Babies Should Sleep in Parents' Bedroom for First Year to Reduce SIDS Risk, Updated AAP Sleep Safety Recommendations Say

Approximately 3500 infants die each year in the United States from sleep-related deaths, including sudden infant death syndrome (SIDS).¹ SIDS is defined as the sudden, unexplained death of an infant younger than 1 year of age. After the American Academy of Pediatrics (AAP) recommended placing infants to sleep on their backs in the 1990s, deaths due to SIDS initially decreased.² However, the overall infant death rate hasn’t declined in recent years.

The most notable update to the recommendations is for infants to share their parents’ bedroom for at least the first 6 months, but ideally for the full first year of life.² Infants should be placed to sleep on their backs in a separate sleeping surface, such as a crib or bassinet. Evidence suggests that sharing a bedroom can decrease the risk of SIDS by about 50%.

The AAP report includes the following other recommendations:²

• Use a firm sleep mattress covered by a fitted sheet with no other bedding or soft objects.
• Breastfeeding is recommended to reduce the risk of SIDS.
• Couches and armchairs should never be used as sleep surfaces because they drastically increase the risk of SIDS.
• Pacifiers can be offered at bedtime, as evidence suggests they may decrease the risk of SIDS.
• Smoke exposure should be avoided during pregnancy and after birth. Smoke exposure can increase the risk of SIDS. Families should be encouraged to maintain smoke-free homes.
• Alcohol and illicit drug use can increase the risk of SIDS and should be avoided during pregnancy and after birth.
• Pregnant women should obtain regular prenatal care.
• Infants should receive all CDC recommended immunizations because recent evidence suggests that vaccines may have a protective effect against SIDS.
• Manufacturers and media advertisements should follow and encourage safe sleep practices.
• All health care professionals should participate in the “Safe to Sleep” campaign.
• Further research on SIDS risk factors and prevention strategies should be conducted.

Pharmacists can play an important role in educating patients in the community and hospital setting about the AAP recommendations. Also, pharmacists can play an integral role in appropriate prenatal care. This can include collaborating with the OB/GYN and recommending prenatal vitamins.

The AAP recommends breastfeeding; however, this may not be feasible for all patients. Some mothers may be taking medications that aren’t compatible with breastfeeding or they may be more comfortable with formula feeding. Pharmacists can make patients feel comfortable with this decision and emphasize the many other recommendations that can decrease the risk of SIDS. Additionally, pharmacists can emphasize the importance of staying up-to-date on all vaccines to reduce the risk of SIDS. Pharmacists can provide smoking cessation programs to reduce the risk of complications during pregnancy and birth. Also, pharmacists can collaborate with other health care professionals to emphasize the importance of the “Safe to Sleep” campaign to reduce the risk of SIDS.

References

• American Academy of Pediatrics. AAP announces new safe sleep recommendations to protect against SIDS, sleep-related infant deaths. AAP website. healthychildren.org/English/news/Pages/AAP-Announces-New-Safe-Sleep-Recommendations-to-Protect-Against-SIDS-Sleep-Related-Infant-Deaths.aspx.
• AAP Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016; 138(5):e20162938.