Health experts are updating NHS recommendations to help reduce the number of babies dying unexpectedly in their sleep.

Nearly 250 babies in England and Wales die from Sudden Infant Death Syndrome (SIDS) every year[1]. No-one knows why this happens, but there have been long-standing doubts over whether sleeping with your baby is safe.

The National Institute for Health and Care Excellence (NICE) is updating its guidance. It has published new, draft recommendations for consultation.

Professor Mark Baker, NICE’s clinical practice director, said: “Falling asleep with a baby, whether that’s in a bed or on a sofa or chair, is risky.

“It’s imperative that all parents and carers know about the association between sudden infant death syndrome and falling asleep with a child under the age of one. This is especially important if parents drink alcohol, take drugs or expose their baby to tobacco smoke.”

The updated draft recommendations – which are relevant for infants from birth until 1 year of age[2] - say that midwives, GPs and health visitors should ensure parents and carers are told of the link between co-sleeping (falling asleep with a baby in a bed, or on a sofa or armchair) and SIDS. They also ask healthcare professionals to:

• advise parents and carers that the association between co-sleeping and SIDS is likely to be greater when they, or their partner, smoke
• inform parents and carers that the association between co-sleeping and SIDS potentially increases if they have used drugs and/or recently drunk alcohol
• tell parents and carers that the association between co-sleeping and SIDS potentially increases if their child had a low birth weight or was born prematurely

NICE is updating its guidance after the Department of Health asked it to review its recommendations last year. This request followed new research which suggested sharing a bed with a baby could increase the risk of SIDS, even among non-smokers.

Professor Baker said the updated recommendations aim to provide further evidence-based clarity to the risk factors associated with co-sleeping and SIDS: “There is no universal agreement on the causes of sudden infant death syndrome.

“We know there is a link between SIDS and falling asleep with a baby in a bed or on a sofa or chair, but studies into why this happens can often give conflicting results. And other factors are likely to play a part in increasing the risk to the infant.

“We recognise that some parents may choose to share a bed with their baby because it could make breastfeeding easier, or for cultural reasons. Or they may be forced to co-sleep because they may not have the space or money for a cot.

“This is why it’s so important for parents to understand what the risks are. The recommendations we are developing aim to help healthcare professionals inform parents and carers of the likely risks associated with co-sleeping, according to the best available evidence.”

The public consultation on these draft recommendations will run until Thursday 31 July 2014. The committee will then consider all comments and the final recommendations will be developed.

Once published, these recommendations will replace some, but not all parts of NICE’s 2006 postnatal care guidance.

Ends

Notes to Editors

Explanation of terms

1. According to the Office of National Statistics, a total of 244 unexplained infant deaths occurred in England and Wales in 2011.
2. The postnatal care guidance covers the core care of women and their babies during the first 6-8 weeks after birth. However, the decision was taken to extend this age range up to one-year-old specifically for the recommendations on sleeping with your baby in a bed, or on an armchair or sofa. This was to allow the committee to consider all available evidence on this issue.

About the guidance

• The NICE quality standard on postnatal care (published 2013) outlines the need for safer infant sleeping to be discussed with women, their partner or the main carer. Its inclusion in the quality standard highlights it as a key area of care in need of improvement.
• The Institute’s 2006 guidance on the routine postnatal care of women and their babies is available to view on the NICE website.
  • The final updated recommendations about co-sleeping and the risk of Sudden Infant Death Syndrome (SIDS) are expected to be published in December 2014.
• The guidance applies to the NHS in England and Wales.