pediatrics
Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS)
Prevention of SUID and SIDS
Clinicians, hospital staff, and child care providers must promote safe infant sleep practices from the beginning of pregnancy. The American Academy of Pediatrics (seeSleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment) recommends that infants be placed on their back on a firm, flat, non-inclined sleep surface for every sleep unless other medical conditions prevent this. Side sleeping or propping is too unstable. (See also theSafe to Sleep®campaign.) The incidence of SIDS increases with overheating (eg, clothing, blankets, hot room) and in cold weather. Thus, every effort should be made to avoid an overly hot or an overly cold environment, to avoid overwrapping the infant or covering the head, and to remove loose bedding, such as blankets and non-fitted sheets, and soft bedding, such as sheepskin, pillows, stuffed toys/animals, mattress toppers, fur-like materials, quilts, and comforters, from the crib. A pacifier is recommended at naptime and at bedtime to help open the airway and reduce the risk of SIDS. Parents/caregivers should not have the infant sleep in their bed. It is recommended that infants sleep in the parents'/caregivers' room close to the parents'/caregivers' bed but on a separate surface designed for infants, ideally for at least the first 6 months. To help prevent flat spots from developing on the infant's head, infants should spend some time on their tummy when they are awake and someone is watching them. Parents/caregivers should be encouraged to begin short periods of tummy time soon after hospital discharge, increasing incrementally to at least 15 to 30 minutes a day by age 7 weeks. To help make the infant's head round, parents/caregivers should change the direction that the infant lies in while in the crib each week and avoid leaving the infant for too long in car seats, carriers, and bouncers. Mothers should obtain regular prenatal care and should avoid smoking,nicotine, alcohol, marijuana, opioids, and illicit drug use during pregnancy and after birth. Infants should not be exposed to smoke. Breastfeeding is encouraged to help prevent infections and is associated with a reduced risk of SIDS. Childhood Vaccination Schedules are recommended for infants. There is no evidence that home apnea monitors reduce the incidence of SIDS and therefore are not suggested for prevention. There is also no evidence to recommend swaddling for prevention of SIDS. 