Sudden infant death syndrome (SIDS) - also referred to as a "cot death" - is defined as the unexpected death of an apparently healthy baby aged 12 months and under, most often during sleep.

Each year, around 3,500 infants in the United States die from sleep-related causes, including accidental suffocation and strangulation in bed.

According to the Centers for Disease Control and Prevention (CDC), while overall rates of SIDS have fallen since the early 1990s, rates of accidental suffocation and strangulation among infants during sleep have risen, reaching 21.4 deaths per 100,000 live births in 2014.

At this week's American Academy of Pediatrics (AAP) National Conference & Exhibition in San Francisco, CA, the organization present a new policy statement with updated guidelines to make an infant's sleep environment safer.

"We know that parents may be overwhelmed with a new baby in the home, and we want to provide them with clear and simple guidance on how and where to put their infant to sleep," says lead statement author Dr. Rachel Moon, of the Division of General Pediatrics at the University of Virginia and AAP member.
Avoid soft bedding, toys, and crib bumpers in sleeping areas

Firstly, the statement authors recommend placing a baby on his or her back on a firm sleep surface, such as a crib or bassinet, and the surface should have a tight-fitting sheet.

Parents and caregivers should also keep the crib or bassinet bare; soft bedding - such as blankets and pillows - should be avoided, as should soft toys and crib bumpers.

The authors note that infants are at the greatest risk of SIDS up to the age of 4 months, but there is increasing evidence that soft bedding can be hazardous to babies after this age.

Infant exposure to smoke, alcohol, and illicit drugs should also be avoided, the authors state, as this can raise the risk of SIDS.

Other recommendations in the policy statement include:

    Offer a pacifier to the infant at nap time or bedtime
    Avoid the use of home monitors or commercial devices - such as wedges or positioners - that claim to lower SIDS risk
    Ensure infants have received all their recommended vaccinations
    Supervised tummy time when a baby is awake is recommended in order to aid development.

The statement authors also recommend that an infant sleep in the same bedroom as their parents; according to the AAP, room-sharing can reduce the risk of SIDS by up to 50 percent.

However, up until the child is 12 months old, an infant should not share the same sleeping service as parents; doing so can increase the risk of overlay, whereby a parent may roll on to the child, causing suffocation.

    "Parents should never place the baby on a sofa, couch, or cushioned chair, either alone or sleeping with another person. We know that these surfaces are extremely hazardous."

    Dr. Rachel Moon

Breast-feeding can protect against SIDS, but caution required

The policy statement considers breast-feeding a protective measure against SIDS, but the authors recommend moving an infant to their own separate sleeping space immediately after feeding.

"If you are feeding your baby and think that there's even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair," said statement co-author Dr. Lori Feldman-Winter, member of the Task Force on SIDS.

In the event a mother does fall asleep while breast-feeding, Dr. Feldman-Winter says the infant should be moved to his or her own bed immediately after awakening,

"There should be no pillows, sheets, blankets or other items that could obstruct the infant's breathing or cause overheating," she adds.

As part of their updated recommendations, the AAP suggest healthcare providers have "open and nonjudgmental" conversations with parents about their infant sleep practices.

Additionally, they call for the media and advertisers to raise awareness of safe sleep recommendations by promoting them in images and messages to the general public.

"We want to share this information in a way that doesn't scare parents but helps to explain the real risks posed by an unsafe sleep environment," says Dr. Moon. "We know that we can keep a baby safer without spending a lot of money on home monitoring gadgets but through simple precautionary measures."