New recommendations for preventing SIDS

stem ↓

Mon, Oct 10 2005, 2:20 pm

The American Academy of Pediatrics came out with new/revised guidelines for preventing SIDS.

Fox News wrote:

Babies should be offered pacifiers at bedtime, and they should sleep in their parents' room — but not in their beds — in order to lessen the risk of sudden infant death syndrome, the nation's largest group of pediatricians says.

Both measures may help keep babies from slumbering too deeply — a problem for infants prone to SIDS, said Dr. Rachel Moon (search), who helped draft the new recommendations on SIDS prevention. They were prepared for release Monday at the annual meeting of the American Academy of Pediatrics.

The death rate from SIDS (search) has fallen sharply in recent years, now that parents are warned not to let their babies sleep on their stomachs or amid fluffy bedding or stuffed toys. But it remains the leading case of death in U.S. infants between ages 1 month and 1 year, killing more than 2,000 U.S. babies each year, and new tactics are needed to fight it, the academy said.

SIDS is defined as a sudden death of an infant, often while sleeping, that remains unexplained even after an autopsy and death scene examination.

Some breast-feeding proponents have advocated letting infants share their parents' bed to facilitate nighttime nursing and have opposed pacifier use because of concern that the devices might interfere with nursing.

But the academy is a longtime supporter of breast-feeding, and the new policy was crafted with that in mind. It recommends delaying pacifier use for breast-fed infants during the first month of life — when SIDS risks are low — "to ensure that breast-feeding is firmly established." And it says placing cribs near the parents' bed makes breast-feeding more convenient. Infants may be brought into the bed to nurse, but should be returned to their cribs afterward, the policy says.

Pacifiers offered at bedtime should not be reinserted if they fall out during sleep, should not be coated in sweet substances, and should not be forced upon infants who refuse them, the policy says.

The new policy, which updates the academy's 2000 SIDS guidelines, also says that the only recommended sleep position for infants is on their backs. Letting babies sleep on their sides, considered a less favorable option in the old policy, is now considered too risky to even be considered an option, because infants could roll over to their stomachs.

In 1992, 4,660 U.S. infant deaths were attributed to SIDS. That annual number fell to about 2,800 in 1998, thanks at least partly to the government-sponsored "Back to Sleep" (search) campaign launched nationwide in 1994. By 2002, the reported number had dropped to 2,295.

"Over 2,000 babies a year are still dying. We should be able to do something about that," said Dr. John Kattwinkel of the University of Virginia, chairman of the academy's SIDS task force.

Doctors think actual numbers are higher because some true SIDS deaths are being blamed on other causes, said Moon, a SIDS researcher at Children's National Medical Center in Washington, D.C. Data suggest, for example, that accidental suffocation, which is hard to distinguish from SIDS, has increased in recent years, Moon said.

Doctors aren't sure about SIDS causes but a prevailing theory suggests that brain stem abnormalities affecting arousal reflexes leave some babies vulnerable when faced with challenges during deep sleep, including overheating and breathing hampered by pillows, stuffed animals or other soft objects. Babies sleeping on their stomachs are at risk because they sleep more deeply and their airway risks being partly obstructed.

Laura Reno, spokeswoman for First Candle/SIDS Alliance, a national advocacy group, said her organization strongly supports the new recommendations.

"We just want to reduce as much risk as possible," said Reno, who lost a baby son to SIDS 21 years ago, long before stomach-sleeping and soft bedding were known risk factors.

"He was sleeping on his tummy on top of a sheepskin. If I had just known then what we know now," she said. "It's a devastating thing for parents and guilt is strongly associated with these deaths."

The academy's new recommendations are based on new research, including studies that have suggested that sucking pacifiers might help keep vulnerable infants from slumbering too deeply to rouse themselves.

Dr. Stephen Sheldon, director of the sleep medicine center at Chicago's Children's Memorial Hospital, said pacifiers also enhance babies' swallowing and are an age-appropriate habit.

While pacifier use can increase the risk of ear infections, these infections are less common during the first year of life — when the SIDS risk is highest — than later on, the academy said.

The policy recommends pacifier use throughout the first year but not beyond.

Pacifier use in older children may increase risks for teeth misalignment, but using them in infancy is not a problem, said Dr. Paul Reggiardo, a Huntington Beach, Calif., dentist and past president of the American Academy of Pediatric Dentistry.

"These are from our point of view appropriate recommendations," Reggiardo said.

nicole81

Mon, Oct 10 2005, 2:28 pm

my baby is 6 months old and has gotten very good at putting herself to sleep, but only on her tummy. I let her take naps completely on her stomach so she won't wake up after 10 minutes, but at night, before I go to sleep, I turn her over to her back.

↑ stem

Mon, Oct 10 2005, 2:31 pm

I put them on their back till they are old enough to roll over. After that, it's out of my hands.

chavamom ↓

Mon, Oct 10 2005, 2:59 pm

You know, the research that was done that concluded it was too dangerous to have a baby sleep in a parent's bed was done where I live. It angers me to no end b/c the research was done on inner city moms - crack addicts and all kinds of horrible situations thrown into the mix. Many of the babies that died were in homes where the babies were sleeping with many other children (and NOT with parents), didn't have a bed at all, etc. And then the results were extrapolated to all parents. AND it ignored all the studies that HAVE been done on safe co-sleeping (not alone, not with other children, etc) which show that it does result in a decrease in SIDS. I think this latest push, esp. with the pacifier recommendation is going to result in a decrease in breastfeeding success.

