Sleeping Baby

SUID/SIDS Gateway

SUID/SIDS Prevention

Resources to Support AAP's Policy Statement
on SIDS and Other Sleep-Related Infant Deaths

The U.S. Maternal and Child Health Bureau's National SUID/SIDS Consortium supports the American Academy of Pediatrics' (AAP) 2011 policy statement, SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment (Policy Statement | Technical Report), with the following resources:


Resources Based on AAP's Recommendations

Level A Recommendations

These recommendations are based on good and consistent scientific evidence. There is high certainty that the net benefit is substantial, and the conclusion is unlikely to be strongly affected by the results of future studies.*

1. Back to sleep for every sleep

2. Use a firm sleep surface

3. Room-sharing without bed-sharing is recommended

4. Keep soft objects and loose bedding out of the crib

5. Pregnant women should receive regular prenatal care

6. Avoid smoke exposure during pregnancy and after birth

7. Avoid alcohol and illicit drug use during pregnancy and after birth

8. Breastfeeding is recommended

9. Consider offering a pacifier at nap time and bedtime

10. Avoid overheating

11. Do not use home cardiorespiratory monitors as a strategy for reducing the risk of SIDS

12. Expand the national campaign to reduce the risks of SIDS to include a major focus on the safe sleep environment and ways to reduce the risks of all sleep related infant deaths, including SIDS, suffocation, and other accidental deaths; pediatricians, family physicians, and other primary care providers should actively participate in this campaign


Level B Recommendations

These recommendations are based on limited or inconsistent scientific evidence. The available evidence is sufficient to determine the effects of the recommendations on health outcomes, but confidence in the estimate is constrained by such factors as the number, size, or quality of individual studies or inconsistent findings across individual studies.*

13. Infants should be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention

14. Avoid commercial devices marketed to reduce the risk of SIDS

15. Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly


Level C Recommendations

These recommendations are based primarily on consensus and expert opinion.*

16. Health care professionals, staff in newborn nurseries and NICUs, and child care providers should endorse the SIDS risk-reduction recommendations from birth

17. Media and manufacturers should follow safe-sleep guidelines in their messaging and advertising

18. Continue research and surveillance on the risk factors, causes, and pathophysiological mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths entirely


General Resources for Professionals


General Resources for Families


Translating Recommendations into Action

The challenge for the field is to effectively communicate the new AAP recommendations and to engage families and communities in implementing the array of behaviors that will address SIDS and suffocation deaths. Meeting this challenge requires a range of approaches and resources that address the varied cultural values, beliefs and practice that inform child-rearing practices:



* Note: AAP's recommendations are based on the US Preventive Services Task Force levels of recommendation.

Level A: Recommendations are based on good and consistent scientific evidence (ie, there are consistent findings from at least 2 well-designed, well-conducted case-control studies, a systematic review, or a meta-analysis). There is high certainty that the net benefit is substantial, and the conclusion is unlikely to be strongly affected by the results of future studies.

Level B: Recommendations are based on limited or inconsistent scientific evidence. The available evidence is sufficient to determine the effects of the recommendations on health outcomes, but confidence in the estimate is constrained by such factors as the number, size, or quality of individual studies or inconsistent findings across individual studies. As more information becomes available, the magnitude or direction of the observed effect could change, and this change may be large enough to alter the conclusion.

Level C: Recommendations are based primarily on consensus and expert opinion

Developed October 2011; Updated July 2012