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Stomach Sleeping Isn't Only SIDS Risk

Loose Bedding, Bed Sharing, Smoking Are Implicated in New Analysis

Pediatricians' Recommendations

University of Virginia Pediatrics Professor John Kattwinkel, MD, agrees. Kattwinkel, who leads the American Academy of Pediatrics task force on SIDS, says it has become clear in the last decade that infant sleep deaths are largely preventable.

In its latest policy statement, released in 2000, the AAP task force recommended that babies be put to sleep only on their backs -- never on their stomachs or sides. Other recommendations include:

  • Infants should not sleep on waterbeds, sofas, soft mattresses, or other soft surfaces. Likewise, soft materials like pillows and quilts should not be placed under an infant.
  • Pillows, stuffed toys, or loose bedding should be kept out of an infant's bed because they can obstruct the infant's airways.
  • Babies need a certain amount of supervised "tummy time" during the day to lower the risk of developing flat spots on their head.

The group did not take a stand on infants sleeping in the same beds with their parents. But Kattwinkel says the task force will probably revisit the issue soon because of the growing evidence linking it to infant deaths.

"The family bed is a very controversial and emotional issue," he tells WebMD. "Advocates are very firm in their belief that it promotes breastfeeding and has other positive benefits."

One in 5 SIDS Cases Occurs in Day Care

Although it is not clear why, Kattwinkel says smoking is emerging as an important risk factor for SIDS. Other than putting babies to sleep on their backs and keeping loose bedding out of the crib, he says stopping smoking is probably the most important intervention for preventing infant sleep deaths.

It is also very important to make sure day-care providers and other caregivers are educated about SIDS risks. Research has shown that back-sleeping infants who occasionally sleep on their stomachs have a much greater SIDS risk than other babies -- roughly 20 times that of babies who always sleep on their backs and 15 times that of babies who sleep only on their stomachs.

This may explain why as many as 20% of SIDS cases occur in day-care settings. A recent study showed that fewer than half of day-care providers questioned knew to put babies to sleep on their backs.

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