The Changing Concept of Sudden Infant Death Syndrome: Diagnostic
Coding Shifts, Controversies Regarding the Sleeping Environment, and
New Variables to Consider in Reducing Risk
American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome.
PEDIATRICS Vol. 116 No. 5 November 2005 1245
ABSTRACT. There has been a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed down for sleep in a nonprone position. Although the SIDS rate continues to fall, some of the recent decrease of the last several years may be a result of coding shifts to other causes of unexpected infant deaths. Since the AAP published its last statement on SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping.
The AAP also stresses the need to avoid redundant soft bedding and soft objects in the infant’s sleeping environment, the hazards of adults sleeping with an infant in the same bed, the SIDS risk reduction associated with having infants sleep in the same room as adults and with using pacifiers at the time of sleep, the importance of educating secondary caregivers and neonatology practitioners on the importance of “back to sleep,” and strategies to reduce the incidence of positional plagiocephaly associated with supine positioning. This statement reviews the evidence associated with these and other SIDSrelated issues and proposes new recommendations for further reducing SIDS risk.
Coding Shifts, Controversies Regarding the Sleeping Environment, and
New Variables to Consider in Reducing Risk
American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome.
PEDIATRICS Vol. 116 No. 5 November 2005 1245
ABSTRACT. There has been a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed down for sleep in a nonprone position. Although the SIDS rate continues to fall, some of the recent decrease of the last several years may be a result of coding shifts to other causes of unexpected infant deaths. Since the AAP published its last statement on SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping.
The AAP also stresses the need to avoid redundant soft bedding and soft objects in the infant’s sleeping environment, the hazards of adults sleeping with an infant in the same bed, the SIDS risk reduction associated with having infants sleep in the same room as adults and with using pacifiers at the time of sleep, the importance of educating secondary caregivers and neonatology practitioners on the importance of “back to sleep,” and strategies to reduce the incidence of positional plagiocephaly associated with supine positioning. This statement reviews the evidence associated with these and other SIDSrelated issues and proposes new recommendations for further reducing SIDS risk.
Pediatrics 2005;116:1245– 1255; SIDS, sudden infant death syndrome, sudden unexpected infant death, infant mortality, supine position, infant sleep, infant bedding.
