Any parent to a newborn worries about Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Infant Death (SUID) and what they can do to prevent it. SIDS deaths are unexplained while SUID deaths in infants are secondary to things like suffocation, entrapment, infections, or trauma. The new recommendations take research on all of these risks into account and are specific to guide parents to reduce risks for SIDS and sleep-related suffocation, asphyxia, and entrapment among infants in the general population.
I’ve been interviewed a lot lately about all the fancy new baby trackers, monitors and even smart cribs available to the public being marketed as SIDS reducers. These are not the answer to safer sleep — no data to prove it. I’m a digital enthusiast but it doesn’t change my concern that these devices are entering the market out of the place of fear, not science for improved safety. I think we have to acknowledge that these trackers might amp and rev up anxiety more than they will decrease it in some parents.
What we CAN do to decrease risk of SIDS is follow new research-based guidelines published this month from the American Academy of Pediatrics (AAP) to reduce the likelihood of SIDS and suffocation. This new set of guidelines are updates to the 2011 recommendations, some being similar, and others a bit different. Big changes from my perspective are the stronger recommendations for pacifier use in infants, the strong recommendation against feeding babies in the nursing chair at night, and the ongoing urging to have your babies in BARE, BORING, BASIC sleeping environments in a parents room. Pillows, blankets, bumpers, and stuffed animals are cute but not safe for infants under 1 year of age. Where we feed our hungry babies in the middle of the night matters, too. The recs out this month help define ways to do this with more confidence you’re reducing risk.
“Parents should never place the baby on a sofa, couch, or cushioned chair, either alone or sleeping with another person. We know that these surfaces are extremely hazardous.” ~Rachel Moon, the lead author of the new guidelines and professor of pediatrics at University of Virginia School of Medicine
10 Ways To Reduce Risk Of SIDS And Suffocation
- Room Sharing Without Bed Sharing: Infants should sleep in the same room as their parents for at least the first six months of their life, ideally for the entire first year. Oooffff — this can be intimidating and exhausting but it’s a great way to facilitate easier nighttime feeding, improve safety, and decrease parental anxiety. This stat may help ease the stress of a baby sleeping in your room for a year: room-sharing decreases the risk of SIDS by as much as 50%. To be perfectly clear on this one…having baby sleep in your room does NOT mean having baby sleep in your bed. Research suggests that sleeping in a parent’s room likely exposes them to sounds and motions/co-motion in the room that changes how they sleep and how they move through sleep cycles thus potentially decreasing the patterns that may lead to SIDS.
- Put Baby on Their Back In Bare, Basic, Boring Cribs: Put babies on their back when you put them down for naps and sleep. Side sleeping isn’t safe. This is true even in babies with reflux or spitting up — research shows that does not increase choking. Continue to place babies on their backs on a firm surface on a tight, fitted sheet with no other bedding, bumpers, blankets, pillows and/or stuffed animals. Nothing new here. Even after babies can roll over, keep putting them on their backs but know you don’t have to police them and roll them back over if they turn! AAP reminds, “Because rolling into soft bedding is an important risk factor for SUID after 3 months of age, parents and caregivers should continue to keep the infant’s sleep environment clear of soft or loose bedding.” Just a strong reminder that anything but a firm mattress and a tight fitted sheet increases the risk of SIDS, suffocation, and/or entrapment until age 1 year. Swings and carseats are not places for babies to sleep unattended. AAP says, “sitting devices, such as car seats, strollers, swings, infant carriers, and infant slings, are not recommended for routine sleep in the hospital or at home, particularly for young infants. Infants who are younger than 4 months are particularly at risk, because they may assume positions that can create a risk of suffocation or airway obstruction or may not be able to move out of a potentially asphyxiating situation.”
- Breastfeeding Over Formula Decreases Risk: Breastfeeding has been shown to reduce the risk of SIDS. Protection increases with exclusive breastfeeding but for many of us that’s not possible. Just know, any breastfeeding has been shown to be more protective against SIDS than no breastfeeding. In addition, new guidelines help advise moms how to breastfeed in the middle of the night when they, too, are sleepy. The most hazardous environment to feed your baby is a nursing chair or an armchair (because you can fall asleep and so can your baby), so the AAP recommends feeding baby in a bed without loose blankets and pillows and then moving them to their own firm sleep surface. If you do fall asleep, the minute you wake up and realize you’re both asleep in bed, AAP advises to move your baby back to their crib or co-sleeper.
- Avoid Exposure To Cigarettes, Alcohol, Drugs: Avoid baby’s exposure to smoke, alcohol and illicit drugs during pregnancy but also during infancy. This means you don’t want babies in a house of smokers or those using alcohol or drugs, but also feeding from a mom using these chemicals and enduring these exposures. Biggest risks are when a baby shares a bed with an adult smoker or an adult using alcohol or illicit drugs.
- Use Pacifiers: Offer a pacifier at nap time and bedtime. The statement from AAP is stronger on this advice this time urging parents to offer a pacifier to their babies during naps and last sleep at night. No need to police the pacifier, meaning no need for you keep putting it back in baby’s mouth. For breastfed infants, pacifier use should be delayed until breastfeeding is firmly established. Infants who are not being directly breastfed can begin pacifier use as soon as parents want.
- No Monitor Is Proven To Prevent SIDS: You don’t need technology in your room or in the baby’s crib. Do not use home monitors or commercial devices, including non-techy things like wedges or positioners, marketed to reduce the risk of SIDS. These have never been found to reduce the risk of SIDS. I think they increase anxiety, they set off alarms and increase awakenings for parents, and they stew more worry. All that and there is simply no data they help. Use a monitor to listen and learn about your baby, sure, but don’t use it thinking it will reduce risk of SIDS or suffocation.
- Vaccinate On Time! Not a single study showing that delaying or declining immunizations during infancy improves safety for babies. Infants should receive all recommended vaccinations. Being up-to-date protects baby, period. AAP states, “recent evidence suggests that vaccination may have a protective effect against SIDS.”
- Don’t Crank The Heat: No need to over-bundle your baby at night but there is some data to say overheating is a risk. Although previous statements brought up the use of fans, this time the AAP says, “There is currently insufficient evidence to recommend the use of a fan as a SIDS risk-reduction strategy.”
- Tummy Time During Day: Supervised, awake tummy time is recommended daily to facilitate development. During the day get that baby off their back and let them explore the floor on a blanket with toys in and out of reach. Join them on the floor and enjoy it, too.
- Swaddling Okay In Early Infancy But Doesn’t Prevent SIDS: Know the rules of swaddling! Swaddling is okay in young infants but it isn’t necessary. Avoid swaddling and placing your baby on their side or tummy. Consider eliminating swaddling when your baby starts showing signs of being able to roll over, this usually happens around 3-5 months of age. The risk of a baby rolling over and getting onto their side or stomach while swaddled may increase risk of SIDS.
“If you are feeding your baby and think that there’s even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair,” said Lori Feldman-Winter, MD, FAAP, member of the Task Force on SIDS and co-author of the report.