Infant Illness Can Negatively Impact Safe Sleep Practice Adherance

Caregivers were less likely to adhere to recommended safe sleep practices --such as ensuring the infant sleeps alone on a firm mattress without soft objects that could potentially block their airway--when the children were ill, according to a study published in the October 2025 Pediatrics. The study, “Changes in Sleep Practices During and After Illness,” published online Sept. 18, surveyed 106 primary caregivers of infants to examine how minor illnesses affect infant safe sleep practices. Most of the children were seen by emergency department clinicians for fever, respiratory issues, or gastrointestinal illness. Caregivers completed surveys about sleep practices before illness, during illness, and at two weeks and one month following their emergency department visit. Overall, only 8.3% of caregivers fully adhered to safe sleep recommendations before illness. Adherence dropped further during illness to 6.1% and did not improve following illness recovery. Caregivers were also less likely to adhere to safe sleep location guidelines, with rates of children sleeping in unsafe places such as beds or couches steadily increasing with a peak at 75% at the one-month follow-up. Bed sharing also increased over the study length starting at about 57% prior to illness to 83.6% at the one-month follow-up. Over 97% of infants were reported as having recovered from their illness at the two-week follow-up. The authors note that these findings support concerns that even minor illness may increase the risk for sudden unexpected infant death. They emphasize the need for further research in larger and more diverse populations. They suggest that illness-specific safe sleep counseling may be an important strategy to reduce the risk for sudden unexplained infant death.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.