Sunday, January 22, 2012

AAP Recommendations to Reduce the Risk of SIDS: An Overview Part 2

By Jennifer Goldbronn, MAS, RD

Last time, we provided an overview of the first 5 updated and expanded recommendations from the American Academy of Pediatrics to reduce infants’ risk for SIDS and other sleep related deaths. In this post, we continue with the next 6 "level A" recommendations. For the full report, see the link below.

6. Avoid smoke exposure during pregnancy and after birth
“Both maternal smoking during pregnancy and smoke in the infant’s environment after birth are major risk factors for SIDS.”

Important Points:
• This includes second-hand smoke in an infant’s environment, such as the car or home.
• The risk is highest when the infant bed-shares with a smoker.

7. Avoid alcohol and illicit drug use during pregnancy and after birth
“There is an increased risk of SIDS with prenatal and postnatal exposure to alcohol or illicit drug use.”

Infants are at a particularly high risk of SIDS when parents bed-share with infants while under the influence of drugs or alcohol.

8. Breastfeeding is recommended.

Important Points:
• The protective effects of breastfeeding against SIDS increase with the amount of exclusivity. The AAP recommends 6-months of exclusive breastfeeding for all infants if possible.
• Any breastfeeding is more protective than none.

9. Consider offering a pacifier at nap time and bedtime
“Although the mechanism is yet unclear, studies have reported a protective effect of pacifiers on the incidence of SIDS. The protective effect persists throughout the sleep period, even if the pacifier falls out of the infant’s mouth.”

Important Points:
• Use the pacifier when your baby is falling asleep.
• You do not need to put the pacifier back in your baby’s mouth if it falls out.
• Do not force your infant to take a pacifier if he doesn’t want to!
• Do not attach the pacifier to the infant while the infant is sleeping.
• Wait to give pacifiers to breastfeeding infants until breastfeeding is firmly established, or when babies are about 5 to 6 weeks old.

10. Avoid overheating
“Although studies have revealed an increased risk of SIDS with overheating, the definition of overheating in these studies varied. Therefore, it is difficult to provide specific room temperature guidelines for avoiding overheating.”

Important Points:
• Dress your infant comfortably for his environment with no more than one more layer than you would wear.
• Signs of overheating include sweating or the chest being hot to the touch.
• Avoid over bundling and covering the face and head.

11. Do not use home cardiorespiratory monitors as a strategy for reducing the risk of SIDS
“Although cardiorespiratory monitors can be used at home to detect apnea, bradycardia, and, when pulse oximetry is used, decreases in oxyhemoglobin saturation, there is no evidence that use of such devices decreases the incidence of SIDS. They might be of value for selected infants but should not be used routinely.”

For more information, ask your doctor.

Resources and References
Full AAP report: SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf+html
Consumer Product Safety Commission (crib safety):
http://www.cpsc.gov/info/cribs/index.html.

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