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   The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org 
   
   ​​​​​​Sudden infant death syndrome (SIDS) and other sleep-related causes of infant mortality have several known risk factors, but little is known if these factors change for different age groups. In a new study in the August 2014 Pediatrics, “ Sleep Environment Risks for Younger and Older Infants ,” published online July 14, researchers studied sleep-related infant deaths from 24 states from 2004-2012 in the case reporting system of the National Center for the Review and Prevention of Child Deaths. Cases were divided by younger (0-3 months) and older (4 months to one year) infants. In a total of 8,207 deaths analyzed, majority of the infants (69 percent) were bed-sharing at the time of death. Fifty-eight percent were male, and most deaths occurred in non-Hispanic whites. Younger infants were more likely bed-sharing (73.8 percent vs. 58.9 percent), sleeping on an adult bed or on/near a person, while older infants were more likely found prone with objects, such as blankets or stuffed animals in the sleep area. Researchers conclude that sleep-related infant deaths risk factors are different for younger and older infants. Parents should follow the American Academy of Pediatrics (AAP) recommendations for a safe sleep environment and understand that different factors reflect risk at different developmental stages. ||||| 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. ||||| ​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.
target: – 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.)