New Recommendations to Prevent Sudden Infant Death Syndrome

The position of a sleeping infant may literally mean the difference between life or death, according to the American Academy of Pediatrics (AAP). Since the 1995 AAP recommendations to change a baby’s sleeping position from stomach to back or side, there has been a 15% – 20% decrease in the incidence of Sudden Infant Death Syndrome (SIDS).

At the AAP conference held recently in Boston, Mass., John Kattwinkel, M.D. discussed the success of the “Back to Sleep” campaign launched in 1994, which encouraged parents to place a baby on its back or side when sleeping. Due in large part to this campaign, the rate of infants sleeping in a prone, or “face-down”position has dropped from 70% in 1992 to 24% in 1996. However, Kattwinkel also announced that the AAP was now modifying its initial recommendations to support the back position as the most preferred. The modification was based on research studies done in New Zealand and England, which noted that side sleepers might roll over into the face down position.

It is estimated that SIDS, also called “crib death,” causes 6,000 deaths annually, primarily in infants under one year of age. The incidence seems slightly more prevalent in male children, and deaths occur more frequently during the winter months. Although the exact cause of SIDS still remains a mystery, one possible explanation may be a lack of oxygen caused by a baby lying face down.

The new report from the AAP urges parents and caregivers to note the following:

* Place infants in a non-prone position, preferably on their back, when putting them to sleep.

* Make sure that bedding is a firm surface. Don’t use fluffy blankets, pillows or crowd the air space with stuffed animals, sheepskin, etc.

* These recommendations are for healthy infants only; there may be certain medical conditions whereby a physician will recommend that a baby be placed in the face down position.

* The back side down, face up position is recommended only for sleeping; a certain amount of “tummy time” is recommended while infants are awake and is being observed. This insures adequate development of upper arm and shoulder muscles.

Previous recommendations, which the AAP still supports, include keeping the baby’s environment smoke-free, and maintaining room temperature at a comfortable, but not too warm, level.