The updated policy continues to emphasize key points from the previous version: that promoting back sleep and avoiding bedsharing with infants is incredibly effective for preventing sleep-related deaths in babies, especially in those first few months of life. But for the first time, the policy addresses weighted blankets and swaddles, as well as a few other topics.
Multiple weighted products that promise to help babies sleep better have become popular since the AAP last updated its safe sleep policy in 2016. Popular examples include Nested Bean and Dreamland Baby products. That’s likely why the AAP decided to address them in this update, says Funke Afolabi-Brown, M.D., a pediatric pulmonologist and sleep medicine physician and a member of BabyCenter’s Medical Advisory Board.
While there isn’t clear evidence that weighted swaddles and blankets are unsafe, there also isn’t proof that they’re definitely safe for babies, who are still vulnerable and developing.
"Babies' chest walls are softer than adults', and they often take smaller and faster breaths," says Dr. Brown. "A weighted blanket or swaddle may restrict their ability to breathe effectively, which could be quite dangerous. We need more studies on these types of products to see if they actually impact sleep duration, if they’re safe for sleep, and, if so, what weight is appropriate. For now, based on babies' breathing patterns and the risks associated with restricted breathing, I recommend against these.”
If you’re unsure if a product is safe for sleep or not, Dr. Brown recommends against using it. “There are so many new products out there, and we really need more research to see if they’re safe or not.”
Additional key changes in the updated policy include:
You might recall a recent study about a potential biomarker for SIDS. It sparked headlines that implied scientists had identified the cause of SIDS, and that safe sleep practices might not be important. “That just isn’t true,” says Dr. Brown.
“Much more research needs to be done, and it’s still important to follow safe sleep practices, which have helped decrease the number of sleep-related deaths in infants drastically over the past few decades,” says Dr. Brown.
Since a national education campaign about safe sleep practices started in the 1990s, the SIDS rate in the U.S. dropped from 130.3 in 100,000 to 33.3 per 100,000.
“This was one of the most impactful interventions that have been put in place that has really caused a significant decline,” says Dr. Brown. “We really need to create an awareness that following safe sleep practices with our newborns and infants is a lifesaving measure.”
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American Academy of Pediatrics. 2022. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 [Accessed June 2022]
Centers for Disease Control and Prevention. 2021. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome. https://www.cdc.gov/sids/data.htm [Accessed June 2022]
Robin Hilmantel is the editorial director of special projects at BabyCenter. She has more than a decade of experience in health and lifestyle reporting, writing, and editing. She lives in Chapel Hill, North Carolina, where she enjoys spending her nonworking hours with her husband, two sons (Marlow and Wylie), and tripod dog (Kiwi).