Keeping infants safe while sleeping

When the Back to Sleep Campaign was launched by the American Academy of Pediatrics in the 1990s, our nation saw unprecedented decreases in sudden unexplained infant death (SUID) based on initial recommendations that babies are safer if placed on their backs to sleep. That progress has stalled in recent years, particularly among communities of color.

With a focus on reducing these disparities, the AAP updated its safe sleep guidance in a new policy statement released on June 21. In addition to reiterating the “ABCs” that babies should sleep Alone on their Back in a Crib, the AAP makes the following key updates:

† Sleeping surfaces should be flat.

† Breastfeeding for all infants younger than six months is recommended.

† Co-sleeping with an infant is especially risky when done with specific other behaviors.

† To address racial disparities, there should be additional funding for research on the social determinants of health, health care inequalities and the impact of structural racism.

Pediatricians face limitations to implementing safe sleep practices, such as limited time for conversations and different lived experiences from those in the communities they serve. That is why community-based collaborations are so important to conveying guidance in cultural contexts, the goal of Cook County Health’s participation in the Child Safety Forward initiative.

As part of the initiative, Cook County Health has convened a multi-disciplinary group of stakeholders and has deployed an innovative simulation training at the Child Protection Training Academy of the University of Illinois at Springfield, to help identify risk factors for communities that can lead to unsafe sleep practices.

Using a public health approach based on the AAP’s guidelines, we are working with stakeholders to build knowledge and share timely information. Educating specifically through an equity and diversity lens will more effectively achieve our goal of helping all families implement safe sleep practices to reduce child fatalities.

Daniel P. Riggins, M.D.,

Cook County Health; Verleaner Lane, project director,

Project CHILD of Cook County Health

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