Safety first! Hey mama. Did you know? Infant sleep is one of the neglected topics that mamas need to know about. If you're not so sure what precautionary measures to take, I'm here to make it easy for you! Create a safe and secured routine sleeping environment for your little one with these updated guidelines I'm about to share with you.
Last June 2022, the American Academy of Pediatrics (AAP) released an updated guideline that can help your local pediatrician guide families and mamas like you to practice safe infant sleep.
Just so you know, about 3,500 sleep-related infant deaths happen in the US every year. The AAP's committee developed the 2022 safe sleep guidelines with hopes of keeping sudden infant death syndrome (SIDS) rates lower and helping moms stay informed.
Find out what causes SIDS and what you can do to keep your baby safe while they sleep.
Why I am here and who I am:
Hey mama, I am Trish— AKA Labor Nurse Mama. I am a labor and delivery nurse with over 15 years of high-risk OB experience. I am also a mama to 7 kids and have given birth to 6. I have labored thousands of mamas and delivered many, many babies. I am the online birth class educator for Calm Labor Confident Birth and The VBAC Lab birth classes. I am passionate about your birth and motherhood journey!
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What is Sudden Infant Death Syndrome (SIDS)?
SIDS, also known as sudden infant death syndrome, is the leading cause of infant deaths in the US. SIDS occurs mostly under one year of an infant's age with the common causes being: suffocation or strangulation in bed, and breathing obstruction while sleeping.
Other risk factors of SIDS are due to babies sleeping in:
- their parent's bed
- a crib or bassinet with blankets, pillows, stuffed animals, or crib bumpers
- excessive clothing
Safe Sleep Best Practices: Learn the A, B, C, Ds of Safe Sleep
Since being a mama requires a full-time commitment, it's hard to memorize the dos and don'ts of raising your baby. That's why I created this easy-to-remember acronym for you so you don't forget!
Always keep your baby placed on their back when sleeping
Breastfeeding helps your baby boost their immune system
Check if the sleeping surface is safe and secured
Don't let your baby sleep with objects (pillows, blankets, toys, soft objects) in their sleeping area
Now that we've covered the basics, let's dig a little deeper into the details!
Side note: Check out my Instagram post on AAP's safety sleep tips!
Infants need to sleep, but they also need to be safe.
For safe sleep to happen, the American Academy of Pediatrics (AAP) recommends the following:
- Always keep your baby on their back every sleeping and napping time.
- Put your baby on a flat, firm surface like a crib or bassinet during sleep (even nap time!).
- If you're using a mattress, make sure it's firm and covered by a fitted sheet with a snug fit.
- Keep soft objects and loose bedding outside the crib.
- Sleep positioners (anti-roll pillows, nests, or any mat with wedges on the side) are a BIG NO-NO as they can increase the risk of suffocating.
- Put your baby's crib in their own room and away from windows or doors.
- Breastfeeding helps lower the risk of SIDS.
- Monitor tummy time at all times. Increase slowly to at least 15-30 minutes total daily until 7 weeks of age.
- Keep your baby's head uncovered while sleeping. No hats that are covering your baby's face!
In What Position Should My Baby Sleep?
AAP recommends putting your baby on their back for every sleep until they reach 1 year of age. Sleeping on their side or tummy is NOT okay, even for short naps. That's because when your little one's on their stomach, their airway is not as stable and able to be as open unlike when they're laying flat on their back.
Another reason why tummy time isn't recommended as it raises your baby's temperature, resulting in them overheating. Sleeping on their side means your baby can easily roll and lay on their stomach. That's why you have to supervise swaddling sessions, too. If your baby starts to learn how to roll during swaddling, it can increase their risk for strangulation and suffocation from the swaddle blanket.
Lastly, having your baby on their back makes it easier for them to tilt their head sideways when they spit up. If they're on their tummy, they can only turn their head into the mattress, making this position more prone to choking… and we wouldn't want that!
A little science trivia here is when your baby's on their back, gravity pulls the spit-up back and down into the food pipe (esophagus) rather than pushing it towards the windpipe (trachea).
What Surface Should My Baby Sleep On?
AAP only recommends alternative sleep surfaces to be safe IF they comply with the June 2021 CPSC rule. The June 2021 CPSC rule simply certifies that these infant sleep products meet the existing federal safety standards for safe sleep.
You can explore using cribs, bassinets, portable cribs, or play yards. You can also look into inclined sleeping products like travel bassinets, compact bassinets, baby nests, baby tents, hammocks, baby boxes, pods, or in-bed sleepers.
The golden rule is if that product doesn't meet federal safety standards, DON'T BUY IT!
What is Room Sharing?
When it comes to your baby's safety, the common misconception is to keep them close to you when you sleep. However, AAP recommends room sharing over bed sharing AKA keeping your baby's crib or sleep area in the same room where you sleep. Ideally, you should do this for at least 6 (sometimes up to 8 months, depending on your baby's motor skill progress) months of age.
The main idea is to have your baby sleep on a separate surface that's designed for infants but have them close enough to you for easy access. Put your baby's crib, bassinet, or play yard in your bedroom next to your bed. Doing so makes it easier for your to watch your baby and attend to them right away if they need feeding or comfort.
