Literature review for - Flourish Paediatrics

• Keep soft objects and loose bedding out of the crib
• Do not smoke during pregnancy
• A separate but proximate sleeping environment is recommended: the infant’s crib or
bassinet should be placed in the parents’ bedroom, which, when placed close to their bed, will
allow for convenient breastfeeding and contact
• Consider offering a pacifier at nap time and bedtime: the pacifier should be used when
placing the infant down for sleep and not be reinserted once the infant falls asleep. If the
infant refuses the pacifier, he or she should not be forced to take it. For breastfed infants,
delay pacifier introduction until 1 month of age to ensure that breastfeeding is firmly
established
• Avoid overheating
• Avoid commercial devices marketed to reduce the risk of SIDS
• Do not use home monitors as a strategy to reduce the risk of SIDS
• Avoid development of positional plagiocephaly: encourage “tummy time” when the infant
is awake and observed. This will also enhance motor development. Avoid having the infant
spend excessive time in car-seat carriers and “bouncers,” in which pressure is applied to the
occiput. Upright “cuddle time” should be encouraged
• Continue the Back to Sleep campaign
Recommendations for sudden infant death syndrome prevention: a discussion
document (Mitchell 2007)
Mitchell includes the following comment in his narrative review for the UK Ministry of
Health:
Breastfeeding
Advice to breastfeed if possible is included in the SIDS prevention programme in New
Zealand, but is not mentioned in the UK Department of Health advice. Almost all studies
show that breastfeeding is associated with a reduced risk of SIDS.(McVea, Turner et al.
2000)
However, in countries such as the UK where breastfeeding rates are low and strongly
associated with socioeconomic status, adjustment for socioeconomic status decreases the
level of protection, leading some authors to conclude that there is no reduced risk. However,
the larger studies consistently show a reduced risk of SIDS with breastfeeding even after
adjustment for socioeconomic status (Alm, Wennergren et al. 2002). Breastfed infants have
more arousals than bottle-fed infants, which may explain a possible protective effect (Horne,
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