Table 2. Recommendations to reduce the risk of SIDS.

Adapted with permission from [118].

SIDS: Sudden infant death syndrome

Risk factors	Recommendations
Bed sharing	Infants may be brought into the bed for feeding or comforting but should be returned to a separate sleep area when the parent is ready to return to sleep. It is prudent to provide separate sleep areas and avoid co-bedding for twins and other infants of multiple gestations. Room sharing without bed-sharing is recommended. Devices promoted to make bed-sharing safe are not recommended. There are specific circumstances in which bed-sharing is particularly hazardous, and it should be stressed to parents that they avoid bed-sharing during the following situations at all times: If either parent smokes If the infant is younger than three months If the infant is placed on excessively soft surfaces (e.g., waterbeds, sofas, armchairs) If soft bedding accessories (e.g., pillows, blankets) are used If there are multiple bed sharers If the parent has consumed alcohol If the infant is bed-sharing with someone who is not a parent
Bedding	Pillows, quilts, comforters, sheepskins, and other soft surfaces are hazardous when placed under the infant or when loose in the sleep environment. Wedges, positioning devices, bumper pads, and similar products are not recommended.
Breastfeeding	Breastfeeding is recommended. If a breastfeeding mother brings the infant into her bed for nursing, the infant should be returned to a separate sleep area when the mother is ready to return to sleep.
Infant monitors and apparent life-threatening events	Infant monitors should not be used to prevent SIDS. There is no evidence that apparent life-threatening events are precursors to SIDS.
Overheating and head covering	Avoid overheating and head covering in infants.
Pacifier use	Consider offering a pacifier at nap time and bedtime.
Prenatal care and postnatal exposures	Avoid alcohol and illicit drug use during pregnancy and after the infant's birth. Pregnant women should obtain regular prenatal care. Women should avoid smoking during pregnancy, and exposure to smoke in the pregnant woman's or infant's environment should be avoided.
Sleep areas	Car seats and other sitting devices are not recommended for routine sleep at home or in the hospital, particularly for young infants. Infants should sleep in a safety-approved crib, portable crib, play yard, or bassinet.
Sleep position	Sleeping in the supine position is recommended for infants to reduce the risk of SIDS; prone or side sleeping is not safe and is not advised. Once an infant can roll from the supine to the prone position and back again, he or she can remain in either position during sleep. Supervised, awake tummy time on a daily basis can promote motor development and minimize the risk of positional plagiocephaly. SIDS = sudden infant death syndrome. Information from reference 5.