Crib Safety: Creating a Safe Sleep Environment for Your Baby

I sat down today to review a ton of information for a client I am seeing next week. I am going into the home of first-time parents-to-be to teach them the baby basics; essentially a baby “boot-camp” if you will. I LOVE working with first-time parents—there is an amazement and wonder that they hold that just makes me smile and the confidence they gain in their newly learned skills is a fantastic sight to behold! However, as I reviewed the information I have seen a thousand times at least, it reminded me that new parents are made every day, and safety is never out of style. So I want to talk about crib safety today.

The following guidelines are set forth by the American Academy of Pediatrics (AAP) and have very specific reasons for them.

• Breastfeeding is recommended and is associated with a reduced risk of SIDS.
• Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation, or entrapment.
• Always place your baby on his or her back for every sleep time. Once the baby can roll, it is considered safe for them to sleep in whatever position they settle into for sleep.
• Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep as the angle of the car seat or device may create airway obstruction and suffocation. (This includes Rock and Plays—they are not a safe sleep environment.)
• The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
• Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads. There should be nothing but a mattress, sheet, and a correctly used swaddle blanket or sleep sack. (Wedges and positioners should not be used unless specifically advised by a medical professional for a diagnosed medical condition.)
• Pregnant women should receive regular prenatal care from a qualified and licensed provider.
• Don’t smoke during pregnancy or after birth.
• Offer a pacifier at nap time and bedtime as pacifier use has been shown to reduce the risk of SIDS.
• Avoid covering the infant’s head or overheating; maintain a temperature comfortable for a lightly clothed adult (ideal nursery temperature is generally considered 68-72 degrees).
• Do not use home monitors or commercial devices marketed to reduce the risk of SIDS as a preventive device.
• Infants should receive all recommended vaccinations.
• Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).

(citation: http://pediatrics.aappublications.org/content/128/5/e1341)

To me, all of these seem clear, straightforward, and common sense. But many people question them. What's the harm in them sleeping in their car seat, for example, is a question I get a lot. One of our company experts Lisa Cote, CPST and Special Needs Trained, had this to say about allowing a baby to sleep in their car seat:

Car seats are a great safety device for the travel of your baby, but are you aware that sleeping in them poses a safety hazard? Car seats are just that, seats to be used in the vehicle for safely transporting your baby. Once you reach your destination you ideally want to remove your baby from their seat.

The old adage of never wake a sleeping baby is not one to be followed with car seat safety. First, the baby really needs to be tightly strapped and buckled into their seat the entire time they are in it. Parents tend to loosen the harness when not in the vehicle and this poses the first safety hazard for sleeping. It allows the baby room to shift and scoot and highly increases the opportunity of strangulation by the harness and retainer clip (chest clip). Second, infants require a specific degree of recline during vehicle installation, 45*. This recline helps prevent the chin from falling forward onto the chest and inhibiting the airway causing asphyxiation. When the infant car seat is in use outside of the car and it's base the car seat is rarely at its required 45* angle for use again increasing the risk of asphyxiation.

Always transfer your baby to a stroller set to a proper angle, into your wearable baby carrier, or your arms once at your destination. While we all want to enjoy the peacefulness that comes with a sleeping baby it's vitally important to not set aside your baby's safety for those few extra minutes of sleep.”

Another question I get a lot is “won’t the baby struggle with breastfeeding if I give them a pacifier?” Of course, like any topic where people have an opinion, you can find all the information you want to support your viewpoint if you look for it. This topic is no different.  You will find lots of “evidence” on both sides of this. Here is what I can tell you. In 30 years of working in this industry, I have never once experienced a case where an infant got confused by the difference between sucking on a pacifier and on the breast and I don’t know any other NCS who has experienced this with a client baby either. And since the AAP is recommending it, I think it is worth doing your own research on it, deciding what you believe, and then following that.

Breastfeeding is always recommended by the AAP, and there is a fair amount of evidence that suggests that it directly contributes to the reduction of SIDS-related deaths. Rather than explain it all over again, I will allow the “Nation’s Pediatrician” Dr. Sears to share his wisdom instead: http://www.askdrsears.com/topics/health-concerns/sleep-problems/sids/8-reasons-breastfeeding-reduces-sids.

And, of course, there is the always fun (not) topic of vaccinating. I am not here to tell you to vaccinate or not vaccinate. It is a given that the AAP is going to recommend it. Here is what our stance at Newborn Care Solutions is on vaccination: DO YOUR RESEARCH. Look at BOTH sides of the topic. NEVER take one person’s word on it—even your pediatrician's. Investigate it fully and then make the best decision you can for your family. So long as you have done a full investigation, I am confident that you will make the right decision.

Keeping an infant safe in their crib is best done by following the clear and easy steps listed above and recommended by the American Academy of Pediatrics. If you have any questions about safe sleep or any other newborn and infant-related topics, please don’t hesitate to ask. Newborn Care Solutions is all about education and we are happy to help!

Tonya Sakowicz
Founder & CEO
https://www.newborncaresolutions.com
info@newborncaresolutions.com
Additional Articles by Tonya: https://newborncaresolutions.com/author/tonya/