From Safe Sleep Summit 2014 held by Children's Trust of South Carolina. Presentation by, Deborah Greenhouse MD, FAAP, President, South Carolina Chapter, American Academy of Pediatrics

1. Deborah Greenhouse MD, FAAP
President
South Carolina Chapter
American Academy of Pediatrics

2. The AAP and Safe Sleep
 1992- Initial recommendation for supine sleep for all
newborns and young infants
 Resulted in significant initial decrease in SIDS but the
rate has stabilized and other causes of sleep-related
death including suffocation, asphyxia and entrapment
have increased over time

3. Sleep- Related infant deaths in
the US- By the Numbers
 SIDS deaths 1992- 120 deaths per 100,000 live births
 SIDS deaths 2001- 56 deaths per 100,000. The rate has
remained constant through 2006.

4. Sleep Related Infant Deaths by the
Numbers
 Racial Disparities
 Non-Hispanic Black infant SIDS rates 2005- 99 deaths
per 100,000 live births
 American Indian/ Alaskan native infants- 112 deaths
per 100,000 live births
 Non-Hispanic White infants- 55 deaths per 100,000
live births

5. The AAP and Safe Sleep
 2011- Expanded recommendations released in an AAP
policy statement focusing on safe sleep with the goal of
decreasing all sleep-related deaths, both explained
and unexplained.

6. What’s are the Expanded AAP
Recommendations?
 Back to Sleep for every sleep until 1 year of age. Once
the baby can roll supine to prone and prone to supine,
the infant can be allowed to remain in the position
that he or she assumes.
 Use a firm sleep surface- A firm crib mattress with a
fitted sheet is recommended. Sitting devices including
car seats, swings, slings etc. are not recommended.

7. Expanded AAP Recommendations
 Room sharing without bed sharing is recommended.
Devices designed to make bed sharing safe (ex. In-bed
cosleepers) are not recommended.
 The crib should be free of soft objects and loose
bedding. Bumper pads are not recommended.

8. Expanded AAP Recommendations
 Avoid smoke exposure during pregnancy and after
birth. There are multiple reasons for this
recommendation in addition to safe sleep concerns.
 Avoid alchohol and illicit drug use during pregnancy
and after birth.

9. Expanded AAP Recommendations
 Breastfeeding is recommended. Exclusive
breastfeeding provides the most protection in the first
6 months but any breastfeeding provides more
protection than no breastfeeding at all.
 Consider offering a pacifier at naptime and bedtime.
Breastfed infants should not use a pacifier until
breastfeeding is well established.

10. Expanded AAP Recommendations
 Avoid overheating- This is difficult to define.
Overbundling and covering the face and head should
be avoided.
 Infants should be immunized according to the AAP
and CDC recommendations.
 Avoid commercial devices marketed to reduce the risk
of SIDS.

11. Expanded AAP Recommendations
 Do not use home monitors to decrease the risk of
SIDS. There is no evidence that they are effective.
 Supervised, awake tummy time is recommended. This
promotes development of motor skills and prevents
positional plagiocephaly.

12. Expanded AAP Recommendation
 Health care professionals, staff in hospital nurseries
and neonatal ICUs and child care providers should
endorse these recommendations from birth.
 Media and manufacturers should follow these
guidelines in their messaging and advertising.

13. Expanded AAP Recommendations
 A national campaign should be undertaken to spread
the message of safe sleep recommendations.
 Research should continue to further determine the
risk factors for sleep-related infant deaths with the
ultimate goal of completely eliminating them.

14. Perfection is not
attainable, but if we
chase perfection we can
catch excellence.
Vince Lombardi