Q&A with Pediatrician on New AAP Safe Sleep Recommendations

Q&A with Pediatrician on New AAP Safe Sleep Recommendations

The American Academy of Pediatrics recently released its newest recommendations for infant safe sleep, advocating infants should sleep in the same room as their parents for at least six months to decrease the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths. UnityPoint Health pediatrician, Nicole Baumann-Blackmore, M.D., answers questions parents might have following the new recommendations.

1. What happens if my child exceeds the weight limits of some suggested sleeping surfaces (basinets, sleepers, etc.)? Do I need to get another alternative sleeping surface before a crib?  Not necessarily, as you could move the crib into your bedroom, if feasible, and if you want to continue to room share.  If it is not feasible to move the crib, you could consider using a portable crib or play yard that could then also be used for travel, etc. 

2. If I’ve already moved my child to a crib, and he/she is under a year, do you recommend I bring my baby back into my bedroom?   This is a frequent discussion amongst pediatricians and parents right now, and there is no "one size fits all" answer to this question. The official recommendation would be to bring the baby back into the parents' bedroom until at least 6-months-old. That being said, families need to do what works for them and keeps everyone rested and happy. 

3. If I don’t move my child from the crib, what precautions should I take to ensure my baby’s safety in another room?  The most important things are to lay your baby down on his/her back to sleep (every time, even for naps) and to make sure that they have a safe sleep environment – firm mattress with a tight, fitted sheet; no loose bedding; no pillows or stuffed animals and no bumper pads.  Other precautions you can take include putting your baby down with a pacifier, keeping the room cool and making sure your baby isn't overheated (a good rule of thumb for newborns and young infants is to add one layer more than an adult would be comfortable wearing in that same environment). 

A question that comes up a lot is what to do once a baby rolls over on its own – do you let baby be or roll him/her back onto the back position? If your baby can roll on his/her own, then stop swaddling (if you still are), continue to place on his/her back to sleep, continue to make sure the sleep space is safe and free of soft objects and then let your baby be. Otherwise, you will never get any sleep yourself. 

4. The study mentions feeding or sleeping in an adult bed is safer than on a couch or armchair. Can an adult bed be a safe feeding environment for mom/baby?   It can be with proper precautions – no pillows, sheets or blankets should be in the space.  Parents should be in a position on the bed so that if they were to fall asleep, the baby would not be dropped off the side, and parents should not be impaired in any way (no sedating medications, alcohol or other drugs, etc.). If a parent were to fall asleep while feeding the baby, it is important that mom or dad lay baby down in his/her separate sleep space as soon as they realize this happened. This is not recommended for term infants younger than 4-months-old, preterm or low birth weight infants or if parents smoke. Of note, a waterbed is NOT considered safe. 

5. While the study doesn’t endorse co-sleeping, it suggests it can be safer than other places of inadvertently falling asleep with a child. What are your thoughts on co-sleeping?   The policy statement is really trying to articulate what common sense tells us but also address the realities of parenthood.  Sharing a room but not the bed is the safest for babies. However, parents are often times exhausted and have a difficult time staying awake for middle of the night feedings. In these situations, it is much safer to feed in a space without soft cushions or armrests, which babies have been known to slide down into and suffocate. This way, if a parent does fall asleep with the baby, the risk is less…still not as low as when babies have their own proper sleep space, though. 

6. How should I bring up sleeping habits with my child’s pediatrician? Should I tell my pediatrician if I’ve been co-sleeping with their child?  Your baby’s pediatrician REALLY wants you to be honest. We have heard it all and don’t judge. If you are co-sleeping, we want to help you make it as safe as possible for your baby. 


For any questions related to your child’s health, contact your UnityPoint Health pediatrician or provider.

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