Thursday, April 16, 2009

Safe Sleep; Round Heads

There is nothing more tragic than the loss of a precious baby! Advice comes from USCPSC (U.S. Consumer Product Safety Commission).

Since the implementation of the "Back to Sleep" campaign in 1994, SIDS and other unexplained sleep-related infant deaths have been reduced by 50% (85% among exclusive back sleepers). This is wonderful news but we still have more to learn. This is a simple message that reaps great results when it is practiced.

Sometimes, even nurses in the hospital do not follow this recommendation so if you see it done improperly there, don't repeat what you see! In fact, call the nurse on it. They may need to be reminded because old habits die hard. It takes about 17 years for health practices to change, even when we know better ways to do things. We used to believe the baby on its side or tummy would have less chance of aspiration if he or she was spitty, but now we know they can actually handle it better when on their backs and the other benefit definitely make this the right position for a sleeping baby.

What risk factors have been identified?

A risk factor is not a cause, but it can suggest complications that might increase the likelihood of this tragic event. Risk factors do not exist in all SIDS deaths.
  • Smoking by others in baby's environment (Just say "no!")
  • Teenage mother
  • Preterm baby or small size (small for gestational age)
  • Wrong sleep position (other than back) - should not happen, even for naps
  • Sleep environment concerns (too-soft sleep surface, bumper pads, pillows, loose, fluffy bedding, toys, bedsharing*, lack of air circulation, overheating)
  • Childcare provider or family member who does not understand this newer concept and does not place child on the back (even side position is risky because baby can slide to tummy).
  • Overfeeding may be a risk factor, especially if placed on tummy afterward. Breastfed babies eat about every two hours at the beginning and do not take more than they need so overfeeding is not a problem there.
The most common risk factor is bedsharing. Babies do best when they are not co-sleeping with an adult or sibling, though having the baby close by is protective. Sofa-sleeping is not safe, but especially when it is with another person who could roll onto the baby or the baby gets wedged in the cushions and pillows where oxygen is insufficient.
*As with all such data, there is controversy surrounding the studies and results. Conflict of interest also enters in. Dr. Sears has an excellent article discussing the findings and showing alternatives for parents who prefer co-sleeping with their babies. He contends that the Juvenile Products Manufacturers Association which co-sponsors the campaign discouraging co-sleeping may have a conflict of interest and he gives compelling data on how you can sleep with your baby safely. The trouble is that so many adults do not know what that means. Read his view here. If you choose to sleep with your baby to facilitate breastfeeding, be sure you have read this article.
What is a safe sleep surface?

The American Academy of Pediatrics (AAP) states that safe sleep means sleeping in a safe crib, bassinet or play yard--a flat firm surface. Deaths have occurred in car seats when the baby was brought in from the car, in the car seat, bundled up with blankets over their faces, presenting multiple risk factors. Check out Sleep Sacks

Tummy Time

In addition to the risk of Sudden Infant Death Syndrome (SIDS), too much time in a car seat and swing often results in babies with flattened heads. While sleeping on the back is the right way to do it, your baby needs tummy time as well. This is "awake" time when you are near by, hopefully interacting with your baby.
Getting the baby out of the seats, carriers, bouncers and swings, sometimes even referred to as "buckets" will result in a rounder head and the baby will develop his or her neck muscles appropriately. Underdevelopment of these muscles is an unpleasant side-effect of the otherwise successful "back to sleep" campaign. Some parents erroneously believe they should NEVER put their babies on their tummies or sides. This is false; it's just that the babies should be attended when in another position - when left to sleep, they must be placed on their backs without pillows, comforters, fluffy blankets and toys, etc.

An ideal way to carry your baby is in a baby sling. This helps free your arms while still snuggling your baby next to your heart. Nursing moms find this ideal because they can get so adept at breastfeeding, she can nurse without much interruption at all - the baby is in a comfortable and convenient position when the need to nurse arises. By the way, breastfeeding babies have a decreased incidence of SIDS.Click on the post title to learn more about safe sleep tips for your baby.

Here are some recommendations for your baby's sleeping place. It does not have to be a decorator nursery and your baby won't know if his/her room is from Pottery Barn. Keeping the baby in the parents' room is often ideal.

A fan for circulating air in baby's room is a good thing. Of course you don't want a fan that is low enough the baby could get a finger caught. A ceiling fan is good. The idea is to be sure the baby gets good air flow and oxygen during the immature first year of life when SIDS is a risk for all babies.

Taking these few steps will help you to sleep better at night too - on your back, side or tummy! Best Blogger Tips


  1. We need to buy a mattress for our baby's crib and I was wondering what is the best spring/cord mattress to buy? There are so many and some are more expensive than others. I just wasn't sure.

  2. It doesn't matter if you get a spring type or foam, either is safe as long as it fits tightly in the crib. Most these days do, so unless the crib is unusual (or perhaps antique), size should not be a concern. Firm is important and you can tell by the resistance when you depress it with your hand.

    If you get springs, it will be a heavier mattress, so harder to lift when changing the sheets, Usually a higher spring count is associated with a firmer mattress. Keep in mind your baby needs firm; not soft and cushiony like adults sometimes prefer. A multilayer cover usually means greater durability. I hope this helps.


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