Clerkship Ready: Pediatrics

Before You Counsel about Infant Safe Sleep

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Following safe sleep guidelines is the best way to protect a baby from dying suddenly and unexpectedly from sudden infant death syndrome (SIDS), accidental suffocation or strangulation, and deaths with unknown cause. Today we’re going to talk about what you need to know before you talk to a family about what safe sleep looks like for their infant. We’re going to talk about the importance of safe sleep habits, the AAP safe sleep recommendations, guidelines for infant sleep products, and tummy time.

  • Why do we talk about safe sleep for infants?
  • What causes infants to die suddenly and unexpectedly?
  • Goals of safe sleep recommendations are to increase infant arousability and decrease asphyxiating environments
  • Asking about sleep practices
  • ABCs of safe sleep: Alone, Back, Crib

    • Safe sleep recommendations:

    • Infants should be on their backs
    • Infants should sleep on a firm, flat, noninclined sleep surface
    • There should be no bedding, such as pillows, blankets, bumper pads, stuffed toys, or fur-like materials in the infant’s sleep area.
    • The infant should be breastfed as much and for as long as possible.
    • The infant should sleep in the parents’ room, close to the parent’s bed but on a separate surface designed for infants, ideally for at least the first 6 months of life.
    • Couches, sofas, and padded armchairs are extremely dangerous places for infants to sleep.
    • Offer a pacifier at sleep time
    • Parents should stay smoke-free during pregnancy and after the infant is born.
    • Parents should avoid alcohol, marijuana, opioids, and illicit drug use during pregnancy and after birth
    • Infants should be fully immunized.
    • Commercial sleep products are only safe if they are consistent with safe sleep recommendations
    • Tummy time

      •  References:

      1. Moon RY, Carlin RF, Hand I, American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome and the Committee on Fetus and Newborn. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics. 2022 Jul 1; 150(1):e2022057990. https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022?autologincheck=redirected
      2. Won’t my baby choke if they spit up when placed on their back to sleep? https://safetosleep.nichd.nih.gov/reduce-risk/back-sleeping
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