American Academy of Pediatrics (AAP), in an updated policy statement and technical report is expanding its guidelines on safe sleep for babies, with an additional information for parents on creating a safe environment for babies to sleep.

"We have tried to make it easier for parents and providers to understand the recommendations by providing specific answers to common questions," according to Rachel Moon, MD, FAAP, chair of the AAP SIDS task force and lead author of the new guidelines.

"As a health care community, we need to do a better job translating what the research identifies as 'best practices' into the day-to-day practice of caring for infants in both the hospital and home environment."

In 1992, the AAP recommended that all babies should be placed on their backs to sleep. From then on, deaths due to Sudden Infant Death Syndrome have dramatically declined. However, sleep-related deaths from other causes like suffocation, entrapment and asphyxia have increased.

The guidelines, last updated six years ago, aim to help reduce the 4,600 sudden unexpected infant deaths (SUIDS) that occur each year, 50 percent of which are classified as SIDS. The guideline is also meant to address issues on breastfeeding, crib bedding, sleep space and positioning.

"We are making good progress in understanding SIDS and the importance of the infant's environment in preventing suffocation deaths. However, we still see evidence of unsafe sleeping practices, and we hoped to address those in these new guidelines." said Rachel Moon, M.D., Guideline Committee chair, Health News reports.

Part of the significant change in the guidelines is the recommendation not to use padded bumper in the crib. The use of bumper cribs bear no evidence that it has helped reduce the risk of SIDS but it can pose as a hazard if the infant rolls up against the bumper pad.

This is part of the trend to remove all unnecessary objects from a crib, including animals, toys, and excess blankets.

Additional recommendation focuses on the use of a firm sleep surface. Pillows or cushions should not be used as substitutes for mattresses or as an addition to mattress. All cribs should meet safety standards of the CPSC, Juvenile product Manufacturers Association and the ASTM International. If using an older crib, close attention should be placed on the slat spacing, snugly fitted and firm mattress with no drop sides to avoid injury.

AAP also recommends that infants share a room or sleep space with their parent but not sharing a bed. Staying in the same room with the parents has shown that it has decreased the risk of SIDS by as much as 50% in an article published in the issue of Pediatrics. On the other hand, sharing a bed can increase the likelihood of overheating, airway obstruction, suffocation and entrapment of the baby.

Recommended sleeping position is still supine, that is, to sleep in one's back. Previous generation preferred to lie prone ( tummy/abdomen down) or side-lying position . These two positions (prone and side-lying) increase the risk of rebreathing expired gases.

PubMed Central mentioned in a previous article of a study regarding the reported association between cot death and sleeping prone that could be related to rebreathing expired gases. The study done utilized a mechanical model simulating an infant's respiratory system. The simulated study showed that commonly used bedding materials can cause an accumulation of carbon dioxide of about 10% with baby model lying face down.

Once an infant is capable of rolling from side to side and thus change sleeping position on their own, they can be allowed to remain in that sleep position, whether it is supine, prone or side-lying. However, it is recommended that at the onset, the baby is placed in their sleeping environment at their backs.