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Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation and strangulation in bed.

After an initial decrease in the 1990s, the overall sleep-related infant death rate has not declined in more recent years.

Although SIDS was defined somewhat loosely until the mid-1980s, there was minimal change in the incidence of SIDS in the United States until the early 1990s.

In 1992, in response to epidemiologic reports from Europe and Australia, the AAP recommended that infants be placed for sleep in a nonprone position as a strategy to reduce the risk of SIDS.

The SUID category captures deaths with an underlying cause coded as ICD-10 R95, R99, and W75.

Despite the decline in SIDS and SUIDs in all races and ethnicities, the rate of SUIDs among non-Hispanic black (172 per 100 000 live births) and American Indian/Alaska Native (191 per 100 000 live births) infants was more than double that of non-Hispanic white infants (84 per 100 000 live births) in 2010–2013 (Fig 2).

Source: Centers for Disease Control and Prevention/National Center for Health Statistics, National Vital Statistics System, compressed mortality file.

(Figure duplicated from all-cause postneonatal death rate follows a trend similar to the SIDS and SUID rates, with a 26% decline from 1992 to 2001 (from 314 to 231 per 100 000 live births).

This code also includes deaths while sleeping on couches and armchairs.

New evidence and rationale for recommendations are presented for skin-to-skin care for newborn infants, bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age.

In addition, expanded recommendations for infant sleep location are included.

All iterations of the search terms were used for each topic area.

For example, the pacifier topic search combined either “SIDS,” “SUID,” “sudden death,” or “cot death” with “pacifier,” “dummy,” “soother,” and “sucking.” A total of 63 new studies were judged to be of sufficiently high quality to be included in this technical report.