Guideline sources The following summarized guidelines for the management of sudden infant death syndrome (SIDS) are prepared by our editorial team based on guidelines from the American Academy of Pediatrics (AAP 2022). 1 Guidelines 1. Preventative measures Prenatal counseling: provide regular prenatal care to pregnant people to reduce the risk of SIDS. A Breastfeeding: encourage breastfeeding as it is associated with a reduced risk of SIDS. A Routine immunizations: provide immunization in infants in accordance with the current published guidelines. A Sleep position: advise placing infants in a supine (back) position for every sleep by every caregiver until the child reaches 1 year of age to reduce the risk of sleep-related death. Do not advise side sleeping as it is not safe. A Sleep surface: advise using a firm, flat, non-inclined sleep surface to reduce the risk of suffocation or wedging/entrapment. A Sleep location: advise placing infants for sleep in the parent's room, close to the parent's bed, but on a separate surface designed for infants, ideally for at least the first 6 months, in order to reduce the risk of SIDS (by as much as 50%), and to prevent suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed. A https://web.pathway.md/diseases/rec21EKKnlxJr0iXa 1/3 6/24/23, 3:14 PM Sudden infant death syndrome Pathway Soft objects: advise keeping soft objects (such as pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like materials, and loose bedding such as blankets and nonfitted sheets) away from the infant's sleep area to reduce the risk of SIDS, suffocation, entrapment/wedging, and strangulation. A Pacifier: advise offering a pacifier at naptime and bedtime to reduce the risk of SIDS. A Show 2 more Overheating: advise avoiding overheating and head covering in infants to reduce the risk of SIDS. A Swaddling: insufficient evidence to recommend swaddling as a strategy to reduce the risk of SIDS. I Home cardiorespiratory monitors: Advise not to use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. A Advise avoidIng the use of commercial devices inconsistent with safe sleep recommendations. B Safe infant sleep guidelines: ensure that physicians, nonphysician clinicians, hospital personnel, and child care providers endorse and model safe infant sleep guidelines from the beginning of pregnancy. A Safe infant sleep promotion: Ensure that media and manufacturers follow safe sleep guidelines in their messaging, advertising, production, and sales to promote safe sleep practices as the social norm. A Promote safe sleep campaigns (such as the Eunice Kennedy Shriver NIH and Human Development "Safe to Sleep" campaign) focusing on ways to reduce the risk of all sleep-related deaths, and share the campaign messages by pediatricians and other maternal and child care providers as key promoters. A Tummy time: advise having supervised, awake tummy time to facilitate development and to minimize the risk of positional plagiocephaly. Encourage parents to place the infant in tummy time while awake and supervise for short periods of time beginning soon after hospital discharge, increasing incrementally to at least 15-30 minutes total daily by age 7 weeks. A Exposure to smoking: Advise avoiding smoke and nicotine exposure during pregnancy and after birth to reduce the risk of SIDS. Advise that no one smoke near pregnant people or infants. A Recognize that the risk of SIDS is particularly high when the infant bed shares with an adult smoker, even when the adult does not smoke in bed. A Exposure to toxic substances: advise avoiding alcohol, marijuana, opioids, and illicit drug use during pregnancy and after birth to reduce the risk of SIDS. A References https://web.pathway.md/diseases/rec21EKKnlxJr0iXa 2/3 6/24/23, 3:14 PM Sudden infant death syndrome Pathway 1. Rachel Y Moon, Rebecca F Carlin, Ivan Hand et al. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics. 2022 Jun 21;e2022057990. Open https://web.pathway.md/diseases/rec21EKKnlxJr0iXa 3/3