US updates baby safe sleeping guidelines

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US safe baby sleeping guidelines have been updated and brought in line with those recognised by Australian health authorities.

The American Academy of Paediatrics (AAP) issued the recommendations which emphasise the importance of a baby sleeping in the same room - but not the same bed - as the mother for at least the first six months of life.

After reviewing research on sudden infant death syndrome, the AAP is reinforcing previous advice that the safest way to put an infant down to sleep is on the baby's back and be in a separate bed near the mother.

Dannai Harriel, program manager of Allegheny County's Maternal and Child Health Program, said sharing a room is already popular with some families.

"I think it will reinforce what families want to believe," she said.

"They want to be close to their children. We can say to our families: This is a win for you."

A member of the task force that developed the AAP guidelines, Lori Feldman-Winter, said the recommendations are aimed at reducing the number of babies lost to SIDS.

"Studies were done showing you can decrease (SIDS) risk by 50 per cent and they included infants up to 1 year," she said.

The highest risk of death by SIDS occurs in infants under 6 months old.


"We know from additional evidence, room-sharing facilitates breastfeeding," Dr Feldman-Winter said, adding that exclusive breastfeeding has been linked to reducing the risk of SIDS by up to 70 per cent.

It's the academy's first update of safe-sleep guidelines in five years. Key recommendations include:

  • Baby sleeps on his back, on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
  • The cot should be empty: no soft bedding, including bumpers, blankets, pillows and soft toys.
  • Put baby to sleep on a separate surface in the parents' bedroom.
  • Skin-to-skin care should start immediately after delivery, for at least an hour.
  • Breastfeeding is recommended. After feeding, the baby should be moved to his or her separate sleeping surface.

Other recommendations from the academy, which are in line with Australian recommendations, include offering a dummy at sleep time after breastfeeding is established, keeping a child up to date with vaccinations, regular tummy time while awake to help development, and avoiding use of home monitors or other devices that claim to reduce the risk of SIDS.

"Just because these are marketed and being sold doesn't mean it's safe for your baby," Feldman-Winter pointed out.

"Portable cribs are fine, playpens are okay as long as they have a tight-fitting mattress and tight-fitting sheet."

SIDS-prevention devices aren't helpful, she said.

"That's really sending the wrong message. It assumes the baby will be in a separate sleep environment."

In addition to these new US recommendations, Australian safe baby sleep guidelines state:

  • Never sleep your baby on his tummy or side in any environment, even when resting on an adult's chest. 
  • Never leave your baby surrounded by loose bedding, toys or clothing.
  • Don't sleep your baby on a tri-pillow (boomerang pillow), bean bag or hammock.
  • Don't expose your baby to cigarette smoke.