​By: Rachel Y. Moon, MD, FAAP 
 
 More than 3,500 babies in the U.S. die suddenly and unexpectedly every year while sleeping, often due to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or strangulation. 
 
 In an effort to reduce the risk of all sleep-related infant deaths, the American Academy of Pediatrics' (AAP) updated policy statement and technical report includes new evidence that supports skin-to-skin care for newborn infants; addresses the use of bedside and in-bed sleepers; and adds to recommendations on how to create a safe sleep environment. 
 
 Note: All of these recommendations, unless mentioned otherwise, are for babies up to 1 year of age. Talk with your pediatrician if you have questions about any of the recommendations listed. 
 
 Until their first birthday, babies should sleep on their backs for all sleep times—for naps and at night. We know babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides. The problem with the side position is that the baby can roll more easily onto the stomach. Some parents worry that babies will choke when on their backs, but the baby's airway anatomy and the gag reflex will keep that from happening. Even babies with gastroesophageal reflux (GERD) should sleep on their backs. 
 
 Newborns should be placed skin-to-skin with their mother as soon after birth as possible, at least for the first hour. After that, or when the mother needs to sleep or cannot do skin-to-skin, babies should be placed on their backs in the bassinet. While preemies may need to be on their stomachs temporarily while in the NICU due to breathing problems, they should be placed on their backs after the problems resolve, so that they can get used to being on their backs and before going home. 
 
 Some babies will roll onto their stomachs. You should always place your baby to sleep on the back, but if your baby is comfortable rolling both ways (back to tummy, tummy to back), then you do not have to return your baby to the back. However, be sure that there are no blankets, pillows, stuffed toys, or bumper pads around your baby, so that your baby does not roll into any of those items, which could cause blockage of air flow. 
 
 If your baby falls asleep in a car seat, stroller, swing, infant carrier, or sling, you should move him or her to a firm sleep surface on his or her back as soon as possible. 
 
 Use a firm sleep surface. A crib, bassinet, portable crib, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC) is recommended along with a tight-fitting, firm mattress and fitted sheet designed for that particular product. Nothing else should be in the crib except for the baby. A firm surface is a hard surface; it should not indent when the baby is lying on it. Bedside sleepers that meet CPSC safety standards may be an option, but there are no published studies that have examined the safety of these products. In addition, some crib mattresses and sleep surfaces are advertised to reduce the risk of SIDS. There is no evidence that this is true, but parents can use these products if they meet CPSC safety standards. 
 
 Room share—keep baby's sleep area in the same room where you sleep for the first 6 months or, ideally, for the first year. Place your baby's crib, bassinet, portable crib, or play yard in your bedroom, close to your bed. The AAP recommends room sharing because it can decrease the risk of SIDS by as much as 50% and is much safer than bed sharing. In addition, room sharing will make it easier for you to feed, comfort, and watch your baby. 
 
 Only bring your baby into your bed to feed or comfort. Place your baby back in his or her own sleep space when you are ready to go to sleep. If there is any possibility that you might fall asleep, make sure there are no pillows, sheets, blankets, or any other items that could cover your baby's face, head, and neck, or overheat your baby. As soon as you wake up, be sure to move the baby to his or her own bed. 
 
 Never place your baby to sleep on a couch, sofa, or armchair. This is an extremely dangerous place for your baby to sleep. 
 
 Bed-sharing is not recommended for any babies. However, certain situations make bed-sharing even more dangerous. Therefore, you should not bed share with your baby if: 
 
 Your baby is younger than 4 months old. 
 
 Your baby was born prematurely or with low birth weight. 
 
 You or any other person in the bed is a smoker (even if you do not smoke in bed). 
 
 The mother of the baby smoked during pregnancy. 
 
 You have taken any medicines or drugs that might make it harder for you to wake up. 
 
 You drank any alcohol. 
 
 You are not the baby's parent. 
 
 The surface is soft, such as a waterbed, old mattress, sofa, couch, or armchair. 
 
 There is soft bedding like pillows or blankets on the bed. 
 
 Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation out of the baby's sleep area. These include pillows, quilts, comforters, sheepskins, blankets, toys, bumper pads or similar products that attach to crib slats or sides. If you are worried about your baby getting cold, you can use infant sleep clothing, such as a wearable blanket. In general, your baby should be dressed with only one layer more than you are wearing. 
 
 It is fine to swaddle your baby. However, make sure that the baby is always on his or her back when swaddled. The swaddle should not be too tight or make it hard for the baby to breathe or move his or her hips. When your baby looks like he or she is trying to roll over, you should stop swaddling. ||||| Sharing a bed and objects in bed are the biggest risk factors for sleeping infants, according to a new study. 
 
 The study published in the journal Pediatrics on Monday found that babies aged 0-3 months were most likely to die as a result of bed-sharing. For older infants ages four months to a year, the greatest risk for sleep-related death is objects in the sleep environment, the study found. 
 
 The study relied on a database compiled between 2004 and 2012—using information from 24 states—by the National Center for the Review and Prevention of Child Deaths. Researchers analyzed 8,207 deaths in total. 
 
 Of the younger victims, 74% were sharing a bed at the time of their death. The study defines “bed-sharing” as sleeping with a person or an animal. Of the older victims, 39% of deaths happened in a sleep area containing an object such as a blanket or a pillow. And 18% changed their sleeping position from on their side or on their back to prone. 
 
 But the study makes it clear that it hasn’t uncovered any clear cause and effect. Instead it states its “objective was to determine any associations between risk factors for sleep-related deaths at different ages.” 
 
 The American Academy of Pediatrics guidelines on safe sleep environments suggest placing babies on their back on a firm surface, in the same room as their parents, and with no soft objects or loose bedding until the age of one. ||||| Sudden infant death syndrome is the leading cause of death for babies under the age of 1 year. In a new policy statement, the American Academy of Pediatrics have updated their recommendations to help parents and caregivers protect infants against unexpected sleep-related death. 
 
 
 
 The AAP have issued new safe sleep guidelines with the aim of protecting against SIDS. The AAP have issued new safe sleep guidelines with the aim of protecting against SIDS. 
 
 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." 
 
 Read about a study that details the role serotonin might play in SIDS.
– Frilly crib bumpers may add a whimsical touch to a nursery, but they could be dangerous for infants. A study published in August’s Pediatrics journal says that sharing a bed, as well as items left in a baby’s sleep area are risk factors in infant deaths, reports Time. How much of a factor depends on the baby’s age: The study found that 74% of the younger infants who died (ages newborn to 3 months) were sharing a bed with another person or animal, while 39% of the older infants (ages 4 months to 1 year) were surrounded by blankets, pillows, stuffed animals, or other objects. Most of the babies in the study—which was based on information about 8,207 infant fatalities compiled from 24 states by the National Center for the Review and Prevention of Child Deaths—were non-Hispanic whites, according to the American Academy of Pediatrics; 58% were male. As Time points out, the study doesn’t prove any clear cause-and-effect: Researchers say they were simply trying “to determine any associations between risk factors for sleep-related deaths at different ages.” Still, the AAP recommends that parents create a “safe sleep environment,” which includes placing babies on a firm mattress with a fitted sheet in a crib that meets safety standards (not in an adult bed or on a sofa), keeping toys and loose bedding such as blankets and pillows out of the crib, and dressing the baby in sleep clothing (e.g., sleep sacks). (Click here to read about other sudden infant death cases and possible causes.)