BREASTFEEDING OUTLOOK SPECIAL BULLETIN
AAP POLICY STATEMENT ON SIDS - OCTOBER 11, 2005

On Monday, October 10, 2005, the American Academy of Pediatrics (AAP) released its latest policy statement on SIDS, entitled "The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk." This statement updates information contained in the AAP's 2000 SIDS statement. Among the most important changes are:

1. BABIES SHOULD BE PLACED ON THEIR BACKS TO SLEEP EACH AND EVERY TIME.
   The AAP no longer finds side-sleeping to be an acceptable alternative, stating that the risk of babies' rolling onto their stomachs is unacceptable. They do have recommendations for reducing the development of
   positional plagiocephaly.
2. BABIES SHOULD NEVER SHARE ADULT BEDS.
   The AAP finds that while parents may take their children to their beds for brief periods of breastfeeding or comforting at night, the babies are to be returned to the cribs as soon as possible. The researchers do recommend that the crib or bassinet be located in the parents' room.
3. BABIES SHOULD BE GIVEN PACIFIERS WHEN SLEEPING.
   The AAP argues that use of pacifiers reduce the risk of SIDS. They feel that studies about reduced breastfeeding duration and dental problems resulting from pacifier use are not significant enough to warrant not using pacifiers. They do allow that pacifiers may not be used during the first month of a breastfed infants' life, while breastfeeding is being established.

The AAP makes no changes to its earlier recommendations in favor of firm sleeping surfaces, eliminating soft objects and bedding from the sleep environment, against maternal smoking during pregnancy, and avoiding
overheating. The AAP does not endorse commercial devices marketed to reduce SIDS, including the use of home monitors for this purpose. The AAP recommends the development of educational programs to increase awareness of the "Back to Sleep" campaign among secondary care providers, such as child care workers and grandparents.

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