Sudden Infant Death Syndrome (SIDS) previously known as “crib death” is every parent’s nightmare. Documentation of this tragic phenomenon can be traced back to the 13th century. Formal investigation of SIDS in the United States began in 1963 leading to the 1974 “Sudden Infant Death Act.” In 1992, the “Back to Sleep” campaign was implemented by the American Academy of Pediatrics (AAP) and reduced the incidence of SIDS by 50% (from 1.2/1,000 to .57/1000) but there are still approximately 3,500 infant deaths annually from sleep-related deaths. Although there have been many factors identified that may play a role in SIDS (bed sharing, smoke exposure, soft sleeping surface, overheating and objects in crib) there is no clear explanation as to what causes SIDS.


Since 1992 the AAP has released updates on sleep recommendations as research on SIDS has progressed. The most recent guidelines came out on October 24th, 2016. The most significant change in the AAP recommendations is that; “Infants share their parents’ bedroom (but not the same sleeping surface) for at least the first 6 months of life, and optimally, for the first year of life based on the latest evidence.” The word ‘parent’ can be substituted with the word “caregiver,” and can include family members, friends, a baby nurse or nanny, or other qualified individuals.

This recommendation is a dramatic change and has already lead to an outpouring of questions and concerns. It is important to realize that these are recommendations and that the purpose of this article is to alert you to changes. As always, ANY individual advice about your infant must come directly from your physician. Boston Baby Nurse strongly suggests that you contact your physician to discuss how these recommendations apply to you and your infant.

Parent information is available at  


  • Always place your baby on his or her back for every sleep time
  • Always use a firm sleep surface.  Car seats and other sitting devices are not recommended for routine sleep
  • Keep soft objects or loose bedding out of the crib. This includes pillows, blankets and bumper pads
  • Wedges and positioners should not be used
  • Pregnant women should receive regular prenatal care
  • Do not smoke during pregnancy or after birth
  • Breastfeeding is recommended
  • Offer a pacifier at nap and bedtime
  • Avoid covering an infant’s head or overheating
  • Do not use home monitors or commercial devices marketed to reduce the risk of SIDS
  • Infants should receive all recommended vaccinations
  • Supervised awake tummy time is recommended daily to facilitate development and minimize positional plagiocephaly (flat heads).

In summary, put your baby to sleep on a firm sleep surface in your bedroom without anything in the crib and avoid overheating. Get prenatal care, don’t smoke, breastfeed if possible, use a pacifier at sleep time, immunize your infant and do not use monitors or devices marketed to reduce the risk of SIDS. Don’t forget about awake and supervised daily tummy time!!  

Enjoy every moment of parenting an infant — time goes so fast!