Approximately 3,500 infant fatalities in the US are due to sleep-related deaths each year. Infants must have a safe sleep environment to prevent injuries and fatalities. In 2022, the American Academy of Pediatrics (AAP) provided updated recommendations associated with reducing sleep-related deaths and Sudden Infant Death Syndrome (SIDS). Sudden Unexpected Infant Death (SUID) in an umbrella term that describes an unexpected death of a baby less than 1 year old. These deaths include SIDS, accidental suffocation in a sleeping environment, and other deaths from unknown causes.
AAP Safe Sleep Recommendations to Reduce Sleep-Related Deaths
AAP also provided recommendations on breastfeeding, tummy time, immunizations, and pacifier use that are associated with reducing sleep-related deaths. Swaddled infants should always be placed on their back and should no longer be swaddled once they appear to begin to roll. All family members providing care for infants should follow safe sleep practices every nap, every night.
Risks Associated with Sleep-Related Deaths
The AAP encourages parents to practice room-sharing, rather than bed-sharing. Avoid using the term “co-sleeping,” since it is less specific and can include both practices. Bed-sharing raises the risk of infant injury and death. This risk is higher if the baby is younger than 4 months or was born early or with low birth weight. Infants can suffocate when placed with pillows, blankets, or toys, as well as from wedging or entrapment along mattress edges or couch cushions. Infants sharing sleep surfaces with others can die of suffocation or strangulation due to overlap or compression from adults, siblings, or pets rolling over. Avoid parent and infant exposure to nicotine, alcohol, marijuana, opioids, or illicit drugs.
There is no evidence that swaddling reduces risk of SIDS, and weighted swaddles and clothing are not safe. Other hazardous products, like “inclined sleepers” and “crib bumpers” are now illegal due to the Safe for Sleep Babies Act enacted in 2022. Companies have misled parents to think that these products offer a safe sleep environment, but instead they have caused dozens of preventable infant deaths. Despite recalls, millions of these banned products are still in use in many American households, endangering infants who sleep in them.
Sitting devices are not recommended for routine sleep. Infants who fall asleep in car seats, strollers, infant carriers, bouncers, swings, or infant slings should be moved to a safe sleep environment as soon as possible. AAP also does not recommend cardiorespiratory monitor products as a strategy to reduce the risk of SIDS in healthy infants because research does not yet support the use of these relatively new technologies, and they can lead to false alarms. Check with your local hospital for course offerings on life-saving infant CPR and choking skills.
**CASE MANAGER IMPORTANT NOTE: Safe sleep discussions MUST occur at home visits with caregivers for any children under age 1. We MUST also observe the sleeping arrangements in the home for all children but for children under age 1 in the context of safe sleep habits. This discussion and observation must be documented in FSFN.
RESOURCES: CDC
American Academy of Pediatrics
US Consumer Product Safety Commission
Safe Sleep – Florida Department of Children and Families (myflfamilies.com)
