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Early Childhood FYI: Key Points from Updated Safe Sleep Recommendations for Newborns and Infants

The updated safe sleep recommendations from the American Academy of Pediatraics were released a few days ago. Here's the key points:

  • Reccomendation for infants to sleep in the room near caregivers is now applicable for at least 6 months rather than one year.

  • Place the child on his/her back to sleep every time

  • Sleep surface should be firm, flat, non inclined

  • It is recommended that weighted products are not used for sleep including weighted swaddles.

  • Use of a pacifier is recommended as there is support that it helps prevent SIDS. (Note: A family could delay the use of a pacifier for breastfed babies until breastfeeding is well established.)

  • The danger of having a hat in the sleep space outweighs the benefits of wearing the hat for warmth so the use of hats is not recommended (except for the first couple days in the hospital after birth.)

  • Layers are recommended for warmth rather than blankets

  • It is recommended that families not bed share for sleep or breastfeed in bed. This is especially not recommended before 4 months of age. After 4 months of age, if you are going to breastfeed while sleeping, it is recommended that this happens in a bed rather than on a couch or chair as these surfaces have a higher likelyhood of having SIDS occur.

  • Infants that can roll can stay in their chosen position. It is not necessary to turn them onto their backs if they choose to roll onto their bellies to sleep.

  • It is recommended to move the baby if he/she falls asleep in sitting position as soon as possible including in the care seat and stroller.

  • Cobedding for multiples is not recommended as the benefits of cobedding do not outweigh the dangers.

(These AAP recommendations apply for up to 1 year of age unless otherwise specified)

Other interesting stuff:

  • The Triple Risk Model - "The triple risk model proposes that SIDS occurs when an infant with intrinsic vulnerability (often manifested by impaired arousal, cardiorespiratory, and/or autonomic responses) undergoes an exogenous trigger event (eg, exposure to an unsafe sleeping environment) during a critical developmental period."

  • Babies who are breastfed for at least 6 months are less likely to experience SIDS. This is especially important for preterm or low birth weight babies.

  • Swaddling is a good strategy for warmth and comfort if a family chooses to use it but swaddling does not protect against SIDS.

  • "Rates of sleep-related death, like other causes of infant mortality, have notable and persistent racial and ethnic disparities, reflecting broader racial and ethnic societal inequities." Read the full article (linked above) for a litle more detail but this is a very interesting point.

  • Survivor bias often happens with this topic. Families will indicate that we dont need to follow these recommendations because they have children who survived infancy without experiencing complications in their sleep even though they didnt follow all of these recommendation. We can't lose sight of the, literally, countless lives that these recommendations have saved when followed by families and child care providers. (Note: Even though families have choice in this matter, child care facilities and providers MUST follow these safe sleep practices while babies are in their care.)

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