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Deborah Greenhouse MD, FAAP
President
South Carolina Chapter
American Academy of Pediatrics
The AAP and Safe Sleep
 1992- Initial recommendation for supine sleep for all
newborns and young infants
 Resulted in significant initial decrease in SIDS but the
rate has stabilized and other causes of sleep-related
death including suffocation, asphyxia and entrapment
have increased over time
Sleep- Related infant deaths in
the US- By the Numbers
 SIDS deaths 1992- 120 deaths per 100,000 live births
 SIDS deaths 2001- 56 deaths per 100,000. The rate has
remained constant through 2006.
Sleep Related Infant Deaths by the
Numbers
 Racial Disparities
 Non-Hispanic Black infant SIDS rates 2005- 99 deaths
per 100,000 live births
 American Indian/ Alaskan native infants- 112 deaths
per 100,000 live births
 Non-Hispanic White infants- 55 deaths per 100,000
live births
The AAP and Safe Sleep
 2011- Expanded recommendations released in an AAP
policy statement focusing on safe sleep with the goal of
decreasing all sleep-related deaths, both explained
and unexplained.
What’s are the Expanded AAP
Recommendations?
 Back to Sleep for every sleep until 1 year of age. Once
the baby can roll supine to prone and prone to supine,
the infant can be allowed to remain in the position
that he or she assumes.
 Use a firm sleep surface- A firm crib mattress with a
fitted sheet is recommended. Sitting devices including
car seats, swings, slings etc. are not recommended.
Expanded AAP Recommendations
 Room sharing without bed sharing is recommended.
Devices designed to make bed sharing safe (ex. In-bed
cosleepers) are not recommended.
 The crib should be free of soft objects and loose
bedding. Bumper pads are not recommended.
Expanded AAP Recommendations
 Avoid smoke exposure during pregnancy and after
birth. There are multiple reasons for this
recommendation in addition to safe sleep concerns.
 Avoid alchohol and illicit drug use during pregnancy
and after birth.
Expanded AAP Recommendations
 Breastfeeding is recommended. Exclusive
breastfeeding provides the most protection in the first
6 months but any breastfeeding provides more
protection than no breastfeeding at all.
 Consider offering a pacifier at naptime and bedtime.
Breastfed infants should not use a pacifier until
breastfeeding is well established.
Expanded AAP Recommendations
 Avoid overheating- This is difficult to define.
Overbundling and covering the face and head should
be avoided.
 Infants should be immunized according to the AAP
and CDC recommendations.
 Avoid commercial devices marketed to reduce the risk
of SIDS.
Expanded AAP Recommendations
 Do not use home monitors to decrease the risk of
SIDS. There is no evidence that they are effective.
 Supervised, awake tummy time is recommended. This
promotes development of motor skills and prevents
positional plagiocephaly.
Expanded AAP Recommendation
 Health care professionals, staff in hospital nurseries
and neonatal ICUs and child care providers should
endorse these recommendations from birth.
 Media and manufacturers should follow these
guidelines in their messaging and advertising.
Expanded AAP Recommendations
 A national campaign should be undertaken to spread
the message of safe sleep recommendations.
 Research should continue to further determine the
risk factors for sleep-related infant deaths with the
ultimate goal of completely eliminating them.
Perfection is not
attainable, but if we
chase perfection we can
catch excellence.
Vince Lombardi

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Safe Sleep for South Carolina’s Babies

  • 1. Deborah Greenhouse MD, FAAP President South Carolina Chapter American Academy of Pediatrics
  • 2. The AAP and Safe Sleep  1992- Initial recommendation for supine sleep for all newborns and young infants  Resulted in significant initial decrease in SIDS but the rate has stabilized and other causes of sleep-related death including suffocation, asphyxia and entrapment have increased over time
  • 3. Sleep- Related infant deaths in the US- By the Numbers  SIDS deaths 1992- 120 deaths per 100,000 live births  SIDS deaths 2001- 56 deaths per 100,000. The rate has remained constant through 2006.
  • 4. Sleep Related Infant Deaths by the Numbers  Racial Disparities  Non-Hispanic Black infant SIDS rates 2005- 99 deaths per 100,000 live births  American Indian/ Alaskan native infants- 112 deaths per 100,000 live births  Non-Hispanic White infants- 55 deaths per 100,000 live births
  • 5. The AAP and Safe Sleep  2011- Expanded recommendations released in an AAP policy statement focusing on safe sleep with the goal of decreasing all sleep-related deaths, both explained and unexplained.
  • 6. What’s are the Expanded AAP Recommendations?  Back to Sleep for every sleep until 1 year of age. Once the baby can roll supine to prone and prone to supine, the infant can be allowed to remain in the position that he or she assumes.  Use a firm sleep surface- A firm crib mattress with a fitted sheet is recommended. Sitting devices including car seats, swings, slings etc. are not recommended.
  • 7. Expanded AAP Recommendations  Room sharing without bed sharing is recommended. Devices designed to make bed sharing safe (ex. In-bed cosleepers) are not recommended.  The crib should be free of soft objects and loose bedding. Bumper pads are not recommended.
  • 8. Expanded AAP Recommendations  Avoid smoke exposure during pregnancy and after birth. There are multiple reasons for this recommendation in addition to safe sleep concerns.  Avoid alchohol and illicit drug use during pregnancy and after birth.
  • 9. Expanded AAP Recommendations  Breastfeeding is recommended. Exclusive breastfeeding provides the most protection in the first 6 months but any breastfeeding provides more protection than no breastfeeding at all.  Consider offering a pacifier at naptime and bedtime. Breastfed infants should not use a pacifier until breastfeeding is well established.
  • 10. Expanded AAP Recommendations  Avoid overheating- This is difficult to define. Overbundling and covering the face and head should be avoided.  Infants should be immunized according to the AAP and CDC recommendations.  Avoid commercial devices marketed to reduce the risk of SIDS.
  • 11. Expanded AAP Recommendations  Do not use home monitors to decrease the risk of SIDS. There is no evidence that they are effective.  Supervised, awake tummy time is recommended. This promotes development of motor skills and prevents positional plagiocephaly.
  • 12. Expanded AAP Recommendation  Health care professionals, staff in hospital nurseries and neonatal ICUs and child care providers should endorse these recommendations from birth.  Media and manufacturers should follow these guidelines in their messaging and advertising.
  • 13. Expanded AAP Recommendations  A national campaign should be undertaken to spread the message of safe sleep recommendations.  Research should continue to further determine the risk factors for sleep-related infant deaths with the ultimate goal of completely eliminating them.
  • 14. Perfection is not attainable, but if we chase perfection we can catch excellence. Vince Lombardi