Recommendations focus on preventing cot death in infants

A safe sleep environment to prevent sleep-related deaths—including sudden infant death syndrome (SIDS), which is often called cot death or crib death in India—is the focus of a recent policy statement from the American Academy of Pediatrics (AAP). The new statement is intended to reduce the risk of sleep-related suffocation, asphyxia, and entrapment, in addition to SIDS, among infants.

The recommendations in the statement are intended for both healthcare providers and parents. The advice, which you can share with parents and parents-to-be, includes[s2If !is_user_logged_in()]…

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Key Point: A safe sleeping environment for infants is considered one that is free of loose bedding and other objects that can cause entrapment and suffocation. The child should be placed on a firm sleep surface and in the supine position for sleep. Bed sharing is not recommended but room sharing may decrease the risk of SIDS.
  • Place infants in the supine position for sleep for the first year of life; side sleeping is not safe and therefore is not advised.
  • Use a firm sleep surface. Do not place pillows under the infant and do not place them on beds.
  • There should be no gaps between the mattress and the sides of the crib or bassinet.
  • Sharing a room with an infant without bed sharing may decrease the risk of SIDS by as much as 50%. Bed sharing may increase the risk of SIDS or suffocation; no bed-sharing arrangement appears safe.
  • Soft objects and loose bedding (ie, blankets, sheets, bumper pads) should be kept out of the crib to reduce the risk of SIDS, suffocation, entrapment, and strangulation.
  • Regular prenatal care is advised.
  • Mothers should not expose their infants to smoke, as it increases the risk of SIDS.
  • Alcohol and illicit drug use by mothers should be avoided.
  • Breastfeeding is recommended to reduce the risk of SIDS; exclusive breastfeeding is recommended for the first 6 months.
  • Pacifiers at bedtime and naptime may reduce the risk of SIDS, even if the pacifier falls out of the infant’s mouth.
  • Dress the child appropriately for the environment to avoid overheating; infants should be evaluated for signs of overheating (ie, sweating, a chest that feels hot to the touch).
  • Make sure that infants have all of their recommended immunizations.
  • Don’t use special mattresses and other devices marketed to reduce the risk of SIDS because there is no evidence of their effectiveness.
  • Do not use home cardiorespiratory monitors with the intent of reducing the risk of SIDS.
  • Supervised tummy time is recommended when the child is awake.

Source: American Academy of Pediatrics. SIDS and Other Sleep-related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics 2011;128(5):1030-1039.

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