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

Risk Reduction Education

AAP SIDS Risk Reduction Recommendations

The policy recommendations include:

  • Back to sleep: Infants should be placed for sleep in a supine position (wholly on back) for every sleep.
  • Use a firm sleep surface: A firm crib mattress, covered by a sheet, is the recommended sleeping surface.
  • Keep soft objects and loose bedding out of the crib: Pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects should be kept out of an infant’s sleeping environment.
  • Do not smoke during pregnancy: Also avoiding an infant’s exposure to secondhand smoke is advisable for numerous reasons in addition to SIDS risk.
  • A separate but proximate sleeping environment is recommended such as a separate crib in the parent’s bedroom. Bedsharing during sleep is not recommended.
  • Consider offering a pacifier at nap time and bedtime: The pacifier should be used when placing infant down for sleep and not be reinserted once the infant falls asleep.
  • Avoid overheating: The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult. Avoid commercial devices marketed to reduce the risk of SIDS: Although various devices have been developed to maintain sleep position or reduce the risk of rebreathing, none have been tested sufficiently to show efficacy or safety.
  • Do not use home monitors as a strategy to reduce the risk of SIDS: There is no evidence that use of such home monitors decreases the risk of SIDS.
  • Avoid development of positional plagiocephaly (flat back of head): Encourage “tummy time.” Avoid having the infant spend excessive time in car-seat carriers and “bouncers.” Place the infant to sleep with the head to one side for a week and then changing to the other.
  • Ensure that others caring for the infant (child care provider, (child care provider, relative, friend, babysitter) are aware of these recommendations.