Tag Archives: infant sleep safety

For Baby Beds, It’s Back to Basics

(Full disclosure: As a grandmother of two I have gone bonkers at every baby store in Northern Virginia. And the first night after baby Allison came home, I kept her in my own bed … allegedly so her mom could get a good night’s sleep.)

You’re an OB. You love pregnant women and babies and all that this wonderful time entails. And since you’re a good OB, you listen to your moms and relish their nesting behavior. It’s a good sign when they begin talking about Baby’s room and bed, all the cute stuff they’ve gotten from loving family and friends.

Now you – and your pediatric colleagues – are  going to have to let your moms down gently.

To prevent SIDS, AAP recommends against newborns sleeping in cribs set up like this. Sarah G. Breeden/Elsevier Global Medical News (2)

Bumper pads, stuffed toys, crib canopies (made popular by Jennifer Lopez’s royal nursery pictures), and even the fuzzy baby blanket Grandma crocheted – none of it belongs in a newborn’s bed.  And experts at the American Academy of Pediatrics (AAP) are targeting the issue in big way. On Oct. 18, the group issued a new policy statement on safe sleep for infants.

It turns out that the newest  best place for a baby to bed down is totally retro: a nearly bare (but consumer-safety approved) crib with a firm mattress and a single tight-fitting sheet.  PJs should be  a sleeper appropriate to the room’s temperature without a chance of overheating Baby, who should be sleeping on his back without so much as a blankie. And that’s it.

Virtually every OB and pediatrician discusses the topic of Sudden Infant Death Syndrome (SIDS) and supports AAP’s  17-year-old “Back to Sleep” campaign. The push resulted from research that pinpointed stomach- and side-sleeping as significant risk factors for SIDS. Since its adoption, there’s been up to a 66% decrease in SIDS deaths in the U.S.

But, Dr. Rachel Moon said at AAP annual meeting, this encouraging trend has a dark twin – a quadrupling in the number of infants who’ve died from suffocation and entrapment. And many of these deaths have been linked to getting stuck in loose bedding, or even from stuffed animals who topple over in the night and obstruct breathing.

Sleeping with parents is a big problem too, Dr. Moon said. Many groups – and not a few doctors – have promoted bed-sharing as the most natural way to care for a newborn, especially facilitating breastfeeding, a mighty defense against SIDS. But unfortunately, cross-eyed lethargy – a state familiar to every new parent – does not a safe bedfellow make.

And it goes without saying that a parent on pain meds  (any of your patients ever have an episiotomy or C-section?), or who is using other drugs or alcohol, is more likely to roll over on Baby. Deaths don’t necessarily have to be dramatic – like being crushed under adult weight, squashed between parents, or dropped on the floor. Even an arm that moves over a newborn’s mouth can obstruct breathing enough to kill.

Make sure family caregivers and daycare providers know the rules too, AAP advises.  Infants in child care settings are significantly more likely to die from SIDS,   perhaps because providers aren’t following the advice for safe sleep

Babies who sleep in plain cribs with firm mattresses and tight-fitting sheets are at a lower risk of SIDS.

More AAP advice? After the 4 a.m. feeding, stress that Baby goes back to her own crib, positioned safely  supine, uncovered, and hopefully with a pacifier.

Yes, the much-loved binkie now has a justified place in the scientific literature. It seems that pacifiers help reduce the risk of SIDS, probably by occasionally arousing the baby during sucking frenzies.

So tell  your patients’ thrilled Grandmas to relax  and rejoice by contemplating  how many pacifiers they can buy for the price of just one coordinated Peter Rabbit crib set.

—Michele G. Sullivan


Filed under Emergency Medicine, Family Medicine, Health Policy, IMNG, Obstetrics and Gynecology, Pediatrics