Today’s guest blog post is by a colleague and friend, Dr. Emily Scott. Dr. Scott is an assistant professor of clinical pediatrics at Riley Hospital for Children at IU Health. She has been tirelessly advocating for safe sleep during her rounds at newborn nursery, while teaching residents and speaking about this at community events and on the news. Check out this video clip of her advocating for the ABCs of Safe Sleep  from February 22, 2018 on Fox 59 news.


How to keep your baby safe while sleeping

Contributed by Dr. Emily Scott

As a pediatrician who works in a newborn nursery, I send new parents home with a sweet little bundle of joy every day of the week.   It is an absolute pleasure to see families get to know their little one over the first few days of life. One of my favorite questions to ask as parents are packing up their hospital room is – “What part of being a new parent worries you the most?” The overwhelming answer – SLEEP!!!

To be honest, how a baby sleep worries me too! Babies are still dying in America due to unsafe sleep environments. In fact, a new study estimated that 1100 babies died in 2015 due to unsafe positioning in sleep. These deaths are completely preventable. [1]

Remembering the key points of the American Academy of Pediatrics safe sleep guidance [2] is as easy as knowing your ABCs.

A – All by myself. Your baby should always sleep by himself. Co-sleeping or surface-sharing on an adult bed, couch or armchair greatly increases a baby’s risk for sleep-related death. Your baby should also not sleep on your chest unless you are fully awake to make sure your baby is breathing comfortably and that his nose isn’t obstructed.   It is good for your baby to sleep in the same room with you through the first 6 months of his life. This helps everyone sleep better, makes breastfeeding easier and has been shown to decrease the risk of sudden infant death syndrome (SIDS).

B – Back.   Your baby should always be placed to sleep on his back – never on his side or his tummy. Your baby will not choke if he spits up while he is lying on his back. A baby’s body knows how to protect his breathing if he spits up. And your baby won’t have any delays in rolling or learning to crawl if you practice lots of supervised tummy time while baby is awake.

C – Crib. Your baby should always be in his own sleeping space – like a crib or a bassinet. It is important that your baby’s bassinet or crib is flat and empty. Swings, bouncy chairs, car seats and inclined infant rockers are not safe for baby to sleep in. Your baby’s neck is still very floppy, and he can develop problems with, or even stop, breathing if he is placed to sleep at an incline. I tell new parents that the only cute thing in their baby’s crib should be their baby. Take all the bumper pads, fluffy blankets and stuffed animals out of the crib. You don’t want anything in the crib that baby can suffocate on. Boring is best!

RELATED: The Healthy Children Show: Sleep (www.healthychildren.org)

Do you want to know other ways to protect your baby from sleep-related death? Breastfeeding is a great way to protect baby from SIDS – breastfeeding for 2 months cuts baby’s risk of SIDS in half. We also know that any exposure to cigarette smoking can increase your baby’s risk of sleep-related death – another great reason to quit smoking! And finally, using a pacifier during sleep will also decrease baby’s risk of SIDS.

Advice to parents to decrease a baby’s risk of SIDS:

Breastfeed your baby

Quit smoking

Use a pacifier

Parents will often ask my advice on swaddling. Swaddling is safe for parents to do in the first two months of life as long as they use a lightweight blanket (like a receiving blanket) or a sleepsack. A baby’s arms should can be swaddled tight, but their legs should not be tightly wrapped. A baby should be able to move his legs freely in his swaddle to prevent problems with baby’s hips. Once a baby is showing signs of being ready to roll over, we advise parents to stop swaddling their baby. This is because there is actually an increased incidence of sleep-related deaths in babies who were still swaddled after being able to roll over. [3] I tell parents to stop swaddling their babies by two months of age.

Once a baby is showing signs of being ready to roll over, we advise parents to stop swaddling their baby.

New parents should make sure that everyone who cares for their baby practices safe sleep all the time. They will want to make sure that grandparents and older caregivers know the newest safe sleep recommendations.   And parents should make sure that their baby has his own crib or bassinet at childcare. Parents can check to make sure their childcare provider has had safe sleep training.

It may take a little time to get your newborn to learn to sleep on his own in his bassinet. After all, he is used to being with mom all the time! Being alone is a new skill for him to learn. But it is important for a baby to learn to get to sleep by himself – the earlier the better! Every day it will get a little easier. It is okay for your baby to cry a little bit while he is settling in his bassinet. As long as he knows that you are nearby, he will feel comforted. And remember, there is no better way to love your baby than to keep him safe!

I highly recommend this sweet board book, Sleep Baby Safe and Snug, for parents to read to their baby.   It also reinforces safe sleep guidance for families.

For more information – check out the American Academy of Pediatrics’ safe sleep advice for parents –

https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

References:

  1. Gao, Y., D.C. Schwebel, and G. Hu, Infant mortality due to unintentional suffocation among infants younger than 1 year in the united states, 1999-2015. JAMA Pediatrics, 2018.
  2. SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 2016.
  3. Pease, A.S., et al., Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics, 2016.

RELATED: AAP Expands Guidelines for Infant Sleep Safety and SIDS Risk Reduction (Healthychildren.org)

RELATED: Get Bumpers Out of Cribs, Doctor Group Urges (CNN.com)

RELATED: Parents’ Guide to Sleep (Purple.com)

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Written by

Nerissa Bauer

I am a behavioral pediatrician, consultant, child advocate and blogger. I am a wife, mommy to 2 amazing children and a golden retriever. Love cooking, travel, reading, tap and creating.