Conference Coverage

Updated AAP safe sleep recs for infants reinforce life-saving messages


 

EXPERT ANALYSIS FROM AAP 16

Raising awareness

“As a father and pediatrician, I want parents to know that their baby is safest following the AAP safe sleep recommendations, and spreading this message has become my life’s mission,” said Dr. Samuel P. Hanke, a pediatric cardiologist at the University of Cincinnati, who knows the heartbreak of SIDS firsthand.

Dr. Lori B. Feldman-Winter (R), Dr. Samuel P. Hanke, Dr. Catherine Spong Catherine Cooper Nellist/Frontline Medical News

Dr. Lori B. Feldman-Winter (R), Dr. Samuel P. Hanke, and Dr. Catherine Spong at the AAP press conference on media and children.

He and his wife lost their son, Charlie, to SIDS, prompting them to found Charlie’s Kids Foundation to promote safe sleep practices. The foundation has published the first children’s bedtime book dedicated to safe sleep, “Sleep Baby Safe and Snug” (Cincinnati, Ohio: Blue Manatee Press, 2013), which is based on the AAP recommendations.

“We know practicing safe sleep is hard. We have to be vigilant. We need to start adopting a mentality that safe sleep is not negotiable,” Dr. Hanke asserted. “We cannot emphasize enough that practicing safe sleep for every sleep is as important as buckling your child into a car seat for every drive. And just like car seats, this change won’t occur overnight.”

Federal commitment

Since the 1970s, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in Bethesda, Md., has been supporting and performing much of the research on which the updated recommendations are based. This research continues to help identify areas where greater efforts are needed, according to acting director Catherine Y. Spong, MD.

Dr. Catherine Spong Catherine Cooper Nellist/Frontline Medical News

Dr. Catherine Spong

“Through our research, we have learned that caregivers are more likely to follow recommendations if they come from multiple sources, particularly from physicians,” she noted. Yet, “many women report that they are not getting advice from their physicians about the ways to reduce the risk of SIDS.”

NICHD also conducts and collaborates on related education campaigns, such as Safe to Sleep, to disseminate messages such as those in the updated AAP recommendations as widely as possible.

“I encourage all physicians, pediatricians, nurses, and other health care and child care providers to lend their authoritative voices to the Safe to Sleep effort,” Dr. Spong said. “Join us all in sharing safe infant sleep recommendations and in supporting parents and caregivers to make informed decisions that will help keep their baby safe during sleep.”

A closer look at setting

Published in conjunction with the guidelines is a study on risk factors that looked at the role of the setting in which sleep-related infant deaths occur (Pediatrics. 2016 Oct 24:e20161124).

The analysis of nearly 12,000 such deaths found that, relative to counterparts who died in their home, infants who died outside of their home were more likely to be in a stroller or car seat at the time (adjusted odds ratio, 2.6) and in other locations, such as on the floor or a futon (1.9), and to have been placed prone (1.1). They were less likely to have been sharing a bed (0.7).

The groups did not differ in terms of whether the infant was sleeping in an adult bed or on a person, on a couch or chair, or with any objects in their sleep environment.

“Caregivers should be educated on the importance of placing infants to sleep supine in cribs/bassinets to protect against sleep-related deaths, both in and out of the home,” conclude the investigators, one of whom disclosed serving as a paid expert witness in cases of sleep-related infant death.

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