to their infants.
Dr. Moon added that there is good compelling evidence showing no link between immunizations and SIDS. In fact, immunizations reduce the risk of SIDS by about 50%.
The recommendations also advise parents to get rid of bumper pads. Dr. Moon said “If you’ve got bumper pads in your crib, they need to go.” Previous guidelines recommended that certain types of puffy bumper pads not be used – now the AAP says it is against all types. There is no evidence bumper pads prevent injuries, but they raise the risk of entrapment, strangulation or suffocation.
Being in the same room as the infant is fine, as long as he/she is not in the same bed as the parents. Being in the same bed raises the risk of suffocation. Being in the same room and close to the baby makes feeding more convenient and the monitoring of the baby more effective.
Dr. Moon added:
“The nice thing about these new recommendations is that, while some of these things may be unpopular with patients, the AAP is trying to answer some frequently asked questions that will make things much more concrete and specific for people. These recommendations are not arbitrary; we can tell you why your baby has to sleep on her back.”
Regarding what health care professionals can do to properly promote safe sleep education, Dr. Moon said:
“We know more now than we did a generation ago,” she said. “We know a lot more about safety in general, to be honest. Now we know more about why certain practices are safe and why others are not, and we want to be sure that parents know this as well.”
In short, the AAP recommends, among other things, the following to promote good sleep and minimize the risk of SIDS:
- Place infants on their backs to sleep. There should be nothing else in the crib/bassinet, such as cuddly toys, bumper pads, etc.
- Breastfeed the baby
- Make sure the infant has his/her scheduled shots
- Don’t sleep with infant in same bed
- Keeping infant in your bedroom is fine
SIDS is the unexpected and sudden death of an infant or baby under the age of two years who appeared to be healthy. In the majority of cases, death occurs when the baby is sleeping. Most cases of SIDS happen during the first six months of the infant’s life.
Approximately 2,500 babies die from SIDS each year in the USA, says the American SIDS Institute. According to the NHS (National Health Service), about 300 babies die in the UK from SIDS annually.
SIDS is the most common reasons for death among babies aged at least one month.
More boys than girls die from SIDS. Low birth weight babies, as well as premature infants have a higher risk of SIDS.
An SIDS event is devastating, bewildering and shocking for parents – it occurs with no warning and there is usually no clear cause.
Even though SIDS is a common cause of infant deaths, the risk is tiny. In 2005 in the USA, SIDS was responsible for 0.542 deaths per 1,000 live births.
Written by Christian Nordqvist