Back to sleep: is there room in that crib for both AAP recommendations and developmentally supportive care?

This article offers one institution's approach to implementation of the recommendations for infant sleep positioning as set forth by the American Academy of Pediatrics. The guidelines are directed toward healthy infants in the first year of life, a population not always encountered by the neonatal nurse. The guidelines focus on supine sleep position and the minimization of additional bedding, both of which can be challenging when contrasted with accomplishing supportive positioning and the goals of developmentally supportive care for ill or preterm infants. A multidisciplinary task force was formed to consider this challenge. The outcome is an evidence-based policy that is presented as an example for other clinicians. The policy addresses the following major components: sleep position with specific clinical exceptions, the use of bedding materials, play position during awake states, and parent education with preparation for discharge. The article also outlines the process by which the task force plans to implement and evaluate necessary practice changes.