Table 2 Summary of recommendations and strength of recommendations by PrevInfad and the AAP
Effective strategies to reduce SIDS | PrevInfad 2016a | AAP 2016a |
|---|---|---|
Modifying behaviours and care related to the sleeping environment and nutrition | ||
Supine position for sleeping | Grade A | Grade A |
Supervised awake tummy time | Recommended but not graded | Grade B |
Firm surface for sleeping | Recommended but not graded | Grade A |
Soft objects and loose bedding away from the sleep area | Recommended but not graded | Grade A |
Avoid overheating and head covering | Grade I | Grade A |
Room-sharing with the infant on a separate sleep surface | Grade B | Grade A |
No bed-sharing if father or mother are tobacco smokers, have consumed alcohol, anxiolytic, antidepressant or hypnotic drugs and in case of extreme exhaustion. | Grade B | Recommended but not graded |
No routine use of commercial devices that are inconsistent with safe sleep recommendations. | Not reported | Grade B |
Consider offering a pacifier at naptime and bedtime | Grade B | Grade A |
Breastfeeding on demand | Grade A | Grade A |
Counselling to modify behaviours and care related to maternal factors | ||
Regular prenatal care | Grade B | Grade A |
Avoid smoke exposure during pregnancy and after birth | Grade A | Grade A |
Avoid alcohol and illicit drug use during pregnancy and after birth | Grade B | Grade A |
Infant-related factors | ||
Prematurity and low birth weight | Not graded | Not reported |
Sibling with SIDS | Not graded | Not reported |
Other strategies to modify behaviours | ||
Infants should receive immunizations following respective national immunization programme | Grade I | Grade A |
No use of cardiorespiratory monitors at home as a strategy to reduce the risk of SIDS | Grade I | Grade A |
Health care providers, staff in newborn nurseries and neonatal intensive care units, and childcare providers should endorse and model the SIDS risk-reduction recommendations from birth. | Not reported | Grade A |
Media and manufacturers should follow safe sleep guidelines in their messaging and advertising. | Not reported | Grade A |
Continue the “Safe to Sleep” campaign, focusing on ways to reduce the risk of all sleep-related infant deaths, including SIDS, suffocation, and other unintentional deaths. Paediatricians and other primary care providers should actively participate in this campaign. | Not reported | Grade A |
Continue research and surveillance on the risk factors, causes, and pathophysiologic mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths entirely. | Not reported | Grade C |
There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS. | Not reported | Grade C |