Breaking Down The AAP’s Updated Safe Sleep Guidelines
The American Academy of Pediatrics is the leading source of information when it comes to babies and sleep safety. Recently, the AAP released the first update to their Safe Sleep Guidelines since 2016.
I am going to break down the top revisions or key points in the updated guidelines. All of the changes, including ones that I do not touch on in this blog post, can be found here.
“Use a firm, flat, noninclined sleep surface.”
This change likely stems from the recall of baby items such as the Rock N’ Play, that were being used for sleep and unfortunately resulted in the death of a number of infants. The new guidelines states that “sleep surfaces with inclines of [more than] 10 degrees are unsafe for infant sleep.”
In other words, it is not safe to allow infants to sleep in car seats, strollers, swings, baby nests, loungers, etc. The safest sleep space for infants is on a firm, flat, noninclined sleep surface that meets all federal safety standards.“Feeding of human milk is recommended.”
Previously, the AAP recommended exclusive breastfeeding for 6 months to reduce the risk of SIDS. Recent changes have been made to accommodate pumping/bottle feeding, but still discourages any formula or other supplements for at least 6 months, if not 1 year or longer.
I feel it is important to note that mothers who are unable to breastfeed or pump/bottle feed can still protect their infant by following all other safe sleep guidelines.“It is recommended that infants sleep in the parents’ room . . . ideally for at least the first 6 months.”
Let me start by saying the key point here is room sharing, NOT bed sharing. Both the AAP, and myself, strongly advise parents to avoid bed sharing in order to reduce the risk of SIDS.
I am loving this updated recommendation! Previously, the AAP recommended infants room share with their parents for at least the first 6 months, but ideally the first year of their life. The updated guideline has changed the recommendation to 6 months, which I find is much more suitable and realistic for most families.“Weighted blankets, weighted sleepers, weighted swaddles, or other weighted objects [should] not be place on or near the sleeping infant.”
This is huge! In recent years weighted products have taken over the sleep market and until now, there have not been any firm recommendations on safe use of these products for infants.
Rather than weighted products, the AAP stands firm in recommending layered clothing and wearable blankets (sleep sack) rather than weighted products or added bedding.“Delay pacifier introduction until breastfeeding is firmly established.”
This is not a new change, more so a clarification to accommodate the variation in each individual breastfeeding journey.
The biggest change with this recommendation is the addition of the acknowledgement that “the time required to establish breastfeeding is variable.” If you are struggling with, or concerned about breastfeeding, speak with your Paediatrician or Lactation Consultant.“It is advised not to place hats on infants when indoors except in the first hours of life or in the NICU.”
This addition to the Safe Sleep Guidelines is due to the “questionable benefit of hat use for the prevention of hypothermia and the risk of overheating.”
Basically, the risk of overheating (and in my opinion, suffocation) are far greater than the benefit of hypothermia prevention.“Use of home cardiorespiratory monitors.”
Cardiorespiratory monitors include heart rate and pulse oximetry monitors (such as the Owlet monitor). These items are sold as consumer wellness devices and therefore are “not required to meet the same regulatory requirements as medical devices and . . . are not to be used to prevent sleep-related deaths.”
Now, this isn’t saying that use of these items increases the chance of sleep-related death, but the concern is that parents trust and rely on these items which may in turn lead to “complacency and decreased adherence to safe sleep guidelines.”“Tummy time.”
The AAP has updated their tummy time recommendation to include a more specific guideline for parents. They have moved from a mere recommendation of tummy time, to a recommendation of using awake and supervised increments “beginning soon after hospital discharge, increasing incrementally to at least 15-30 min total daily by age 7 weeks.”“Swaddling.”
Two updates have been included for swaddling. The first is to avoid the use of weighted swaddles or weighted objects within swaddles, and the second is a more specific timeline of when to remove the swaddle. Previously the AAP recommended removing the swaddle when “an infant exhibits signs of attempting to roll” but they have now included that this “usually occurs at 3-4 months, but may occur earlier.”“Media and manufacturers.”
How often have you seen media portray this beautiful crib setup including stuffies, pillows, bumper pads, blankets, etc, etc, etc… Or maybe you’ve come across a marketing photo of a baby sleeping soundly in a lounger. These images give parents the idea that these products are safe to use for sleep, which is simply not true!
The AAP has expanded the safe sleep recommendations for media and advertising to include what companies use in their “messaging, advertising, production, and sales to promote safe sleep practices as the social norm.”
Safe sleep is a HUGE part of my practice as a Sleep Consultant. I aim to provide parents with education and knowledge so that they can make the best decisions for their little ones.
Have any questions or want to chat about safe sleep? Send me an email here - I’d love to hear from you!
