Back to Sleep

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Supine positioning is one of the few truly effective measures known to reduce the incidence of SIDS (sudden infant death syndrome.) In accord with the American Academy of Pediatrics recommendations, once a NICU patient’s acute illness has resolved and the infant is approaching discharge, all term and near-term infants without contraindications should be placed on their backs to sleep. Soft bedding materials should not be used. Parents should be educated as to the reasons and importance of supine positioning at home in the unmonitored infant.

All preterm infants without contraindications should be placed on their backs once they graduate to a bassinet or crib.  Boundaries formerly  used for developmental care to mimic the confines of the womb should be removed (although snuggling is still appropriate.)

Contraindications to supine positioning include respiratory distress, airway issues (macroglossia/glossoptosis, Pierre Robin syndrome, tracheolaryngomalacia) and severe gastroesophageal reflux disease (at risk for aspiration, apnea.) Infants with these exceptional conditions should have precaution notices on their bassinets or cribs.

References:

AAP. Infant Positioning and SIDS. Pediatrics 1992;89:1120-126.

AAP. Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position. Pediatrics 2000;105:650-656.

Discussed at Collaborative Pathways meeting 7/25/01 and included in the NICU Nursing Guidelines Manual #40:08.56.