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

Abstract

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).

An Investigation of the Nurse Practitioner’s Knowledge and Self-Efficacy on Expanded Back to Sleep Guidelines and Practice of Providing Anticipatory Guidance: A Descriptive Correlational Study

“…Expanded guidelines from the AAP advises health care professionals, staff in the NICU and newborn nurseries, and child care providers to endorse and model SIDS risk-reduction recommendations (Meadows-Oliver & Hendrie, 2013). Furthermore, primary care-based interventions, particularly those addressing caregiver concerns and misconceptions about safe sleep recommendations, can be valuable in improving adherence with recommendations among their patients (Moon, 2011). The AAP recommends primary care providers develop quality improvement initiatives to foster adherence with the expanded recommendations (Moon, 2011).…”

“…The AAP recommends primary care providers develop quality improvement initiatives to foster adherence with the expanded recommendations (Moon, 2011). With improved modeling and education of the SIDS risk-reduction recommendations by health care professionals; advertisements following safe sleep guidelines; expansion of national campaigns; and continued research and surveillance on risk factors, causes, and pathophysiological mechanisms of SIDS and SUIDS; there can be more public awareness and therefore, an overall reduction in the risk of both SIDS and other sleep-related infant deaths (MeadowsOliver & Hendrie, 2013;Moon, 2011).…”

“…No wedges or positioning devices should be used, and soft objects and loose bedding should be kept out of the crib (Moon, 2011). 4. An infant sleep surface be in close proximity to the parent's bed to foster comforting, feeding and monitoring (Moon, 2011).…”

“…An infant sleep surface be in close proximity to the parent's bed to foster comforting, feeding and monitoring (Moon, 2011). (This "room sharing" has been found to reduce SIDS).…”

“…No one should share sleep surfaces with an infant (Moon, 2011). ("bed sharing" in which the infant sleeps on the same surface, such as a bed, couch or chair with another person, increases risk of suffocation and other sleep-related causes of death (Moon, 2011). 6.…”