sleep

AAP Updates Safe Sleep Recommendations for Room Sharing

SAN FRANCISCO—Risk of sudden infant death syndrome (SIDS) can be reduced if infants sleep in the same room as their parents, but on a separate surface such as a crib or bassinet designed for infants, according to new guidelines from the American Academy of Pediatrics.

The guidelines, which are the first update to the safe sleep policy since 2011, recommend room sharing for at least 6 months and ideally up to 1 year. Room sharing can reduce risk of SIDS by up to 50%, the Academy said. However, bed sharing is not recommended.

The Academy’s recommendations include:

  • Infants should sleep on their backs until 1 year of age.
  • Mothers and infants should have skin-to-skin contact for at least an hour as soon as the mother is medically stable and awake after birth.
  • Infants should sleep on a firm surface, such as a crib with an appropriately fitted sheet. Stuffed animals, bedding, or other soft objects should not be in the crib.
  • Crib bumpers should not be used.
  • Mattress toppers that make the sleep surface softer should not be used.
  • Exclusive breastfeeding for at least 6 months reduces SIDS risk, though any breastfeeding is more protective against SIDS than no breastfeeding.
  • For at least 6 months, infants should sleep in the same room, close to their parents’ bed, but on a firm sleeping surface designed for infants. Bed sharing is not recommended.
  • Offering a pacifier at naptime and bedtime is protective against SIDS, though the mechanism remains unknown.
  • Mothers should avoid smoking, alcohol use, and drug use in the prenatal period and after birth.
  • Overheating is associated with SIDS. Infants should be dressed in no more than 1 layer than an adult would use for the particular environment.

More than 3,500 infants die each year of SIDS. Although deaths were reduced greatly in the 1990s after safe sleep recommendations, reductions have recently plateaued.

The Academy also cautions parents and health care providers about the risks of unproven commercial products. “Be particularly wary of devices that claim to reduce the risk of SIDS. Examples include, but are not limited to, wedges and positioners and other devices placed in the adult bed for the purpose of positioning or separating the infant from others in the bed,” the report stated.

—Lauren LeBano