Meema2Kids

Mon, Oct 10 2005, 3:02 pm

With my last baby starting when he was a month I let him sleep on his tummy. Otherwise he would only sleep for 45 minutes at a time and I was severely sleep deprived. I felt the risk of my getting into a car accident, or having some other accident C"V from sleep deprivation was higher than the risk of SIDS. We also didn't have any of the other risk factors - we breastfeed, no drugs, etc.

TzenaRena

Mon, Oct 10 2005, 3:48 pm

My babies (breastfed) spit up alot, and some were colicky. I always worried about them chv choking on spit-up, which is why I always did put them to sleep on their stomach, which I felt was comforting to a baby with colic.

I wonder whether the Academy adresses this concern.

Tovah

Mon, Oct 10 2005, 4:14 pm

I heard a story where a baby choked on spit up and passed away. the baby was on the back.
I don't know which is better tummy can sufficate and back can choke. I guess we need to just moniture our babies and daven.

imanut

Mon, Oct 10 2005, 5:32 pm

infants used to be put on their stomachs to prevent choking on spit-up, but now on backs is considered safer. the only way I let my infant sleep on his stomach is if he's laying on my stomach. (he has tons of gas and is miserable at night. pressure on his stomach seems to help.)

Pearl

Tue, Oct 11 2005, 6:44 am

on the side, with a special pillow to provide from rolling on stomach....

chanala

Mon, Oct 17 2005, 1:28 am

chavamom wrote:

You know, the research that was done that concluded it was too dangerous to have a baby

Well, that will be the NEXT thing they come out with. Scratching Head

(Quote taken completely out of context on purpose)

baby's mom ↓

Mon, Oct 17 2005, 1:31 am

chanala wrote:

chavamom wrote:

You know, the research that was done that concluded it was too dangerous to have a baby

Well, that will be the NEXT thing they come out with. Scratching Head

(Quote taken completely out of context on purpose)

LOL

↑ baby's mom

Mon, Oct 17 2005, 1:34 am

I put my baby on her stomach. Every few years they change their minds about what is best. They dont even know what causes SIDS! These are all assumptions. For their developement , its best for babies to be put on their stomach. Also, they can move their heads from side to side if uncomfortable .
My chiro told me that their will be a new generation with back problems!

↑ chavamom ↓

Mon, Oct 17 2005, 2:06 am

chanala wrote:

chavamom wrote:

You know, the research that was done that concluded it was too dangerous to have a baby

Well, that will be the NEXT thing they come out with. Scratching Head

(Quote taken completely out of context on purpose)

↑ chavamom

Mon, Oct 17 2005, 2:08 am

An important point related to my comment above.

Quote:

PEDIATRIC NEWS UPDATES
Updates from October 2005

October 10 - Dr. Sears speaks out against new AAP policy on co-sleeping
The American Academy of Pediatrics recently published a new policy on Sudden Infant Death Syndrome prevention (To view the policy visit http://www.aap.org/ncepr/sids.htm). They state that side-sleeping may pose a risk of SIDS and now advise parents to avoid the side sleeping position. Back sleeping is the safest, and we agree. They also sight research that suggests pacifier use may decrease the risk of SIDS. We don’t recommend breastfed babies use a pacifier, but parents should make that decision for themselves.

What we do disagree with is that the AAP continues to recommend against co-sleeping with a baby in the parents’ bed. In our experience and review of worldwide research, sleeping with a baby in the parents’ bed dramatically reduces the risk of SIDS. While the AAP policy doesn’t say co-sleeping causes SIDS, it says the risk of accidental suffocation of approximately 65 babies each year in a parent’s (which isn’t SIDS – it’s accidental death) warrants avoiding co-sleeping. What the AAP continues to ignore, however, is the fact that virtually all of the 2500 cases of SIDS each year in the U.S. occur in cribs.

The logical conclusion is that a baby is much less likely to suffer an accidental suffocation in a parent’s bed then they are to die of SIDS. Therefore, co-sleeping is much safer. And if parents follow our safe-sleeping guidelines (click here) they can ensure their baby will be sleeping in the safest possible environment.

Research around the U.S. has shown that about half of American families co-sleep with their babies. We should focus our efforts on teaching parents to do this safely instead of trying to get them to change their parenting instincts and use a crib.

https://www.askdrsears.com/new.....5.asp

RedVines

Mon, Oct 17 2005, 9:51 am

I use that special pillow, and swaddle them until they can lift their head, once they can do that They sleep much better on their tummies. I also heard that they shouldnt have such deep sleeps (bec. of SIDS) I also have used the infant carseats right in the begining!

hisorerus

Sun, Dec 11 2005, 2:20 pm

About the pacifier part of the study:

What was the control group? Was it pacifiers vs crying to sleep, or pacifiers vs nursing to sleep?

It would make a very big difference, obviously.

And I'm curious, do any babies sleeping in carseats succumb to SIDS?