In the early 1990s, the American Academy of Pediatrics (AAP) first called for parents and caregivers not to place their babies on their tummies for sleep. Two years later, in 1994, the National Institute of Child Health and Human Development (NICHD) launched its “Back to Sleep” campaign to simplify and spread the message. Since then, the incidence of SIDS has declined dramatically, by more than 50 percent.
In light of this success, and due to increasing awareness about other sleep-related causes of childhood injury and death, the “Back to Sleep” campaign has received a facelift. As the renamed “Safe to Sleep” campaign, this effort looks beyond the baby’s initial sleep position.
Placing healthy babies on their backs to sleep is “the most effective action that parents and caregivers can take to reduce the risk of SIDS,” the campaign site asserts, but “Safe to Sleep” strives to raise awareness of “actions that parents and caregivers can take to reduce the risk of other sleep-related causes of infant death, such as suffocation.”
In addition to NICHD and the AAP, several other leading health organizations are involved in this effort, including the Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the American College of Obstetricians and Gynecologists (ACOG).
The campaign makes a variety of educational materials available to share with health care providers, caregivers and parents. Some important messages include:
- Babies sleep safest on their backs.
- Sleep position matters at every sleep time—naps and nighttime; inconsistency increases SIDS risk.
- The sleep surface should be a firm crib with a fitted sheet. It should be free of pillows, quilts, soft toys, and crib bumpers (which were banned in the Safe Sleep for Babies Act as hazardous products). Room-sharing is recommended to reduce the risk of SIDS and other sleep-related causes of death.
- Babies should sleep in a safe crib, bassinet, or playpen at home; and in a crib that meets the federal safety standards of the Consumer Product Safety Commission (CPSC) when at a child care facility. (Child care crib regulations came into effect on December 28, 2012.)
- Car seats, carriers, swings, and similar devices should not be used for everyday sleep; babies should never be placed to sleep on soft surfaces like couches, pillows, or blankets.
- Never use sleep wedges or positioners. These items, which may encourage side sleeping, put babies at an increased risk of accidentally rolling onto their stomachs and can cause suffocation by obstructing the baby's nose and mouth. They are included as hazardous products in the Safe Sleep for Babies Act.
- Parents should not drink alcohol or use illegal drugs. Also, they should not smoke or allow smoking around their babies.
- Breastfeeding reduces the risk of SIDS, but babies brought into bed for a feeding should be returned to their cribs afterward.
- Pacifiers during sleep are encouraged but should not be forced.
- Babies should be dressed in no more than one layer more than an adult would wear, to avoid overheating.
- Babies should have plenty of supervised “tummy time.”