AAP Revises SIDS Prevention Guidelines ~ Christina Elston

The American Academy of Pediatrics (AAP) has revised its guidelines and recommendations for the prevention of sudden infant death syndrome (SIDS), the nation’s leading cause of infant deaths beyond the newborn period.

The pediatric organization announced the revision Oct. 10 at its national conference in Washington, D.C. Previous AAP recommendations on SIDS have included avoiding soft bedding, pillows and fluffy crib toys; keeping babies away from cigarette smoke; and dressing infants lightly for sleep. The newly updated guidelines suggest three new practices:

• Avoid side sleeping. Put infants down to sleep only on their backs. The organization previously recommended putting infants to sleep on their backs or sides, because research has shown that stomach sleeping is associated with increased SIDS risk. However, subsequent studies have found that infants placed on their sides often roll onto their stomachs. “A lot of babies that start on their sides end up in a different position,” says AAP spokesperson Rachel Moon, M.D., who adds that propping infants with wedges or pillows also isn’t recommended because of the danger of suffocation.

• Keep infants in close proximity to, but not in the same bed as, caregivers. Babies who share a bed with an adult are in danger of falling off the bed, or having the adult roll onto them, according to Moon. And adult bedding is just the type of soft stuff that increases SIDS risk. “You put your hand on a baby mattress and you can’t dent it,” she says. Sharing a room, on the other hand, decreases risk of SIDS by up to 20 percent, possibly because it keeps the baby from sleeping too soundly. “If you’re in the same room with the baby, neither one of you sleep quite as deeply,” Moon notes.

• Offer a pacifier. Given the continuing debate about whether pacifier use leads to such health problems as ear infections, this recommendation might take parents by surprise. “It surprised us, too,” says Moon, but she adds that some studies found pacifier use decreases SIDS risk by up to 90 percent. Though researchers don’t yet know why, Moon says, “just about every study that has looked at it – that’s what we find.” The AAP recommends that caregivers offer a pacifier at naptime and bedtime, but not force it if the infant refuses.

SIDS and the Heart

Sleeping habits aren’t the only factor in recent SIDS studies. Researchers reporting at the European Society of Cardiology’s annual meeting in September found that as many as one in 10 cases of SIDS could be prevented by early screening for a heart condition called long Q-T syndrome. The syndrome is a hereditary disorder of the heart’s electrical rhythm that can lead to an abnormally rapid heart rhythm (arrhythmia). It usually affects children and young adults.

Researchers found that up to 8.4 percent of SIDS victims carry genetic mutations associated with the treatable condition, which has long been suspected as a cause of some SIDS cases.

Christina Elston is the contributing health editor for United Parenting Publications.

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