Updated AAP Infant Sleep Safety Guidelines
The American Academy of Pediatrics (AAP) recently released its updated 2022 recommendations on safe infant sleep. These safe sleep guidelines are mainly directed around preventing Sudden Infant Death Syndrome (SIDS), which causes about 3,500 infant deaths per year [1], as well as other sleep-related infant injuries and death.
If you’ve been following me for a while, you’ll know that I believe the sleep environment is an essential part of great sleep! One of the central elements of the sleep environment is the sleep space (whether that’s a crib or a bassinet), and one of the most important jobs of the sleep space is to keep your baby SAFE.
If you have a newborn and would like some extra support and guidance on keeping them safe, as well as avoiding sleep issues you’ll later want to reverse, check out my Ultimate Baby Sleep Bundle!
While many of the AAP recommendations surrounding safe infant sleep remained the same, 7 new guidelines were introduced. Here is what you need to know about each one.
AAP Recommendations and 7 Newly Introduced Guidelines
7 New AAP Guidelines
No weighted sleepwear
This new guideline includes avoiding any weighted swaddles, weighted sleep sacks, or weighted blankets on or in your baby’s sleep space. This does not include unweighted wearable blankets or sleep sacks, which are both safe options I recommend!
No hats during sleep after the hospital
While hats are okay to use for sleep in the hospital (likely because mom and baby are checked on often), once your baby is home, it’s best to discontinue use as the hat could move/fall off while your baby is sleeping and become a potential hazard in your baby’s sleep space.
No inclined sleep items
If your baby has reflux, it’s common to think that keeping them inclined while sleeping would be safest, but the safest position is still flat on their back. While an incline may help decrease regurgitation, this sleep position has been associated with an increased risk of SIDS [2].
Bedside sleepers
Bassinets and portable cribs have all been proven to be safe options, however, bedside sleepers are only “ok” to use if they have passed the Consumer Product Safety Commission standards. There has not been enough data on bedside sleepers for the AAP to recommend them, so while they may be “ok”, you’ll want to do your research first.
Tummy time
By the time your baby is 7 weeks old, your baby should be getting 15-30 minutes of supervised, awake tummy time (within a 24-hour period). This is to help strengthen their neck and back muscles, as well as help prevent flat head syndrome.
Swaddling
While there is no evidence that swaddling can reduce the risk of SIDS, the AAP recommends swaddling your baby as a matter of preference. However, once your baby has started showing signs of rolling, the swaddle becomes unsafe and use should be discontinued. Keep in mind that signs of rolling can be subtle! These subtle signs could include:
Lifting head or shoulders more in tummy time
Rolling to shoulders or side
Scooting in a circle on their back
Rolling hips from side to side, and using legs to lift hips up
Check out this blog for more on swaddling, including the pros, cons, and when you should stop!
Cradleboards
While there is no data on cradleboards regarding their safety, the AAP has recognized them as appropriate sleep spaces in various cultures, as long as the baby is not wearing too many layers which could cause them to overheat.
AAP Guidelines on Reducing Risk That Have Remained the Same
No objects should be in or near your baby's sleep space.
Babies should be placed flat on their backs in their sleep space for both nighttime sleep and naps.
Use a firm, flat sleep surface (with a tightly fitted sheet) - nothing else in the crib or bassinet.
Room-sharing with your baby is recommended for 6-12 months and bed-sharing is not recommended. If you find that you have accidentally fallen asleep with your baby in your arms, return your baby to their safe sleep space as soon as you wake.
The use of pacifiers during sleep has been shown to help reduce the risk of SIDS [3].
Breastmilk has been shown to reduce the risk of SIDS.
Only use products for sleep that are specifically marketed for sleep (this includes loungers, rockers, etc.)
Avoid your baby overheating by dressing them for the temperature they’re in (not too warmly).
All of these recommendations are meant to be judgment-free and to provide important data to help keep your little ones safe during sleep, and be “protective factors,” i.e. actions you can take to decrease risk. Remember, not taking a protective factor (ex: using formula instead of breastmilk or not using a pacifier ) does not increase your child’s risk, it simply keeps it at baseline; whereas using the various risk factors (ex: putting a blanket in the crib with your baby or bedsharing) does increase risk.
Ultimately though, it’s up to you to decide what’s best for your family. I encourage you to do your own research on safe infant sleep. The AAP safe sleep guidelines are a great place to start, as they take years of research into consideration and have a vast evidence base as the reason each recommendation is formed [4]. ⠀⠀⠀⠀⠀⠀⠀
If you are looking for help making changes to your sleep situation, know that you’re not alone and that I’m here to help! Check out my digital sleep guides for step-by-step instructions, recommendations, as well as some extra support.
