This week from the AAP: updated infant sleep recommendations


This week, the American Academy of Pediatrics updated their safe sleep recommendations and released the 2022 bright futures/AAP periodicity schedule for preventive pediatric health care. In part 1, we focus on the updates in sleep recommendations.

In the updated academy policy statement, “Sleep-related infant deaths: Updated 2022 recommendations for reducing infant deaths in the sleep environment,” they emphasized the need for infants to sleep on their backs on flat, noninclined surfaces without soft bedding. Additionally, they detailed the risks of bed-sharing, according to the press release announcing the updates.

Approximately 3,500 infants are victims of sleep related infant deaths annually, according to the AAP, with research indicating that sleep-related death can occur when an intrinsically-vulnerable to SIDS infant is placed in an unsafe sleep environment.

This is the first update to the safe infant sleep recommendations since 2016 and will be published in the July edition of Pediatrics, and online on June 21, 2022. Accompanying the statement, AAP will also supply a technical report that provides evidentiary value to the recommendations given.

The report highlighted the 67 times higher risk of sleep related infant deaths when sleeping with someone on a couch, armchair, or cushion and 10 times higher risk when sleeping with someone who is impaired due to fatigue, using sedating medications, or substances like alcohol, illicit drugs, or smoking. As a baseline, the risk of sleeping on the same surface as someone else as an infant under 4 months of age increases infant death by 5 to 10 times.

“We’ve made great strides in learning what keeps infants safe during sleep, but much work still needs to be done,” said Rachel Moon, MD, FAAP, professor of pediatrics at the University of Virginia School of Medicine and lead author of the statement and technical report, generated by the AAP Task Force on Sudden Infant Death Syndrome and the AAP Committee on Fetus and Newborn, in the release. “A baby’s death is tragic, heartbreaking and often preventable. If we’ve learned anything, it’s that simple is best: babies should always sleep alone in a crib or bassinet, on their back, without soft toys, pillows, blankets, or other bedding.”

To reduce these risks, the AAP recommends:

  • Infant should sleep on a firm, flat, and noninclined surface that is marketed exclusively for sleep.
  • Do not use sitting devices—car seats, strollers, swings, infant carriers, infant slings— for routine sleep.
  • Breastfeeding for at least 2 months partially or exclusively reduces the risk of sleep related infant death.
  • Parents should sleep in the same room but not the same bed as baby.
  • Avoid parent and infant exposure to illicit substances.
  • Baby receives routine immunizations.
  • Pacifier use is associated with reduced risk.
  • Avoid use of commercial devices that claim to reduce risk of SIDS.
  • Supervised tummy time is recommended while awake.
  • There is no evidence that swaddling reduces the risks of SIDS.


American Academy of Pediatrics updates safe sleep recommendations: back is best. American Academy of Pediatrics. Published June 21, 2022. Accessed June 21, 2022.

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