Measures to reduce the risk of infant sudden infant death syndrome (SIDS)

1) Finishing and premature infants should be placed on their backs for sleeping. There are no negative effects from the supine sleeping position. Placement in the supine position is not indicated.

2) Infants should be placed on firm mattresses. Water beds, sofas ,mattresses or other soft surfaces should not be used.

Additional car seats, prams, cots or other seating devices should not be used for sleeping. Sleeping in an upright position may lead to gastro-oesophageal reflux or upper airway obstruction from head bending.

3) Breastfeeding is recommended. Mothers should exclusively breastfeed if possible or feed the baby with the milk they express with a breast pump until 6 months of age.

4) It is recommended that babies sleep in the same room as their parents, but in their own cot or bassinet that complies with safety regulations. Placing the cot close to the mother’s bed facilitates breastfeeding and contact. If parents bring the baby to their own bed for feeding or to settle the infant, the infant should turn to the separate sleeping surface when the parents are ready for bed.

5) Soft materials or loose bedding in the infant’s sleep environment up and down or near the infant should be avoided. These include comforter pillows ,comforter pillows , duvet , woolens, crib rails protectors and stuffed toys. Sleeping clothes such as a blanket instead of a blanket.

6)Consider offering a pacifier at bedtime.

The pacifier should be used when we put the baby to sleep and does not need to be repositioned when they fall asleep. For breastfed infants delay the introduction of a pacifier until breastfeeding is established.

7) Mothers should not smoke during pregnancy or after the baby is born and infants should not be exposed to second-hand smoke.

8) Mothers should avoid drugs and alcohol during pregnancy and after birth.

9) Avoid overheating and excessive clothing. The infant should be dressed lightly for sleeping and the thermostat should be set at a comfortable temperature ( 20-22 degrees).

10) Pregnant women should have regular prenatal care.

11) Infants should be vaccinated according to the national vaccination schedule. There is no evidence that vaccination increases the risk of SIDS. Indeed, recent evidence suggests that vaccination may have a protective effect against sudden infant death syndrome.

12) Avoid the use of commercial devices that do not meet sleep safety standards. Devices that advertise maintaining a sleep position, “protecting” a bed-sharing infant, or reducing the risk of apnea are not recommended because there is no evidence to support their safety and adequacy.

13) Infants should have some time to be in a prone position while awake and supervised. Changing the positioning of the infant’s head or changing the orientation of the bassinet can also minimize the risk of side-head injury from the supine (prone) position.

14) Fasciotomy cannot be recommended as a strategy to reduce sudden infant death syndrome. If the infant is placed in a fascioma a light blanket should be used should be applied well around the shoulders but loosely around the hips to avoid hip dysplasia. Fasciated babies should always be placed on their backs and when babies have gained the ability to turn from supine to prone all fasciolation should be discontinued.