AAP Safe Sleep Policy – The Makers & Scientific Limitations

The founders challenged the AAP Safe Sleep Policy.  In 2016,  Task Force to recognize air-permeable sleeping surfaces as a preferable alternative for the infant who rolls prone during sleep based on scientific studies.

Sudden Infant Death (SIDS) rates have decreased since the popularization of back sleeping.  However, the Back-to-Sleep Campaign has reached a plateau in further reducing infant sleep-related deaths. In particular, AAP safe sleep policy does  not address the infant whose parents followed all the American Academy of Pediatric (AAP) guidelines, who rolls prone and dies face down on their fiberfill crib mattress or play yard pad.  This is where the AAP safe sleep policies fall short.  SafeSleep® is proud to be an organization that challenged these guidelines and influenced changes to the 2016 Safe Sleep Technical Report that now recognizes air permeable sleeping surfaces as a preferable alternative for the infant who rolls prone during sleep. 

Two Michigan Women Influence Changes to the 2016 AAP Safe Sleep Policy

About the American Academy of Pediatrics’ (AAP) Safe Sleep Task Force

scientific limitations


The AAP Safe Sleep Task Force Members, who write the AAP’s safe sleep policies and guidelines, are physicians who volunteer their time and expertise seeking to make sense of the available data. Some safe sleep advocates have approached these guidelines as literal and precise rules, not open for interpretation or consideration.  This was not and cannot be the intended use of these guidelines due to their inherent scientific limitations.  Pediatricians, parents and safe sleep advocates need to realize that the guidelines are just that—guidelines.

The AAP does not endorse products


The AAP, including the Safe Sleep Task Force, does not endorse, certify, or recommend specific products. 


no product cures SIDS


There are NO products on the market that cure or prevent SIDS.  Be cautious about products that claim they do. There are no crib mattresses that have FDA approval.  Even if a crib mattress is considered a “medical device,” a crib mattress is considered a “Class 1″ medical device. Class 1 medical devices are not eligible for “FDA approval.”


AAP Safe Sleep Policy IS Not Supported By Scientific Studies


The AAP safe sleep policies are based heavily on retrospective analysis like infant death scene investigations which can be flawed.  Actual scientific testing is not conducted to prove SIDS theories because unethical testing would be required.

These scientific limitations often result in policies not supported by scientific studies.   For example, it is recommended infants wear wearable blanket sleepers instead of using a loose blanket in the crib.  No scientific studies exist to conclusively show if a wearable blanket will prevent SIDS deaths.  However, many death scene investigations reveal infants who died compared to infants in a similar setting who did not, had loose blankets in their cribs, suggesting they are at an increased risk of SIDS.  The same goes for back sleeping.  No gold-standard scientific studies have been conducted to show if an infant is at increased risk of dying if on their tummy. However, retrospective data shows infants who were on their back were much less likely to die during sleep, suggesting back sleep reduces the risk for SIDS.


The death of infants found face down continues to occur


Deaths of infants placed on their backs and found face down on firm fiberfill crib mattresses and pads continue to occur because nothing prevents these infants from rolling.  There are over 3,000 infant sleep related deaths in the U.S. each year.