How to Keep Your Sleeping Baby Safe: AAP Policy Explained
The U.S. Consumer Product Safety Commission (CPSC) and Fisher-Price took the advice of the American Academy of Pediatrics and issued a recall of 4.7 million Rock 'n Play infant sleepers following reports of infant deaths. This product is dangerous and parents and caregivers are urged to stop using it right away.
An investigation
by Consumer Reports that found 32
infants had died while using the sleeper since 2011. Some of the infants rolled over while unrestrained and some were unable to breathe due to their position.
To
request a refund for the Rock's Play, visit http://bit.ly/RockNPlayRecall or call the company at 866-812-6518. Those who have owned the
Rock's Play for 6 months or less will receive a cash refund while those who
have owned them longer will receive a voucher for a new Fisher-Price product.
The AAP does not recommend letting infants sleep in inclined products like the Rock 'n Play that requires restraining a baby. AAP policy calls for infants to sleep on their back, on a separate, flat and firm sleep surface without any bumpers, bedding or stuffed toys.
More than 3,500 babies
in the U.S. die suddenly and unexpectedly every year while sleeping, often due
to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or
strangulation.
In an effort to reduce
the risk of all sleep-related infant deaths, the American Academy of
Pediatrics' (AAP) updated policy statement and a technical report includes new
evidence that supports skin-to-skin care for newborn infants; addresses the use
of bedside and in-bed sleepers; and adds to recommendations on how to create a
safe sleep environment.
Note: All of these recommendations, unless mentioned
otherwise, are for babies up to 1 year of age. Talk with your pediatrician if
you have questions about any of the recommendations listed.
What You Can Do: Recommendations for Infant Sleep
Safety
·
Until their first
birthday, babies should sleep on their backs for all sleep times—for naps and
at night. We know babies who sleep on their backs are much less likely to die of
SIDS than babies who sleep on their stomachs or sides. The problem with the side
position is that the baby can roll more easily onto the stomach. Some parents
worry that babies will choke when on their backs, but the baby's airway anatomy
and the gag reflex will keep that from happening. Even babies with gastroesophageal reflux (GERD) should sleep on their
backs.
o
Newborns should be placed skin-to-skin with their mother as soon after birth as
possible, at least for the first hour. After that, or when the mother needs to
sleep or cannot do skin-to-skin, babies should be placed on their backs in the
bassinet. While preemies may need to be on their stomachs temporarily
while in the NICU due to breathing problems, they should be placed on their
backs after the problems resolve, so that they can get used to being on their
backs and before going home.
o
Some babies will roll onto their
stomachs. You should always place your baby to sleep on the back, but if your
baby is comfortable rolling both ways (back to tummy, tummy to back), then you
do not have to return your baby to the back. However, be sure that there are no
blankets, pillows, stuffed toys, or bumper pads around your baby so that your
baby does not roll into any of those items, which could cause blockage of airflow.
o
If your baby falls asleep in a car seat, stroller, swing, infant carrier, or sling, you
should move him or her to a firm sleep surface on his or her back as soon as
possible.
·
Use a firm sleep
surface. A crib, bassinet, portable crib, or play yard that meets the safety standards
of the Consumer Product Safety Commission (CPSC) is recommended
along with a tight-fitting, firm mattress and fitted sheet designed for that
particular product. Nothing else should be in the crib except for the baby. A
firm surface is a hard surface; it should not indent when the baby is lying on
it. Bedside sleepers that meet CPSC safety standards may be an option, but
there are no published studies that have examined the safety of these products.
In addition, some crib mattresses and sleep surfaces are advertised to reduce
the risk of SIDS. There is no evidence that this is true, but parents can use
these products if they meet CPSC safety standards.
·
Room share—keep baby's
sleep area in the same room where you sleep for the first 6 months or, ideally,
for the first year. Place your baby's crib, bassinet, portable crib, or
play yard in your bedroom, close to your bed. The AAP recommends room-sharing
because it can decrease the risk of SIDS by as much as 50% and is much safer
than bed-sharing. In addition, room sharing will make it easier for you to
feed, comfort, and watch your baby.
·
Only bring your baby
into your bed to feed or comfort. Place your baby back in his or
her own sleep space when you are ready to go to sleep. If there is any
possibility that you might fall asleep, make sure there are no pillows, sheets,
blankets, or any other items that could cover your baby's face, head, and neck,
or overheat your baby. As soon as you wake up, be sure to move the baby to his
or her own bed.
