Leading pediatricians group recommends infants sleep in cribs, not parents' beds

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"The recommendations are very straightforward and clear: Babies should not be asleep in the same bed that their parents are sleeping in," said James Kemp, M.D., associate professor of pediatrics at Saint Louis University and a world-recognized researcher on SIDS.

Kemp was one of three physicians acknowledged in the American Academy of Pediatrics new position paper on sudden infant death, which was released on Oct. 10. October is SIDS Awareness Month.

The policy statement strengthens recommendations offered in the last American Academy of Pediatrics paper on infant sleep position and sudden infant death syndrome, which was published in 2000, said Kemp, who is director of the Sleep Disorder Program at SSM Cardinal Glennon Children's Hospital.

"The recommendation five years ago said that in some circumstances, allowing a baby to sleep in an adult bed can be dangerous. This one said you shouldn't do it. It's a gutsy type of statement," he said.

Kemp's research, published in the October 2003 issue of Pediatrics, found that babies who sleep in an adult bed face a risk of suffocation that is as much as 40 times greater than babies who sleep in standard cribs.

He also has found that SIDS is more common among African-American infants than in babies of other races because they are more likely to be put to sleep in adult beds or on surfaces other than cribs, such as sofas.

"There are varied reasons for sleeping with your kids. In St. Louis, we found that the practice was more common among families who could not afford safe cribs," Kemp said.

Advocates of bed-sharing argue that allowing a baby to sleep in his or her mother's bed promotes breastfeeding and closeness.

The new American Academy of Pediatrics' recommendation advises putting babies to sleep in "a separate but proximate sleeping environment" - a safe crib, bassinet or cradle that is located in the parents' bedroom.

"Infants may be brought into bed for nursing or comforting but should be returned to their own crib or bassinet when the parent is ready to return to sleep," the policy statement said. "The task force recommends that the infant's crib or bassinet be placed in the parent's bedroom, which, when placed close to their bed, will allow for more convenient breastfeeding and contact."

The policy statement makes other recommendations about where babies should sleep: They shouldn't share beds with other children, nor sleep with an adult on a couch or armchair.

The new policy reiterates that infants should be placed on their backs - not on their stomachs and sides - to sleep. Babies should sleep on a firm crib mattress, covered by a sheet, with no soft, cushy bedding such as pillows, comforters or quilts, in a room that isn't overly hot. Smoking during pregnancy increases a baby's risk of SIDS, and giving pacifiers at naptime and bedtime are associated with a reduced risk of SIDS.

"This is a clear recommendation from the Academy of Pediatrics that looked at a number of factors that contribute to babies dying suddenly and in their sleep," Kemp said.

Saint Louis University