Safe Sleeping Environment

If anyone knows me, has taken my Newborn Education class, past client or just speaks to me about their infant or toddler’s sleep, knows I am a HUGE advocate for a safe sleeping environment.  When I had my son I was not educated on safe sleeping.  There were so many people giving me well-meaning advice, trendy “must have” products that other parents swear by, books, blogs and Facebook posts about how glorious and bonding it is to bed-share, that I was completely ignorant when choosing an unsafe sleeping environment for my son in the first 4 months of his life.

I am one of the incredibly lucky parents that nothing tragic happened to my son but still doesn’t mean that the choices I made were the right and most informed ones… in regards to his sleep environment.  I thank God everyday that the uninformed choices that I made didn’t cost him his life or have been seriously injured.

This blog isn’t to shame you, yell at you or instill fear. It is to help inform you and raise awareness so as parents, babysitters, grandparents, aunts, uncles, godparents, neighbors, best friends, etc. to make more educated and informed choices when selecting a place for our children to sleep.  WE CANNOT DO BETTER IF WE DO NOT KNOW BETTER!

Why do I push for a safe sleeping environment?  The reason I am so passionate about a safe sleeping environment is because we want to prevent SIDS (Sudden Infant Death Syndrome) and SUIDS (Sudden Unexpected Infant Death Syndrome).

SIDS– unexplained death of a baby, younger than 1 year of age, that does not have a known cause even after a complete investigation.

What causes SIDS?  Unfortunately, we do not have a solid answer for that.  SIDS is said to believe that there is a “glitch” in a baby’s brain stem that is within a network of nerve cells that are located in the part of the brain that controls heart rate, breathing, blood temperature and waking up from sleep.  This “glitch” results in the baby being a “vulnerable infant” and increasing their risk of SIDS as well as SUIDS.

What is SUIDS? The death of an infant, younger than 1 year of age, that occurs suddenly and unexpectedly.  After a complete investigation these deaths can be caused by:

  • Suffocation
  • Entrapment
  • Infection
  • Ingestion
  • Metabolic Diseases
  • Cardiac Arrhythmias
  • Trauma (accidental or non-accidental)

SUIDS is more likely to happen when the infant is a combination of a “vulnerable infant” and in an unsafe sleeping environment.  SIDS can happen even if the child is not a “vulnerable infant” but in an unsafe sleeping environment.  Unfortunately, there is no way to test if our newborn has the “glitch” so practicing safe sleep is a for sure way to decrease the risk.

What is a Safe Sleeping Environment? I am going to include the American Academy of Pediatrics recommendations for safe sleeping website… http://pediatrics.aappublications.org/content/138/5/e20162938

I am going to briefly discuss the recommendations and the website will give you a more detailed list:

  1. Back to sleep for EVERY sleep.  Infants, up to the age of 12+ months of age, should always be placed in the supine (on their back) for every single sleep.  Side sleeping is not advised.
  2. Use a firm sleeping surface. A firm (CPSC approved crib mattress) covered by only a tight fitted sheet.  No bother going out and splurging in that expensive and fancy crib bedding because none of it is safe for sleeping.  Return it and get some much needed diapers or wipes! A crib, bassinet, portable crib/play yard (pack n play) that conforms to the safety standards of the CPSC are recommended and safe for supervised and unsupervised sleeping.
  3. Room Sharing WITHOUT Bed Sharing is advised.  Baby should be in the same room as parents but in their own safe sleeping space to reduce the risk of SIDS, suffocation, strangulation and entrapment.  THERE IS NO WAY TO SAFELY BED-SHARE! Devices that are marketed and promoted to make bed-sharing “safe” are not recommended.
  4. Keep any loose bedding and objects along with soft objects out of the crib, bassinet, portable crib/play yard (pack n play).  Objects such as soft pillow-like toys, blankets (of any kind), bumpers (traditional and mesh) and make sure clothing is tight fitting.
  5. Pregnant women should be receiving prenatal care.
  6. Avoid smoke exposure both during pregnancy and after birth.  This includes maternal smoking while pregnant and smoke in an infant’s environment after birth.
  7. Avoid alcohol and illicit drug use during pregnancy and after birth.
  8. Breastfeeding is recommended.  However, formula feeding does NOT increase the risk of SIDS.
  9. Use a pacifier for naps and bedtime. The pacifier should not be around the infant’s neck or attached to clothing.
  10. Avoid overheating.  Always use the 1 layer guide.  Whatever you, as an adult, are comfortable in, infant should not wear anymore than 1 extra layer.  Fingers and toes are not a good indicator of true internal temperature.  The neck, chest, armpit are good areas to check what infant’s true internal temperature is.  Keep room between 67-72 degrees Fahrenheit.  Do not over-bundle and NEVER cover head or face.
  11. Infants should be immunized with accordance to the recommendations of the AAP and the Centers for Disease Control and Prevention.
  12. Avoid commercial devices marketed to reduce the risk of SIDS.  EX: crib wedges, sleep positioners, special mattresses and sleep surfaces, and products that promote “sleep” but are not a crib, bassinet, portable crib/play yard (pack n play).
  13. Do not use home cardiorespiratory monitors that promote to reduce the risk of SIDS.  UNLESS your Dr. has advised you otherwise because of a medical condition.
  14. Supervised and awake tummy time to help development and minimize positional plagiocephaly (flat head).

I understand that it might seem like a lot of rules and restrictions, however, these are all in place to help save your babies life.  In 2016 the CDC reported that, “About 3,600 sudden unexpected infant deaths (SUID) in the United States.” And about 900 hundred of those deaths were due to accidental suffocation and strangulation in bed.  To me those numbers are too high and are not worth the risk for unsafe sleeping practices.

Breakdown of Sudden Unexpected Infant Death by Cause, 2016

The breakdown of sudden unexpected infant deaths by cause in 2016 is as follows: 42% of cases were categorized as sudden infant death syndrome, followed by unknown cause (34%), and accidental suffocation and strangulation in bed (24%).

Yes, we have heard it all… “I never used a car seat, I wrapped you up in blankets and put you on your tummy to sleep, I have smoked for 50 years, I drank and smoked while I was pregnant, etc., and I/YOU turned out just fine”.  That is what we call “survivor bias” talking.  “Survivor Bias” the focus on the success/survivor of a situation that has made it past the failures and facts.  Their lack of visibility is usually what leads to false conclusions.  Also known as Selection Bias.

If you are are ever confused or forget what a safe sleeping environment is think of the “ABC’s” of sleep.  Alone, Back, Crib.

ABCs of Safe Sleep

There are so many books and information out there that it is easy to get confused and swayed into thinking what is safe and right for your baby to sleep in.  I hope this blog has helped to educate and inform you on safe sleeping practices so we can all make better choices for our children.

 

References:

1. Centers for Disease Control and Prevention, June 28th, 2018. http://www.cdc.gov/sids/data/htm

2. SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Sale Sleeping Environment, Volume 130/Issue 5. Police Statement. November 2016 http://pediatrics.aappublications.org/content/138/5/e20162938

 

 

 
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