06/22/2022
Today, the American Academy of Pediatrics released the 2022 safe sleep guidelines! There have been many updates to the previous guidelines. I urge you to read through the first few tables. Table 1 lists definitions of terms, table 2 is a summary of recommendations with different levels of strength of these recommendations, and table 3 lists the safe sleep guidelines that have been substantially revised since 2016. Here are a few notable changes in the guidelines:
-It is recommended that weighted blankets, weighted sleepers, weighted swaddles, or other weighted objects not be placed on or near the sleeping infant.
-When an infant exhibits signs of attempting to roll (which usually occurs at 3–4 mo but may occur earlier), swaddling is no longer appropriate because it could increase the risk of suffocation if the swaddled infant rolls to the prone position. (To clarify after Dr. Moon's previous 8 week recommendation which is not in line AAP guidance)
-Given the questionable benefit of hat use for the prevention of hypothermia and the risk of overheating, it is advised not to place hats on infants when indoors except in the first hours of life or in the NICU.
-Sleep surfaces with inclines of >10 degrees are unsafe for infant sleep.
-It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for at least the first 6 mo. (Removing the previous recommendation of “ideally for the first year of life”)
-The AAP understands and respects that many parents choose to routinely bed share for a variety of reasons, including facilitation of breastfeeding, cultural preferences, and belief that it is better and safer for their infant. However, based on the evidence, we are unable to recommend bed sharing under any circumstances. (This one goes on further)
-Direct-to-consumer heart rate and pulse oximetry monitoring devices, including wearable monitors, are sold as consumer wellness devices. A consumer wellness device is defined by the FDA as one intended “for maintaining or encouraging a healthy lifestyle and is unrelated to the diagnosis, cure, mitigation, prevention, or treatment of a disease or condition.” Thus, these devices are not required to meet the same regulatory requirements as medical devices and, by the nature of their FDA designation, are not to be used to prevent sleep-related deaths. Although use of these monitors may give parents peace of mind, and there is no contraindication to using these monitors, data are lacking that would support their use to reduce the risk of these deaths. There is also concern that use of these monitors will lead to parent complacency and decreased adherence to safe sleep guidelines. A family’s decision to use monitors at home should not be considered a substitute for following AAP safe sleep guidelines.
Read through the full AAP publication release here:
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-057990/188304/Sleep-Related-Infant-Deaths-Updated-2022?fs=e?autologincheck=redirected
