The ‘back to sleep’ campaign is now just about 20 years old and there has been a significant reduction in sudden infant deaths.
The AAP has released a new policy statement this month outlining a broader approach to infant sleep. Similar to the push for ‘medical homes’ this information is somewhat common sense but tries to bring a little bit more together for a broader picture: it isn’t just about putting a baby to sleep on her back but is about the whole environment. Is anyone smoking around the baby? Are there any loose blankets or wedges close to the baby while sleeping? Is the baby fully immunized?
Here’s a link to what we already know are risk factors: SIDS on our website.
Here is a summary quote of what the AAP wants parents to think about: “The recommendations described in this policy statement include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunizations, consideration of using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs.”
In summary, the baby should sleep on her back on a firm surface, free of encumbrances like pillows, blankets, crib bumpers, etc. Parents should not be smoking or using drugs. Breastfeeding is best. Keep an infant fully immunized. Do not overheat or over-bundle a baby. Consider having the baby in the room with you but not in the bed and consider using a pacifier.
Here is a nice table the AAP included in their release: Table 1.
I personally do not think you need to add a pacifier if you have been raising baby without one. The evidence here is real and there is certainly nothing wrong with it. Another common question is that of the baby rolling over on her own. The recommendation is to put the baby back to sleep until one year but you and I both know most babies turn over to side or even tummy long before this. There is no recommendation to pin or wedge them down! If they turn, they turn. The important thing is to keep the sleeping surface firm and unencumbered so there is nothing loose for them to turn into and create a suffocation risk.