·
Never place your baby
to sleep on a couch, sofa, or armchair. This is an extremely dangerous
place for your baby to sleep.
·
Bed-sharing is not
recommended for any babies. However, certain situations make bed-sharing even
more dangerous. Therefore, you should not bed share with your baby if:
o
Your baby is younger than 4
months old.
o
Your baby was born prematurely or
with low birth weight.
o
You or any other person in the
bed is a smoker (even if you do not smoke in bed).
o
The mother of the baby smoked during pregnancy.
o
You have taken any medicines or
drugs that might make it harder for you to wake up.
o You drank any alcohol.
o
You are not the baby's parent.
o
The surface is soft, such as a
waterbed, old mattress, sofa, couch, or armchair.
o
There is soft bedding like
pillows or blankets on the bed.
·
Keep soft objects,
loose bedding, or any objects that could increase the risk of entrapment,
suffocation, or strangulation out of the baby's sleep area. These include
pillows, quilts, comforters, sheepskins, blankets, toys, bumper pads or similar
products that attach to crib slats or sides. If you are worried about your baby
getting cold, you can use infant sleep clothing, such as a wearable blanket. In
general, your baby should be dressed with only one layer more than you are
wearing.
·
It is fine to swaddle
your baby. However, make sure that the baby is always on his or her back when swaddled. The swaddle should not be too tight or make it hard
for the baby to breathe or move his or her hips. When your baby looks like he
or she is trying to roll over, you should stop swaddling.
·
Try giving a pacifier
at nap time and bedtime. This helps reduce the risk of SIDS, even if it falls
out after the baby is asleep. If you are breastfeeding, wait until
breastfeeding is going well before offering a pacifier. This usually takes 2-3 weeks. If you are not
breastfeeding your baby, you can start the pacifier whenever you like. It's OK
if your baby doesn't want a pacifier. You can try offering again later, but
some babies simply don't like them. If the pacifier falls out after your baby
falls asleep, you don't have to put it back in.
What Moms Can Do: Recommendations for Prenatal &
Postnatal
·
Do not smoke during
pregnancy or after your baby is born. Keep your baby away from
smokers and places where people smoke. If you are a smoker or you smoked during
pregnancy, it is very important that you do not bed share with your baby. Also,
keep your car and home smoke-free. Don't smoke anywhere near your
baby, even if you are outside.
·
Do not use alcohol or
illicit drugs during pregnancy or after the baby is born. It is very important
not to bed share with your baby if you have been drinking alcohol or taken any
medicines or illicit drugs that can make it harder for you to wake up.
·
Breastfed babies have
a lower risk of SIDS. Breastfeed or feed your baby expressed breast milk.
The AAP recommends breastfeeding as the sole source of nutrition for your baby
for about 6 months. Even after you add solid foods to your baby's diet,
continue breastfeeding for at least 12 months, or longer if you and your baby
desire.
·
Schedule and go to all well-child
visits. Your baby will receive important immunizations
at these doctor visits. Recent evidence suggests that immunizations may have a
protective effect against SIDS.
·
Make sure your baby
has tummy time every day. Awake tummy time should be supervised by an awake
adult. This helps with the baby's motor development and prevents flat head syndrome. See Back to
Sleep, Tummy to Play for more
information and ways to play with the baby during tummy time.
Use
Caution When Buying Products
·
Use caution when
a product claims to reduce the risk of SIDS. Wedges, positioners,
special mattresses and specialized sleep surfaces have not been shown to reduce
the risk of SIDS, according to the AAP.
·
Do not rely on home
heart or breathing monitors to reduce the risk of SIDS. If you have
questions about using these monitors for other health conditions, talk with
your pediatrician.
·
There isn't enough
research on the bedside or in-bed sleepers. The AAP can't recommend for or
against these products because there have been no studies that have looked at
their effect on SIDS or if they increase the risk of injury and death from
suffocation.
Additional
Information & Resources:
·
Sleep Position: Why Back is Best
·
New Crib Standards: What Parents Need to Know
·
Safe Sleep for Babies (Video)
·
The Healthy Children Show: Sleep (Video)
