New AAP Guidelines on Safe Sleep and SIDS Prevention

By Dr. Jonathan Jassey

Approximately every six years, the American Academy of Pediatrics (AAP) updates its safe sleep recommendations with the goal of reducing the risk of sudden infant death syndrome (SIDS), suffocation and strangulation.

I just reviewed the new guidelines released on June 21, 2022, and wanted to share some highlights.

The AAP strongly recommends that parents sleep in the same room as their infant, but in a separate sleep space, for a minimum of six months. Infants should always be placed on their back to sleep and only on a flat – not inclined – surface. They also discouraged bedsharing, reporting that the risk of infant death is 67 times higher if an infant is co-sleeping or sleeping on a soft surface such as a couch or cushion.

“It’s essential for families and pediatricians to partner with each other, to build trust and have thoughtful conversations about how to keep children safe by lowering risks,” said Rebecca Carlin, MD, FAAP, who co-authored the statement and technical report. “We know that many parents choose to share a bed with a child, for instance, perhaps to help with breastfeeding or because of a cultural preference or a belief that it is safe. The evidence is clear that this significantly raises the risk of a baby’s injury or death, however, and for that reason, AAP cannot support bed-sharing under any circumstances.”

Here are more highlights from the report:

  • Sitting devices, such as car seats, strollers, swings, infant carriers, and infant slings, are not recommended for routine sleep in the hospital or at home, particularly for infants younger than four months.
  • Breastfeeding reduces the risk of sleep-related infant deaths. The AAP recommends exclusive human milk feeding for six months, with the continuation of human milk feeding for one year or longer as mutually desired by parent and infant.
  • Avoid parent and infant exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs.
  • Make sure your baby receives routine immunizations
  • Pacifier use is associated with reducing risk of SIDS 
  • Swaddling for sleep should be stopped as soon as babies begin to roll over 

The AAP also pointed to the new federal Safe Sleep for Babies Act which will eliminate potentially unsafe baby sleep products such as inclined sleepers, in-bed sleepers, loungers, and travel/compact sleepers by mid-2022.

I always recommend that parents and caregivers use their best judgment when it comes to their baby’s health and safety. I urge you to read the full AAP guidelines, here.

Dr. Jonathan Jassey is an AAP Board Certified Pediatrician based in Bellmore, NY. He has been in private pediatrician for over 15 years and has been affiliated with his practice since 2007. Dr. Jassey is the co-author of The Newborn Sleep Book and has received the Patients' Choice Award for three consecutive years and the Compassionate Doctor Recognition Award. 

Swaddling is recommended but, the Academy stresses, only when a baby sleeps on the back; swaddling should stop as soon as babies can roll over.

A summary of the key points made by the AAP on safe sleep:

  • Sleeping flat on the back is recommended for as long as possible (up to 1 year)
  • Sleeping in the same room as parents is recommended (up to 1 year)
  • Bed-sharing and sleeping on couches, chairs, etc. are not recommended
  • Swaddling for sleep should be stopped as soon as babies begin to roll over
  • Sitting devices (swings, car seats, etc.) should not be used for sleep
  • There is not enough research on in-bed sleepers (devices that hold babies in place in an adult bed) to determine if they are safe or not.

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