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Dr. Tayloe Article on Preventing Crib Death: New Recommendations from the American Academy of Pediatrics

Posted: 11/11/2011

PREVENTING CRIB DEATH:  NEW RECOMMENDATIONS FROM THE AMERICAN ACADEMY OF PEDIATRICS

 

Crib Death (Sudden Infant Death Syndrome (SIDS)) is the leading cause of death in babies between the ages of one month and one year.  Most of these tragedies could be prevented if families would adopt new recommendations from the American Academy of Pediatrics (AAP).  The recent AAP policy statement (SIDS and Other Sleep-Related Infant Deaths:  Expansion of Recommendations for a Safe Infant Sleeping Environment (www.pediatrics.org/cgi/doi/10.1542/peds2011:2284)) and Technical Report of the same title (www.pediatrics.org/cgi/content/fuill/128/4/e1341) outline and discuss these recommendations.  Interested persons can go to the AAP website (www.aap.org) and find these documents by clicking on “policy statements.”

 

In 1992, the AAP recommended that all babies sleep on their backs and SIDS rates dropped precipitously.  Today, these rates are trending back up because of the rising number of Sudden Unexpected Infant Deaths (SUIDS).  It is difficult to separate SIDS (unexplained infant deaths that occur during sleep) from SUIDS (infant deaths that are thought to be due to suffocation or strangulation secondary to unsafe sleeping conditions), and often the statisticians lump these groups together and just call them SIDS.

 

The new recommendations address probable causes of SIDS and SUIDS and there is no question that infant death rates would plummet if all families could follow these recommendations.  The most important recommendations for families are:

 

1.  Whenever the responsible adults cannot give their undivided attention to their babies, the babies should be placed on their backs in their own cribs or bassinets.

 

2.  Babies should sleep on firm surfaces.

 

3.  Babies should sleep in the room with their parents but not in bed with their parents.

 

4.  Keep soft objects (pillows) and loose bedding (blankets) out of the crib.

 

5.  Pregnant women should have early and regular prenatal care.

 

6.  All women of childbearing age, and their significant others, should quit smoking.

 

7.  Adults who are immediately responsible for babies should not use alcohol or illicit drugs.

 

8.  All babies should breastfeed.

 

9.  Babies should be offered pacifiers at naptime and bedtime.

 

10.  Avoid overheating and do not cover the baby’s head.

 

11.  Do not use commercial devices (wedges, positioners, special mattresses, and special sleep surfaces) that are marketed to reduce the risk of SIDS.

 

12.  Do not use home heart and breathing monitors as a strategy for reducing the risk if SIDS.

 

13.  Babies should receive all recommended immunizations on time.

 

14.  Babies should not sleep in car seats, swings, strollers, infant carriers, infant slings, or in-bed co-sleepers.

 

14.  Do not use bumper pads for cribs.

 

15.  Parents should not hold their babies when sitting in arm chairs or lying on couches if the parents are likely to fall asleep.

 

16.  Supervised, awake tummy time is recommended daily to facilitate development and minimize flattening of the back of the head (plagiocephaly).

 

As a pediatrician in this community for the last 34+ years, nothing is more distressing than to be called to the hospital emergency department to assist in the resuscitation of a victim of SIDS or SUIDS.  I do not remember ever being successful in these depressing resuscitation attempts.  We know that most of these tragic events could be prevented if all adults who are responsible for babies would follow the very practical recommendations of the American Academy of Pediatrics.

 

 

David T. Tayloe, Jr., MD, FAAP


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