Recommendations from the American Academy of Pediatrics
Last Updated October 2005

• Back to sleep: Infants should be placed for sleep in a supine (wholly on back position) for every sleep.
• Use a firm sleep surface: A firm crib mattress, covered by a sheet, is the recommended sleeping surface.
• Keep soft objects and loose bedding out of the crib: Pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects should be kept out of an infant’s sleeping environment.
• Do not smoke during pregnancy: Also avoiding an infant’s exposure to second-hand smoke is advisable for numerous reasons in addition to SIDS risk.
• A separate but proximate sleeping environment is recommended such as a separate crib in the parent’s bedroom. Bed sharing during sleep is not recommended.
• Consider offering a pacifier at nap time and bedtime: The pacifier should be used when placing infant down for sleep and not be reinserted once the infant falls asleep.
• Avoid overheating: The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult.
• Avoid commercial devices marketed to reduce the risk of SIDS: Although various devices have been developed to maintain sleep position or reduce the risk of rebreathing, none have been tested sufficiently to show efficacy or safety.
• Do not use home monitors as a strategy to reduce the risk of SIDS: There is no evidence that use of such home monitors decreases the risk of SIDS.
• Avoid development of positional plagiocephaly (flat back of head): Encourage “tummy time” during the day.
• Avoid having the infant spend excessive time in car-seat carriers and “bouncers.” Place the infant to sleep with the head to one side for a week and then changing to the other. Ensure that others caring for the infant (child care provider, relative, friend, babysitter) are aware of these recommendations.