The mortality attributed to sudden infant death syndrome ahs decreased significantly in Northern Europe and Australia in conjunction with the majority of infants being placed to sleep on their back or side instead of on their stomach. Since the AAP recommendation in 1992 to place healthy infants on their back or side to sleep, the fraction of infants sleeping prone in the United States has decreased to approximately 43%. It is hoped that the national "Back to Sleep" education campaign will accelerate the acceptance of back or side sleeping for healthy infants so that only a small fraction of infants will be sleeping on their stomach within the next few years. Health-care providers should promote the recommendation in the newborn nursery and at well-baby visits. They should encourage dialogue with caregivers regarding this and other early infant care practices. It is still too soon to know how predominantly nonprone sleeping will affect the rate of SIDS in the United States. It is important that providers continue to stress access to prenatal and well-baby care, and cessation of smoking and substance abuse, as these risk factors may play a larger role in the high-risk communities in the United States. Pediatric medical personnel should advocate for proper death certification for infants and children, to include state legislation that supports autopsies for sudden unexpected deaths in children, and the establishment of state child fatality investigation and review teams. They also should participate in the training of death scene investigators or be part of the death scene investigative team.(ABSTRACT TRUNCATED AT 250 WORDS)