October 21, 2005


AAP releases controversial recommendations on reducing SIDS risk


The American Academy of Paediatrics (AAP) has released a controversial policy statement regarding Sudden Infant Death Syndrome (SIDS).  Contrary to the recommendations of the AAP’s own Section on Breastfeeding, the SIDS report states that the use of a pacifier and the avoidance of co-sleeping reduced the risk of infant death.  These AAP recommendations have received considerable media interest both in the US and in Canada.


This has alarmed many in the health community, as both the use of a pacifier (which the AAP recommends introducing after one month) and sleeping in separate rooms from one’s infant is known to hinder breastfeeding.  Breastfeeding has repeatedly been found to lower the risk of SIDS. 


Furthermore, even doctors involved in the AAP study disagree with its conclusions.  Dr. James McKenna of Notre Dame University was consulted by the AAP, but he believes that safe co-sleeping is highly beneficial.  Research on co-sleeping, which is defined as sleeping in close proximity to one’s infant, though not necessarily in the same bed, has shown that the practice limits babies to lighter sleep patterns.  This is thought to reduce the risk of SIDS, because deep sleep can cause infants to fail to respond to life-threatening situations.  Rather than condemn co-sleeping as dangerous, Dr. McKenna believes the AAP should have emphasized the well-documented benefits of safe co-sleeping.


The confusing recommendations are all the more distressing when one considers that formula companies are major financial contributors to the AAP.  Abbott Ross, makers of Similac infant formula, were among the top three corporate sponsors of the AAP in 2002.1  Formula companies historically give money to the academy through renewable annual grants, and  also contributed $3 million to the construction of the AAP’s headquarters in Illinois.2  It is unclear to what extent this has affected the policies of the AAP, however both the use of pacifiers and the separation of mother and baby are impediments to a healthy breastfeeding relationship and increase the chance of mothers switching to formula.


For further information:


McKenna JJ, McDade T. Why babies should never sleep alone: A Review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Ped Resp Rev  6:134-152, 2005  (see: www.sciencedirect.com)


AAP Task Force on Sudden Infant Death Syndrome. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding Sleeping Environment, and New Variables to Consider in Reducing Risk. Paediatrics 116:1245-1255, 2005


AAP Section on Breastfeeding, Policy Statement: Breastfeeding and the Use of Human Milk. Paediatrics 115:496-506, 2005


  1. New York Times, 9/18/02, C1.
  2. Milk, Money and Madness by Naomi Baumslag and Dia L. Michels (Westport, Conn.: Bergin and Garvey, 1995, p. 172).


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