Intended for healthcare professionals


Babies should sleep in parents’ bedroom for as long as a year, says US guidance

BMJ 2016; 355 doi: (Published 24 October 2016) Cite this as: BMJ 2016;355:i5711
  1. Gareth Iacobucci
  1. The BMJ

Babies should sleep in their parents’ bedroom for six months and ideally as long as a year to decrease the risk of sleep related death, new guidance from the American Academy of Pediatrics (AAP) says.

In its first updated recommendations since 2011 on preventing sudden infant death syndrome (SIDS) and other sleep related infant deaths,1 the AAP said that sharing a room with parents for at least six months, but ideally a year, cuts the risk of SIDS by as much as 50%.

Drawing on the latest evidence, the new policy statement and technical report also advise that infants should sleep on a separate surface in their parents’ bedroom, such as a crib or bassinet—but never on a sofa, armchair, or soft surface.

The report, published in the journal Pediatrics, also includes new evidence supporting skin to skin care for newborn infants. It recommends skin to skin care immediately after birth for at least an hour as soon as the mother is medically stable and awake, regardless of feeding or delivery method.

Babies should be placed on their back on a firm sleep surface such as a crib or bassinet with a tight fitting sheet, the AAP advises.

While infants are at heightened risk for SIDS from 1 to 4 months of age, the AAP said that new evidence showed that soft bedding continues to pose hazards to babies aged 4 months and older. It advises that all soft bedding, including crib bumpers, blankets, pillows, and soft toys should be avoided and that the baby’s crib should be bare.

Breast feeding was also recommended for adding protection against SIDS. After feeding, babies should be moved to a separate sleeping space—preferably a crib or bassinet in the parents’ bedroom, the AAP advises.

Parents should also ensure that infants are not exposed to smoke, alcohol, or illicit drugs, it adds.

Rachel Moon, lead author of the report, said, “We know that parents may be overwhelmed with a new baby in the home, and we want to provide them with clear and simple guidance on how and where to put their infant to sleep.

“Parents should never place the baby on a sofa, couch, or cushioned chair, either alone or sleeping with another person. We know that these surfaces are extremely hazardous.”

Other recommendations include offering a pacifier at nap time and bedtime, not using home monitors or commercial devices that claim to reduce the risk of SIDS, ensuring that infants receive all recommended vaccinations, and allowing supervised, awake “tummy time” daily to facilitate development.


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