AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children Task Force on Sudden Infant Death Syndrome The Changing Concept of Sudden Infant Death Syn

ABSTRACT. There has been a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed down for sleep in a nonprone position. Although the SIDS rate continues to fall, some of the recent decrease of the last several years may be a result of coding shifts to other causes of unexpected infant deaths. Since the AAP pub-lished its last statement on SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleep-ing. The AAP also stresses the need to avoid redundant soft bedding and soft objects in the infant’s sleeping environment, the hazards of adults sleeping with an in-fant in the same bed, the SIDS risk reduction associated with having infants sleep in the same room as adults and with using pacifiers at the time of sleep, the importance of educating secondary caregivers and neonatology prac-titioners on the importance of “back to sleep, ” and strat-egies to reduce the incidence of positional plagiocephaly associated with supine positioning. This statement re-views the evidence associated with these and other SIDS-related issues and proposes new recommendations for further reducing SIDS risk. Pediatrics 2005;116:1245– 1255; SIDS, sudden infant death syndrome, sudden unex-pected infant death, infant mortality, supine position, in-fant sleep, infant bedding. ABBREVIATIONS. SIDS, sudden infant death syndrome; AAP