“Back To Sleep” Turns 20

by Heidi Green
December 21, 2012

It was twenty years ago that the American Academy of Pediatrics (AAP) first called for parents and caregivers not to place their babies on their tummies for sleep. Two years later, the National Institute of Child Health and Human Development (NICHD) launched its “Back to Sleep” campaign to simplify and spread the message. Since then, the incidence of SIDS has declined dramatically, by more than 50 percent.

In light of this success, and due to increasing awareness about other sleep-related causes of childhood injury and death, the “Back to Sleep” campaign has received a facelift. As the renamed “Safe to Sleep” campaign, this effort looks beyond the baby’s initial sleep position.

Placing healthy babies on their backs to sleep is “the most effective action that parents and caregivers can take to reduce the risk of SIDS,” the campaign site asserts, but “Safe to Sleep” strives to raise awareness of “actions that parents and caregivers can take to reduce the risk of other sleep-related causes of infant death, such as suffocation.”

Several leading health and non-profit organizations are involved in this effort. In addition to NICHD and the AAP, partners include the Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), First Candle, and the Association of SIDS and Infant Mortality Programs (ASIP).

The campaign makes a variety of educational materials available to health care providers and parents. Its messages for parents and caregivers include:

• Babies sleep safest on their backs.
• Sleep position matters at every sleep time—naps and nighttime; inconsistency increases SIDS risk.
• The sleep surface should be a firm crib with a fitted sheet. It should be free of crib bumpers and other soft toys. Room-sharing is recommended, to reduce the risk of SIDS and other sleep-related causes of death.
• Babies should sleep in a safe crib, bassinet, or playpen at home; and in a crib that meets the federal safety standards of the Consumer Product Safety Commission (CPSC) when at a child care facility. (Child care crib regulations come into effect on December 28, 2012.)
• Car seats, carriers, swings, and similar devices should not be used for everyday sleep; babies should never be placed to sleep on soft surfaces like couches, pillows, or blankets.
• Sleep wedges or positioners should be avoided (learn why here).
• Parents should not drink alcohol or use illegal drugs. Also, they should not smoke or allow smoking around their babies.
• Breastfeeding reduces the risk of SIDS, but babies brought into bed for a feeding should be returned to their cribs afterward.
• Pacifiers during sleep are encouraged but should not be forced.
• Babies should be dressed in no more than one layer more than an adult would wear, to avoid overheating.
• Babies should have plenty of supervised “tummy time.”

Probably the most controversial suggestion here is that “Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else.” Any parent or grandparent who has had a snoozing child drift off to sleep while nursing or fall asleep on their shoulder will wonder about the need for such a rigid mandate. Ultimately, each parent will need to decide what is best for their own family. You can start your research on sleeping arrangements for you and your family here.

Find out more about sleep safety and SIDS elsewhere on baby gooroo.