WASHINGTON — To minimize the risk for crib death, the nation's largest organization of pediatricians is recommending that babies be put to sleep with pacifiers and in their own beds, despite intense opposition from advocates for breast-feeding and the "family bed."

The American Academy of Pediatrics, hoping to settle some of the most hotly debated, emotional issues related to the care of newborns, is for the first time endorsing routine pacifier use and explicitly recommending against babies sleeping with their parents. In both cases, evidence suggests the precautions would cut the risk of suffocation, the group said.

In an eagerly awaited set of recommendations being unveiled today, the academy's first new guidance in five years also toughens its long-standing policy that babies should always sleep on their backs, saying for the first time that even sleeping on the side is too dangerous. Babies should, however, sleep in the same room as their parents, it says.

An expert committee convened by the academy concluded that the new recommendations are necessary to save more infants from crib death, known formally as sudden infant death syndrome (SIDS). Although the number of babies dying mysteriously in the first few months of life has plummeted in the past decade, recent statistics show the rate has flattened at about 2,500 U.S. deaths a year.

"We're concerned the SIDS rate has plateaued. It's been cut, but there are still a lot of babies that are dying," said John Kattwinkel of the University of Virginia in Charlottesville, who chaired the five-member panel. "We think if more mothers stopped ... taking their babies to bed with them and used pacifiers, we'd be doing a heck of a lot to get at this problem."

While praised by SIDS activists and other pediatricians, the new recommendations drew criticism from proponents of breast-feeding and bed sharing. The evidence that pacifiers are helpful and bed sharing is dangerous is far from conclusive, they said. Moreover, they contend that the recommendations will hinder breast-feeding and mother-child bonding, which are highly beneficial.

"I'm very disappointed," said James McKenna, director of the mother-baby behavioral sleep laboratory at the University of Notre Dame in Indiana. "I really fear this is just another step of inappropriately medicalizing decisions that are best made within the home."

SIDS is a mysterious condition in which otherwise healthy babies stop breathing in their sleep, usually between the second and sixth months of life. While the cause remains unclear, research has suggested it might strike babies who have not yet fully developed the ability to rouse themselves when they have trouble breathing, perhaps from getting stuck under pillows and blankets. SIDS deaths dropped dramatically after a campaign by the academy and other groups encouraging caregivers to put babies to sleep on their backs.

After reviewing the latest scientific studies, the panel decided enough evidence has accumulated to conclude that it is dangerous for babies and parents to sleep in the same bed.

"There are a lot of safety issues surrounding a baby in an adult bed," said Rachel Moon of the Children's National Medical Center in Washington, a panel member.

"A baby can roll over and get caught between the soft mattress and headboard or foot board and suffocate. Babies can fall off the bed. They can get smushed if the parent rolls over on top of them. They can get smushed between pillows and soft bedding and suffocate."

But studies also show it is safer for babies to sleep in the same room as their parents, rather than in their own room down the hall. That way parents are more likely to awaken if their baby is struggling.

"The safest place for the baby to be is in the parents' room next to the parents' bed but on a different sleep surface, like a bassinet or crib next to the bed or even attached to the bed," Moon said.

The pediatricians withdrew a previous recommendation that it was acceptable to let babies sleep on their sides, based on recent studies indicating that this, too, is hazardous.

"The side position is unstable. Babies can roll onto their bellies, which puts the babies at very high risk for SIDS," Moon said.

The panel reaffirmed previous recommendations, such as urging mothers not to smoke and not allowing babies to sleep with blankets, soft pillows and stuffed animals, and it concluded that routine pacifier use could further reduce the risk.

It remains unclear why pacifiers help, but some research suggests their use might affect babies' sleep patterns in ways that allow them to awaken more easily.

Pacifier use has been controversial because of concerns that it might increase the risk of dental problems and infections and make breast-feeding less successful. But the panel concluded these risks are small.

But breast-feeding advocates said they feared the bed-sharing and pacifier recommendations would make it harder for mothers to breast-feed, which has a host of health benefits, including possibly reducing the risk of SIDS.