Expanded 'back-to-sleep' recommendations: Hospital-based safe sleeping practices

International studies in the late 1980s and early 1990s reported highly significant relationships between prone (stomach) sleeping and increased risk for Sudden Infant Death Syndrome (SIDS). Intervention campaigns were initiated and SIDS rates subsequently decreased dramatically as prone prevalence decreased dramatically. Several subsequent studies have evaluated infant care practices and medical outcomes in infants to determine if there is any harm associated with routine supine sleeping. There has not been any evidence to suggest increased symptoms related to gastroesophageal reflux (GER) or aspiration as a consequence of supine sleeping nor any increased mortality from any cause. In most instances, back-to-sleep campaigns did not specifically include babies still in the hospital, whether full term or preterm. In addition, preterm infants were often excluded (actively or passively) from recommendations for 'back-to-sleep' after discharge home.