There has been a major decrease in the incidence of
sudden infant death syndrome (
SIDS) since the American Academy of Pediatrics (
AAP) released its recommendation in 1992 that infants be placed down for sleep in a nonprone position. Although the
SIDS rate continues to fall, some of the recent decrease of the last several years may be a result of coding shifts to other causes of unexpected
infant deaths. Since the
AAP published its last statement on
SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the
AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping. The
AAP also stresses the need to avoid redundant soft bedding and soft objects in the infant's sleeping environment, the hazards of adults sleeping with an infant in the same bed, the
SIDS risk reduction associated with having infants sleep in the same room as adults and with using
pacifiers at the time of sleep, the importance of educating secondary caregivers and neonatology practitioners on the importance of "back to sleep," and strategies to reduce the incidence of
positional plagiocephaly associated with supine positioning. This statement reviews the evidence associated with these and other
SIDS-related issues and proposes new recommendations for further reducing
SIDS risk.