8/28/2023 0 Comments 7 safe sleeping practices![]() study found bedsharing in the absence of hazards was protective against SIDS in infants older than 3 months ( 14). Other analyses of the literature ( 10– 12) have not drawn the same conclusions as the AAP and its statistician who reviewed these two studies ( 16). of 400 SIDS cases from the 1990s and mid 2000s found no increased risk of bedsharing in the absence of hazards ( 14). This study showed an increased risk of death in the absence of hazardous circumstances, but has been criticized for using an unrealistic comparator group for co-sleeping, among other reasons ( 10). as evidence for its recommendation against bedsharing ( 15). ![]() The AAP cited a 2013 study by Carpenter et al. Hazardous circumstances include sofa-sharing, co-sleeping in a chair, infant tobacco exposure, co-sleeping with an adult impaired by alcohol, and co-sleeping with a low-birthweight or preterm infant ( 7, 10, 14). ![]() Authorities in Spain, the United Kingdom, and Norway are no longer advising against bedsharing when no hazards exist ( 11– 13).Ĭo-sleeping is associated with an increased risk of sleep-related death in certain hazardous circumstances. However, not all experts agree that bedsharing is universally unsafe ( 10). There is widespread consensus that co-sleeping (defined here as a sharing any sleep surface) with hazardous circumstances increases the risk of death. In its 2022 recommendations, the AAP states that “on the basis of evidence, the AAP is unable to recommend bed sharing under any circumstances” ( 7). Sleep-related death, or SUID, includes SIDS plus accidental suffocation (ICD-10 code W75), and “ill-defined” death (ICD-10 code R99). However, the AAP and other organizations have long recommended that parents avoid any bedsharing in order to prevent SIDS ( 9), due to concerns that bedsharing may cause SIDS and other sleep-related infant death. Bedsharingīedsharing (defined here as sharing an adult bed) facilitates breastfeeding and is associated with more night-time breastfeeding ( 8). However, it is unclear what aspects of breastfeeding are conferring this protection, and if it is breastfeeding or human milk that is responsible. The evidence for a protective association between breastfeeding and SIDS was consistent enough across many observational studies for the American Academy of Pediatrics (AAP) to recommend “human milk feeding” in its 2022 guidelines to prevent SIDS ( 7). These mechanisms are plausible for some deaths, but more evidence is needed. ![]() Increased brain myelination seen in breastfed infants ( 5) may affect SIDS risk ( 6). Breastfed infants are more easily aroused from active sleep than formula fed infants at 2–3 months of age ( 4). proposed possible mechanisms, including increased arousability of the infant and immunoglobulins and cytokines in breast milk that may protect infants during the vulnerable period of SIDS, particularly considering that SIDS is often preceded by a minor infection ( 2). In their 2011 meta-analysis on breastfeeding and SIDS risk, Hauck et al. Studies have shown that breastfeeding is associated with a lower risk of Sudden Infant Death Syndrome (SIDS) ( 1, 2) and Sudden Unexpected Infant Death (SUID) ( 3), and the association with SIDS is thought to likely be causal ( 2).
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