To reduce sleep deaths, the AAP’s ABCs of sleep are paramount:
A=place infants Alone,
B=on their Back and
C=in a clear Crib with only a firm mattress and a tight-fitting sheet.
In 2016, the AAP updated their sleep recommendations. Let’s hear how they expanded them:
- Back to sleep for every sleep: Head of bed elevation has not been found to be protective against reflux, so is no longer recommended!
- Firm surface covered by a fitted sheet: no soft bedding, no bumpers, cribs must meet CPSC requirements. NO sleeping in car seats, swings, or carriers.
- Breastfeed: At least until 6 months if possible; 12 months is even better!
- Room-sharing without bed sharing: A child’s crib should be in the caregiver’s room, ideally until 12 months (but if you can make it to 6 months, that’s great!)
- Keep everything out of the crib: no blankets or pillows, place in a sleep sack. Swaddling has not been found to be protective against SUID.
- Consider offering a pacifier: they are felt to be protective against SUID. The mechanism is unclear, but even if they fall out, still felt to be protective.
- Avoid smoking, drug use and alcohol: during pregnancy and the newborn period (AND especially if bed-sharing, which is NOT recommended).
- Avoid over-heating and head-covering in newborns: once the newborn can regulate temperature, stop covering the head and avoid over-bundling (no more than one layer over what you are wearing).
- Pregnant women should get routine prenatal care.
- Vaccinate per the CDC/AAP guidelines.
- Avoid use of devices that go against these regulations (bumpers/dock-a-tots).
- Cardio-respiratory monitors do not prevent SIDS (owlets).
- Supervised tummy time is recommended.
- Healthcare and childcare providers should model safe sleep: NICU’s should model these recommendations as soon as the patient is stable. Nurseries should model immediately. All daycares should model with every sleep.
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