Safe Sleep and Breastfeeding Advocates Come Together in NAPPSS

WASHINGTON (Oct. 20, 2016) —  In recent years, recommendations for breast feeding and safe sleep for infants have led to enormous challenges in moving from recommendations to action that benefit infant health. Now, a coalition funded by the U.S. Department of Health and Human Services aims to coalesce more than 60 groups to develop plans that move from “do and don’t” lists toward achieving the goals of breastfeeding and safe sleep advocates.

The National Action Partnership to Promote Safe Sleep (NAPPSS) and its members now await the release on Monday, Oct. 24, of the updated “Recommendations for a Safe Infant Sleeping Environment” by the American Academy of Pediatrics. NAPPSS is hopeful that updates to these well-known recommendations will further the important work of helping families implement both safe sleep and breastfeeding.

Sleep-related sudden unexpected infant death (SUID) is the leading cause of post-neonatal mortality in the United States.  While the biological etiologies of SUID deaths are not always clear, researchers have identified several protective behaviors that can reduce the risk of sleep-related SUID. These include characteristics of infants’ sleep surfaces and what position they should be placed for sleep. In addition, breastfeeding is a protective factor in reducing the risk of SIDS. 

To date, efforts to support families to adopt this full range of behaviors have evolved in silos—one set of advocates for sleep related behaviors and another supporting breastfeeding for its many benefits to both infants and mothers. 

“The separation of these efforts has led to confusion for families and disagreements about what messages families should receive to keep their infants safe and healthy,” explains Suzanne Bronheim, PhD, associate professor of pediatrics at Georgetown University Medical Center and leader of NAPPSS. “It is vital for all concerned with public health to embrace a perspective that promotes both rather than presenting the issues as ‘either/or.’"

The federal Maternal and Child Health Bureau has launched NAPPSS, led by Georgetown faculty in the National Center for Education in Maternal and Child Health (NCEMCH) and the Georgetown University National Center for Cultural Competence, to bring together a broad coalition of national organizations that impact families with infants about how to support the integration of both breastfeeding and safe sleeping practices.

NAPPSS is funded through a cooperative agreement of $1.5 million over three years to NCEMCH from the Maternal and Child Health Bureau of the Health Resources and Services Administration at HHS.  

“Feeding and sleeping are the two biggest concerns that new parents, who are often sleep deprived, have when they bring their infants home,” Bronheim says. “But because safe sleeping and breastfeeding are both integrally vital to infant survival and long-term health of mothers and infants, we need to recognize the realities that families face and their need for information to make decisions and to mitigate risks.”

NAPPSS has termed this perspective the Conversations Approach.

“This means moving beyond telling families what they should do — with guidelines full of do and don’t lists— to offering them information about why the recommendations are offered and ways how to achieve both goals,” Bronheim says. “It is not only about delivering the ‘correct message,’ but about empowering families with information to make their own decisions.  

“In addition to having a positive view of safe sleep and breastfeeding and accurate information, families need to have a sense of self-efficacy—the knowledge, skills, and resources to implement risk-reduction behaviors and this is best achieved in conversations with individual families.”

In addition to Georgetown University faculty, NAPPSS is led by members from First Candle, a safe sleep advocacy and support organization; and the United States Breastfeeding Committee, the national breastfeeding coalition and primary implementation partner of The Surgeon General’s Call to Action to Support Breastfeeding.

About Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook (Facebook.com/GUMCUpdate), Twitter (@gumedcenter) and Instagram (@gumedcenter).

This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.