What About Bed Sharing?
Sharing a bed with your baby can lead to suffocation, strangulation, or overheating. AAP also states that the risk of SIDS from bed sharing is higher for babies who were born full-term but are less than 4 months of age or born pre-term with low birth weight.
On the other hand, some moms argue that bed sharing is the best way to go since you're literally just an inch away from your little one. But, if you're someone who likes to toss and turn in bed and constantly moves a lot during their sleep, having your baby next to you isn't such a good idea.
As a mom, I know how ridiculous it might sound and how it doesn't make sense to not have your baby sleep next to you. Falling asleep because you're so exhausted from all the mom duties during breastfeeding is a common scenario which is why it's more practical to keep your baby next to you.
My role here is to give you a clear picture of doing what's best for your baby and keeping them safe. If bed sharing is what you're comfortable with, I definitely respect that. Just make sure to follow AAP's bed-share recommendations: placing your baby on their back, not using soft bedding materials, and checking the bedding if it's a snug fit to the mattress.
Sleep Safety in Car Seats and While Traveling
Traveling with your baby on the road is inevitable and as a loving mama, it's your job to make sure you know the safety sleep procedure. When your baby falls asleep while they're in a seated position, they relax their head as their chin falls onto their chest. This movement may cause them to obstruct their own airway.
AAP recommends to avoid letting your baby fall asleep in car seats, strollers, swings, infant carriers, infant slings, and other sitting device, especially if they're under 4 months. If this happens, move them to a firm, flat surface and lay them on their back (Of course, as long as it's safe to do so AKA the car isn't moving).
At this point in your baby's infant stage, it's best to always keep an eye on them. Don't leave your baby unattended in a car seat, especially with unbuckled/partially buckled straps to prevent the risk of strangulation.
If you're using a baby carrier or infant sling, always make sure your baby's head is up and visible. No hat or clothing fabric covering their face to avoid suffocation.
Breastfeeding and safe sleep
Breastfeeding is recommended to develop your baby's immune system. Once breastfeeding has been established, you may consider offering them a pacifier at nap time or bedtime afterward.
AAP states that breastfeeding helps reduce your baby's risk of SIDS. If you're wondering if it's safe to breastfeed your baby in your bed, the answer is yes! In fact, it's better to do it while laying in bed than on a sofa or cushioned chair. Just make sure to move the pillows or any bedding away in case you fall asleep.
And if you do fall asleep, move your baby to their crib or bassinet right away when you wake up.
Smoking and safe sleep
This one's a touchy subject for some mamas. I know that smoking can give you a sense of comfort from the everyday stress of motherhood and life itself. But mama, keeping your baby's space smoke-free is a must.
Smoking is a major risk factor for SIDS as it can increase the chances of infant sleep deaths by more than three times. On top of that, it puts your baby at an increased risk of asthma, respiratory illnesses, and ear infections and exposes them to the dangers of nicotine exposure and secondhand smoke exposure.
At the end of the day, I respect everyone's lifestyle, cultural preference, and choices. As a mama of 7, what I can say to you if you're a smoker, is to think about your family and how it will affect you in the future. Having a healthy and smoke-free lifestyle enables you to be more physically able to care for your baby. Plus, the $$ you spend on your vice can be alloted to your baby's essentials instead.
The next time you think of lighting a stick or hitting that vape, remember how each puff will affect your future. There are other ways to cope with stress; healthy ways! Try going for a walk, meditating, doing home exercises, or finding new hobbies to fall in love with.
Several factors can cause your baby to “overheat”, including:
- Keeping them close to you during sleep
- Having extra layers of clothing
- Wearing head covering or hats
- Your baby's room temperature is hot
- Sleeping on baby nests
Most babies don't need any additional bedding other than a nappy.
While head covering serves its purpose, AAP recommends to keep your baby's head uncovered during sleep. Having head covering and excessive clothing/blankets increase the risk of SIDS. As a matter of fact, AAP recommends to not have your baby wear hats indoors and for the first few hours after birth.
If you want to keep your baby cool, try turning the fan on (make sure it's not directly blowing air into them, though!) and keeping the blinds or curtains down during the day.
The best way to check for signs of overheating are:
- flushed skin
- feeling your baby's chest and it feels hot
A monitoring device is used to monitor your baby's heart rate and can also be used at home to monitor your health during pregnancy, afterbirth, and your baby's health as well. These wearable monitors can also help you check your baby's airways and oxygen levels.
Crib bumpers, baby nests, and wedges are designed specifically for babies. AAP recommends to avoid the use of commercial devices AKA smart baby monitors that “claim” to reduce the risk of SIDS as some wearable monitors are only considered to be “wellness devices” and not “medical devices” by the FDA. Meaning, this type of monitoring device doesn't hold the same regulatory requirements as medical devices. Using them as substitutes for medical devices can give you a false sense of security.
If you are looking to use monitoring devices, please make sure they're FDA-approved. Or, ask your healthcare provider if the brand you're eyeing on is something they'd recommend to use!