literature and product testing support an air-permeable sleep surface that does not retain high levels of carbon dioxide as a safer option than the firm fiberfill crib mattress with a sheet to address the situation of the inexperienced infant who is placed supine and rolls prone. 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.
Information for medical professionals
AAP Task force on sudden infant death syndrome
“Risk-reduction strategies are based on the best-available evidence in large epidemiologic studies. These studies have been largely focused on the correlations between the sleep environment and SIDS. Our current understanding is that the cause of SIDS is multifactorial and that death results from the interaction between a vulnerable infant and a potentially asphyxiating sleep environment. Thus, claims that sleep devices, mattresses, or special sleep surfaces reduce the risk of SIDS must therefore be supported by epidemiologic evidence. At a minimum, any devices used should meet safety standards of the CPSC, the Juvenile Product Manufacturers Association, and ASTM International (known previously as the American Society for Testing and Materials). The AAP concurs with the US Food and Drug Administration and CPSC that manufacturers should not claim that a product or device protects against SIDS unless there is scientific evidence to that effect.”
Avoidance of Potentially Asphyxiating Sleep Environments
“Asphyxia has long been thought to be the primary cause of death in many instances of SIDS, based both on the practices (eg, supine positioning and/or lack of soft bedding) known to be protective against SIDS and on the frequent autopsy finding of pulmonary edema, which is often seen with asphyxiation. Infants resting in the prone position or lying with soft bedding may rebreathe exhaled carbon dioxide, potentially leading to hypercarbia and hypoxia. If infants’ environment does not change or infants are unable to extract themselves from the hazardous situation, they will ultimately die of asphyxia.”