2022 Updated AAP Safe Sleep Guidelines

There is so much to know and learn when having a new baby! And the American Academy of Pediatriacs [AAP] is continually updating their recommendations. While it can be sometimes hard to keep up, we know that by following the latest research that we are doing the absolute best that we can to keep our babies safe. So let’s go over what the 2022 updated AAP safe sleep guidelines are and has and hasn’t changed.

Back to Sleep

This has been recommended for going on 40+ years.

For the first year of life, babies should always be placed to sleep on their backs. Once your baby can master rolling both from front-to-back and back-to-front, you should still place them on their back to sleep, but it’s okay to let them roll and sleep on their tummy if they so choose.

Firm, Flat Sleep Surface

Babies should be placed to sleep on a flat, firm sleep surface such as a crib, bassinet, or portable play yard. Do not use a crib that is inclined, any inclined sleeper, positioners, boppy, carseat, swing etc for sleep. The new federal Safe Sleep for Babies Act will help get rid of potentially dangerous baby sleep products such as inclined sleepers, in-bed sleepers, loungers, and travel/compact sleepers on the market by mid-2022!

There should be no gaps between the mattress and the crib or bassinet itself. And Nothing else in the crib besides a tight fitting sheet.

NO stuffed toys, loose blankets, or pillows. Babies can sleep in a sleep sack or swaddle blanket for warmth.

In a recent study, it was found that almost 80% of SIDS deaths happened in a sleep space with pillows, blankets, stuffed animals or bumpers. [Bumpers are also tagged to be no longer legally sold]

Room Environment

The room should be kept at 68°-72° F with good airflow, such as a fan to circulate the air. Overheating and poor circulation is a SIDS risk. A good rule of thumb is that babies need only one light additional layer than what you’re wearing to bed, such as one-piece pajamas and a sleep sack or swaddle.

Roomsharing Vs Cosleeping Vs Bedsharing

Roomsharing and Cosleeping are actually interchangable terms that mean the caregiver sleeps in the same room as the baby.

Roomsharing is highly recommended as a SIDS reducer. It was actually previously recommended for the first YEAR, but thank goodness they reduced it to the first 6 months. It usually makes sense to transition a baby to their own room around the same time that they transition out of a bassinet.

Bedsharing is when the caregiver shares a sleepspace with the baby. This is not recommended. The AAP recognizes that there are many benefits to new tired parents, especially if they are breastfeeding, but that the safety risks outweighs the benefits. If you choose to bedshare, do it as safely as possible:

Never sleep on a couch or recliner, make sure that the surface is firm and flat
Make sure that no bedding or pillows are near the baby.
Make sure that the adult is well rested and sober so that they are able to be attentive to the baby

Bedsharing is particularly dangerous for premature or low birth weight babies, newborns under 4 months of age, babies of parents who smoke or who smoked during pregnancy, and babies of parents who drink alcohol or take medication that promotes drowsiness. Never get too cozy with your baby in a waterbed or other soft surface such as a couch or armchair just in case you drift off.

If you’re having trouble staying awake during nighttime care, ask for help from a family member or consider hiring an overnight newborn care professional.

Offer a Pacifer

Pacifiers have been shown to reduce the risk of SIDS and bonus, they help babies sleep better too!

Weighted Sleep Sacks/Swaddles

This recommendation is new. There are many brands that have a small [or large] weight to help calm the baby. This is now not recommended on the basis of not enough data to recommend safely.

No Hats on Newborns Indoors

This is another new one! The AAP now recommends that once a baby has graduated from the NICU, that hats are not necessary on newborns indoors. The idea is that newborns overheat easily and overheating is a SIDS risk.

Avoid Monitoring Devices

The Owlette and other infant monitoring devices have been on the market for many years. Some parents swear by them, but the research tells us otherwise. There is no statistical reduction of SIDS when using a monitor. The devices are not regulated, can give a false sense of security, or send parents into a panic if they go off on a false alarm.

Breastfeeding

Wait, this is a sleep blog right? Well, exclusively breastfeeding for the first 6 months reduces the overall risk of infant mortality. To be specific, human milk- whether in a bottle or breast is what is so impactful to newborn health. The AAP recommends to exclusively breastfeed for 6 months, and then continue breastfeeding in combination with solids to 2 years and beyond!

Healthy Choices

Avoid smoking, alcohol, and illicit drugs during pregnancy and after baby is born. Attend all well-visits and immunize your baby per the CDC’s immunization schedule. Offer your baby lots of tummy time during the day, to strengthen their core muscles and help them meet developmental milestones.