SIDS Program Manual SIDS & Infant Death Program Manual and Trainer's Guide Trainer's Guide

What is SIDS?

Modifiable Risk Factors

Sleeping baby

Prone Sleep Position and the Back to Sleep Campaign

In the United States during the 1980s, researchers initially did not believe that stomach (prone) sleep was a risk factor for SIDS because most infants slept on their stomachs. However, in countries where fewer infants normally slept on their stomachs, the higher rates of SIDS among infants who slept prone made the prone-sleep position a very strong risk factor. The finding of this strong risk factor in other countries led researchers to try to figure out how prone sleep was associated with infant death.

In April 1992, the AAP’s Task Force on Infant Sleep Position issued a statement recommending that infants be placed on their back or side to sleep to reduce the risk of SIDS. The recommendation came after the AAP reviewed extensive international research that indicated that sleep position was a factor for SIDS risk.

In 1994, the national BTS campaign was initiated as a joint effort of the U.S. Public Health Service’s (USPHS’s) NICHD and MCHB, the AAP, the SIDS Alliance (now First Candle/ SIDS Alliance) and the Association of SIDS and Infant Mortality Programs (ASIP).

In 1996 at the fourth SIDS International Conference, it was reported that infants who sleep on their sides have a greater risk of dying from SIDS than infants who sleep on their backs. As a result of the ongoing research on sleep position and SIDS, the AAP changed its message to pediatricians and parents to recommend the supine (back) sleep position as the preferred sleep position.

According to the 2005 AAP policy statement on SIDS, The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk, the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping.