SIDS and Other Sleep-Related Infant Deaths: Updated 2016 ...

1 POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of all Children SIDS and Other Sleep-Related Infant Deaths: Updated 2016. Recommendations for a Safe Infant Sleeping Environment TASK FORCE ON SUDDEN Infant death syndrome . Approximately 3500 infants die annually in the United States from sleep- abstract related Infant deaths, including sudden Infant death syndrome (SIDS;. International Classi cation of Diseases, 10th Revision [ICD-10], R95), ill- This document is copyrighted and is property of the American de ned deaths (ICD-10 R99), and accidental suffocation and strangulation Academy of Pediatrics and its Board of Directors.

2 All authors have led con ict of interest statements with the American Academy in bed (ICD-10 W75). After an initial decrease in the 1990s, the overall death of Pediatrics. Any con icts have been resolved through a process rate attributable to Sleep-Related Infant deaths has not declined in more approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial recent years. Many of the modi able and nonmodi able risk factors for SIDS involvement in the development of the content of this publication.

3 And Other Sleep-Related Infant deaths are strikingly similar. The American Policy statements from the American Academy of Pediatrics bene t Academy of Pediatrics recommends a safe sleep environment that can from expertise and resources of liaisons and internal (AAP) and external reviewers. However, policy statements from the American reduce the risk of all Sleep-Related Infant deaths. Recommendations for a Academy of Pediatrics may not re ect the views of the liaisons or the safe sleep environment include supine positioning, the use of a rm sleep organizations or government agencies that they represent.

4 Surface, room-sharing without bed-sharing, and the avoidance of soft The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking bedding and overheating. Additional recommendations for SIDS reduction into account individual circumstances, may be appropriate. include the avoidance of exposure to smoke, alcohol, and illicit drugs; All policy statements from the American Academy of Pediatrics breastfeeding; routine immunization; and use of a paci er. New evidence automatically expire 5 years after publication unless reaf rmed, revised, or retired at or before that time.

5 Is presented for skin-to-skin care for newborn infants, use of bedside and DOI: in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. The recommendations and PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). strength of evidence for each recommendation are included in this policy Copyright 2016 by the American Academy of Pediatrics statement. The rationale for these recommendations is discussed in detail FINANCIAL DISCLOSURE: The author has indicated she does not have a in the accompanying technical report ( nancial relationship relevant to this article to disclose.)

6 FUNDING: No external funding. POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential con icts of interest to disclose. BACKGROUND. To cite: AAP TASK FORCE ON SUDDEN Infant death syndrome . Sudden unexpected Infant death (SUID), also known as sudden SIDS and Other Sleep-Related Infant Deaths: Updated 2016. Recommendations for a Safe Infant Sleeping Environment. unexpected death in infancy, or SUDI, is a term used to describe any Pediatrics. 2016;138(5):e20162938. sudden and unexpected death , whether explained or unexplained Downloaded from by guest on October 6, 2019.

7 PEDIATRICS Volume 138, number 5, November 2016:e20162938 FROM THE AMERICAN ACADEMY OF PEDIATRICS. TABLE 1 De nitions of Terms SUIDs, particularly those that occur Bed-sharing: Parent(s) and Infant sleeping together on any surface (bed, couch, chair). during an unobserved sleep period Caregivers: Throughout the document, parents are used, but this term is meant to indicate any Infant ( Sleep-Related Infant deaths), such caregivers. as unintentional suffocation, is Cosleeping: This term is commonly used, but the task force nds it confusing, and it is not used in this challenging, cannot be determined document.

8 When used, authors need to make clear whether they are referring to sleeping in close proximity (which does not necessarily entail bed-sharing) or bed-sharing. by autopsy alone, and may remain Room-sharing: Parent(s) and Infant sleeping in the same room on separate surfaces. unresolved after a full case Sleep-Related Infant death : SUID that occurs during an observed or unobserved sleep period. investigation. Many of the modifiable Sudden Infant death syndrome (SIDS): Cause assigned to Infant deaths that cannot be explained after and nonmodifiable risk factors for a thorough case investigation, including a scene investigation, autopsy, and review of the clinical SIDS and suffocation are strikingly Sudden unexpected Infant death (SUID), or sudden unexpected death in infancy (SUDI): A sudden and similar.

9 This document focuses on unexpected death , whether explained or unexplained (including SIDS), occurring during infancy. the subset of SUIDs that occur during sleep. TABLE 2 Summary of Recommendations With Strength of Recommendation The recommendations outlined herein were developed to reduce A-level recommendations the risk of SIDS and sleep- Back to sleep for every sleep. Use a rm sleep surface. related suffocation, asphyxia, and Breastfeeding is recommended. entrapment among infants in the Room-sharing with the Infant on a separate sleep surface is recommended.

10 General population. As defined Keep soft objects and loose bedding away from the Infant 's sleep area. by epidemiologists, risk refers to Consider offering a paci er at naptime and bedtime. Avoid smoke exposure during pregnancy and after birth. the probability that an outcome Avoid alcohol and illicit drug use during pregnancy and after birth. will occur given the presence of a Avoid overheating. particular factor or set of factors. Pregnant women should seek and obtain regular prenatal care. Although all 19 recommendations Infants should be immunized in accordance with AAP and CDC recommendations.