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Safer Sleep for Babies: New guidelines

November 9, 2011

Moms and Dads, here's some important news: there are new guidelines you should know about that can help your baby sleep more safely. The American Academy of Pediatrics has issued new recommendations for sleep safety and protection against SIDS. SIDS, sudden infant death syndrome, has yet to be fully explained. Its causes remain largely unknown, and though it is relatively rare, it remains the number one cause of death among infants. In 1992, the American Academy of Pediatrics first made the recommendation that infants and babies sleep on their backs at all times. Since then, the occurrence of SIDS-related deaths has decreased significantly. But other types of sleeping and crib-related deaths have increased, including suffocation, entrapment and asphyxia. The new sleep safety guidelines are a response to these increases, and an attempt to provide parents with a broader, more comprehensive picture of how to create a safe sleep environment for their babies.

So, what's new in these recommendations? There are three major additions since the sleep safety guidelines were last updated:
• Breastfeeding is now recommended as a strategy for reducing SIDS risk. There are many benefits to breastfeeding, of course. Research has shown that one benefit of breastfeeding is a reduced risk of SIDS, perhaps by as much as 60 percent.
• It's recommended that all infants be immunized. According to the American Academy of Pediatrics, research has shown that immunization reduces SIDS risk by 50 percent.
• The guidelines also suggest that cribs not contain bumper pads or other types of padding. Parents often think these types of crib padding make their babies safer, but they don't. In fact, they can increase the risk of suffocation and strangulation.

These new guidelines join a series of recommendations that the Academy makes to parents, about how to protect infants and babies from sleep-related injury and death, including SIDS. These include:
• Always place your baby on his or her back for every sleep time.
• Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
• 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.
• Wedges and positioners should not be used.
• Pregnant woman should receive regular prenatal care.
• Don't smoke during pregnancy or after birth.
• Offer a pacifier at nap time and bedtime.
• Avoid covering the infant's head or overheating.
• Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
• Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).

You'll notice that these guidelines include recommendations for parents and moms-to-be, in terms of pre-natal care and healthy behaviors after baby is born. SIDS occurs more frequently in babies who were born prematurely, or whose mothers received less pre-natal care. The risk of SIDS also increases for babies with moms who smoked during pregnancy, or who live in smoking households. Part of guarding against the risk of SIDS and other sleeping risks begins before your baby is even born.

I'd like to add another one recommendation to the list. Using a fan in your baby's room can help keep your child's sleeping environment well ventilated and oxygen rich. This can diminish the amount of carbon dioxide your baby re-breathes during the night. Increased intake of carbon dioxide also poses a greater SIDS risk.

The Academy's report emphasizes the importance of training in these new, expanded guidelines, for health-care and child-care providers-including hospital maternity staff, midwives, and child-care and social workers. These people are often the most direct link to new parents, and can provide a critical service in helping parents understand how to make smart choices when setting up their child's sleeping environment.

I know this is a scary topic for parents. But information is power, and understanding the risks and also the ways to lower them is the best tool we have to keep all infants and babies sleeping not just soundly, but safely.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep DoctorTM
www.thesleepdoctor.com