AAP Releases Updated Safe-Sleep Recommendations for Infants

June 22, 2022


Elizabeth (Izzy) Montgomery, MPA
Policy Analyst

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Weighted blankets and swaddles, crib bumper pads, and inclined sleep surfaces are unsafe for infants and should not be used where infants sleep, according to newly updated safe-sleep recommendations from the American Academy of Pediatrics (AAP).

On Tuesday, June 21, the AAP released a new report on sleep-related infant deaths, along with revised recommendations on safe-sleep practices — the first update of the academy’s recommendations since 2016. The AAP also published a summary of the updates in a news release.

The AAP continues to emphasize many of its past recommendations, including placing infants on their backs to sleep (Safe to Sleep campaign) and avoiding the use of soft bedding, which presents a suffocation hazard. The updated recommendations state that infants should only sleep on flat/non-inclined sleep surfaces, that devices to monitor infants’ vital signs should be avoided (such devices have not been shown to reduce sudden infant death syndrome, or SIDS), and that “tummy time,” periods when an infant is placed on his or her stomach while awake and with someone watching, should begin shortly after hospital discharge.

The recommendations also address room- and bed-sharing. While the AAP continues to recommend that parents share a room with their infant, with the infant sleeping close to the parents’ bed but on a separate surface, it has shortened the recommendation from the first year of life to the first six months. This revised timeline is based on evidence that the highest risk of SIDS occurs within the first six months of an infant’s life. The AAP does not recommend bed-sharing but acknowledges that it is commonly practiced. The academy asks clinicians and parents to have a “frank and non-judgmental discussion” about bed-sharing circumstances, while also noting the extreme risk of co-sleeping with infants on couches, armchairs, and other cushioned surfaces.

The updated recommendations come on the heels of new federal legislation to protect infants. In May, President Joe Biden signed into law the Safe Sleep for Babies Act of 2021, which outlaws the manufacturing and sale of crib bumpers and certain inclined infant sleepers. Inclined sleepers are particularly dangerous for infants, with at least 13 deaths attributed to infant rockers sold by Fisher-Price over the past 12 years.

Arkansas had an infant mortality rate of 7.3 deaths per 1,000 births in 2020 — the fourth highest of all states. SIDS is a leading causing of death among infants, and while researchers do not know its exact cause, it is often linked to unsafe sleeping practices.

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