The (Strict) New Safe-Sleeping Guidelines
If you have a baby younger than 1 year of age, chances are that he or she is sleeping in a way that goes against the latest recommendations from the American Academy of Pediatrics (AAP). At the AAP’s national conference in Boston, which wraps up today, the Academy released their revised policy statement on safe sleeping and SIDS prevention.
Until babies are 1 year old, they should:
Be put to sleep on their back. Always, always, always. At some point, your baby will be able to roll from her back to her front and from her front to her back—and at that point, you can leave her in whatever position she ends up.
Sleep in the same room as—but not the same bed as—their parents. To keep a baby in your room until age 1 may seem… let’s say… difficult, but “these recommendations are most important in the first few months,” says pediatrician Rachel Moon, M.D, lead author of the new guidelines and chair of the AAP SIDS task force. Bedsharing is not recommended at any age, even if you’re using an actual cosleeping device that attaches to the side of your bed. “No bedsharing can be classified as safe,” says Dr. Moon, who adds that babies under 3 months are at a “very, very high risk” of suffocation.
Use a pacifier as often as possible. Pacifiers are associated with a decreased risk of SIDS, perhaps because it may position the tongue in a way that helps keep the airways open, Dr. Moon says. Pacifiers also tend to arouse babies as they sleep (I’ll say! Who else has experienced that sinking feeling every time their newborn’s pacifier popped out of her mouth and woke her up?!), and when babies are able to be easily woken, their risk of SIDS goes down.
Be breastfed. Lots of research backs up the positive connection between nursing and SIDS risk reduction.
Be fully immunized. There may be a protective effect here, too; evidence points to a 50 percent decrease in the risk of SIDS.
Not have anything in their cribs (or bassinets or Pack & Plays) except a tight-fitting sheet. No bumpers—not even the mesh kind. (Chicago now bans the sale of bumpers.) No stuffed animals. No pillows. No blankets. Nothing between the mattress and the sheet to make the surface softer. (“Soft does not equal safe,” says Dr. Moon. “Soft is bad.”) No elevating the head of the crib mattress by propping pillows underneath it, either, because babies can slide down to the bottom of the crib and end up in a position that obstructs their airway, or get wedged between the mattress and the side of the crib.
Not sleep in a car seat, stroller, swing, or sling for more than 60-90 minutes, and even then only under close supervision. Nothing but a crib, bassinet, or Pack & Play is recommended for extended periods of sleep. If your baby falls asleep in one of those other places, Dr. Moon recommends moving him as soon as is practical. Otherwise, they run the risk of sliding or slumping down and boosting the chance of suffocation.
Not sleep with the help of any products marketed as reducing the risk of SIDS. This goes for wedges, positioners, and home apnea monitors. “Parents believe that if a product is sold, it must be safe. They don’t always understand that these items don’t have to be tested or proven to work in order to be in stores,” says Dr. Moon.
She made an important point about why some parents don’t follow safe sleep recommendations. “Everybody thinks their baby is the exception to the rule,” she explains. “They’ll say ‘My baby has reflux.’ ‘My baby was premature.’ ‘My baby’s not a good sleeper.’” But she sees more than her share of infant deaths—at least one per month in her hometown of Washington, D.C. “We have to get the message out.”
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