SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment

Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death occurring during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from being only SIDS-focused to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths including SIDS. The recommendations described in this report include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunization, consideration of a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in this technical report. The recommendations are published in the accompanying “Policy Statement—Sudden Infant Death Syndrome and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment,” which is included in this issue (www.pediatrics.org/cgi/doi/10.1542/ peds.2011-2220). Pediatrics 2011;128:e1341–e1367 METHODOLOGY Literature searches using PubMed were conducted for each of the topics in this technical report and concentrated on articles published since 2005 (when the last policy statement1 was published). In addition, to provide additional information regarding sleep-environment hazards, a white paperwas solicited from the US Consumer Product Safety Commission (CPSC).2 Strength of evidence for recommendations3 was determined by the task force members. Draft versions of the policy statement4 and technical report were submitted to relevant committees and sections of the American Academy of Pediatrics (AAP) for review and comment. After the appropriate revisions were made, a TASK FORCE ON SUDDEN INFANT DEATH SYNDROME

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