Safe Sleeping Tips For Newborns

So parents can rest assured.

By Sheryl Grassie

When you have an infant, keeping them safe is a high priority. We have compiled safe sleeping tips for newborns from a variety of experts, so you’ll know exactly how to keep them out of harm’s way.

The Data

At present in the United States, about 3,600 newborns die each year in what is termed sudden unexpected infant deaths (SUID). These deaths fall into one of three categories: sudden infant death syndrome (SIDS), unknown causes, and accidental suffocation and strangulation in bed (ASSB) as defined by the Centers for Disease Control, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). The first two categories are the largest, with SIDS running in the neighborhood of 1,400 deaths per year, unknown causes roughly 1,300, and suffocation or strangulation around 900 yearly.

These numbers have changed significantly starting in the 1990’s.

  • Death from SIDS has decreased substantially starting in 1990, when strong sleep recommendations for newborns were issued to the public. Parents listened, and made changes, and the infant mortality rate (from SIDS) dropped by a statistically significant margin during the first half of the 1990’s and then leveled off. This indicates that safe sleep practices for newborns are working when it comes to death from SIDS.
  • Infant deaths from unknown causes, in contrast to SIDS, maintained a fairly steady rate from 1990 to about 1998. Then we see an increase going forward all the way to the present. For no apparent reason this category has just continued to grow.
  • ASSB deaths (suffocation and strangulation), also in contrast to SIDS, has been on a small but steady incline over the entire period from 1990 to the present. It appears that factors which have decreased SIDS have not reduced ASSB, and other factors, like a trend towards using crib bumper pads and having toys in the crib, have caused an increase.

Safe Sleeping Tips for Newborns

The American Academy of Pediatrics has launched a concerted effort to educate parents and caregivers regarding safe infant sleep practices. In particular, they highlight things that can be done to reduce the risk of SIDS. The National Institute of Health, in conjunction with the US Department of Human Services, has gotten involved with a campaign called SAFE TO SLEEP, that outlines safe sleep habits and ways to prevent SIDS. The following are their recommendations.

Start With a Healthy Pregnancy

Healthy pregnancies produce healthy babies, and healthy babies have less chance of sudden death. Follow good prenatal care recommendations, see your doctor, take your vitamins, don’t smoke, drink, or use recreational drugs.

Breastfeed Your Baby

The research on breastfeeding is fairly conclusive, it reduces the risk of SIDS significantly. Breastfeeding for as little as 2-4 months can lower the risk by 40%, and nursing for up to 6 months can reduce the risk by 60%.

Have Regular Skin-To-Skin Contact

If you are breastfeeding a baby this will happen naturally, but there are lots of ways to have direct skin-to-skin contact. The American Academy of Pediatrics highly recommends this as a practice, so lay your baby on dad’s bare chest, do baby massage, or take a bath together. Direct skin contact lowers the risk of infant death.

Share a Room, Not a Bed

Sharing a room with your baby decreases SIDS by 50%. The co-sleeping recommendation is to have them in the same room with you for at least the first year, but not in the same bed. They can have a bassinet or a crib, close to your bed. If you have twins, use separate beds, one for each.  If you take the baby into your bed to nurse, try to resist the temptation to fall asleep together. Put them back in their designated sleeping place.

Check for Bed Safety

Getting a hand-me-down crib can be a blessing if it meets consumer safety standards. The Consumer Product Safety Commission publishes information on unsafe cribs. Check before you accept a used crib or play it safe and get a new one.

On Their Back Until 1-Year Old

This is perhaps the single most important change that likely lowered the statistics back in 1990, experts started advising back sleep for babies as a standard practice. Until your child reaches their first birthday, or until they are able to roll themselves from back to stomach and stomach to back, they should be laid to sleep only on their backs. This is for all sleep times including naps.

Sleep on a Flat Firm Tight Fitting Surface

Many of us are so grateful when our babies fall asleep, we wouldn’t dare think of moving them. Recommendations, however, are that you don’t let your baby sleep in a car seat, stroller, or swing. For safe sleeping, and to reduce the risk of infant death, they should sleep on a firm, flat mattress. This means no extra padding, no foam mattresses, and no waterbeds. The mattress should fit snugly in the crib or bassinet and be covered in a tight-fitting sheet. In essence, no soft or loose surfaces.

No Extras in the Crib

This refers to bumper pads, pillows, blankets, toys, loose clothing, or any extra bedding. These items can cause suffocation and strangulation and are easy to eliminate. Picture a crib with nothing but your baby in it.

Swaddle or a Onesie

Yes, you can swaddle your baby for sleeping in the early weeks and months. When they start making motions to rollover, it is time to give their limbs some freedom. In lieu of swaddling, a one-piece sleeper is ideal. With two-piece garments the top can ride up and cause a potential suffocation risk, especially when on their tummies.

Have a Bedtime Routine

Even when they are very small, babies respond to routine and can feel safer when things are predictable. You can pick a time, establish a series of steps, like give your baby a bath, nurse him to sleep, place him in the crib, and turn on music. Whatever routine works for you, let your baby experience a predictable world as part of practicing safe sleep.

Keep a Comfortable Temperature

Best practices in safe sleeping for babies advocates for a minimal to moderate amount of clothing and a room temperature of 70 degrees. Too warm from being overdressed or having the room too hot is considered a risk factor.

Maintain a Smoke-Free Environment

An environment where a baby is exposed to secondhand smoke can greatly compromise health and increase the potential for sudden death. Research on smoking while pregnant or around children and the risks are well known.

Consider Using a Fan

Although there is no conclusive research on using a fan, some experts do believe that air movement can help keep a baby breathing and prevent SIDS.

Use a Pacifier

Similar to using a fan, but with more substantiated research, a pacifier can reduce the risk of infant death. The sucking motion keeps them engaged and breathing.

Inform the Caretakers

Don’t take for granted that a daycare provider, a babysitter, or relatives helping take care of your infant will know what to do. Your parents or grandparents may have regularly placed babies on their tummy to sleep. 1 in 5 five SIDS deaths happen when the child is being cared for by someone other than the parents.

Tummy Time

A suggested practice, to help balance out sleeping on their backs, is to do tummy time. Place your infant on their stomach, on a firm surface for periods of time when you can watch them and engage with them. This helps with countering flat head syndrome, a condition that can occur from too much time in the same position.

SIDS End Notes

Because SIDS, also called crib death, is the most common cause of infant death, there is considerable research on it. It is the sudden, with no warning and no visible cause, death of a child while they are sleeping. It happens in the first year of life and has been associated with stomach sleeping. A few SIDS facts include:

  • SIDS is the leading cause of death between one month and one year.
  • SIDS happens most often between 2-4 months of age.
  • SIDS happens most often during winter months.
  • SIDS happens more frequently with boys.

Summary

Safe sleep practices help guard against a child dying while sleeping. Leaving a baby alone to sleep always has risks, and since they sleep an average of 16 hours a day, you can’t always be right there. You can, however, guard against problems with the safe sleep tips for newborns described above.

A general rule of thumb is that simple is best. The safest place to sleep your infant is in the same room with you, in a separate crib or bassinet, on a firm flat surface, with nothing else in their bed. These basic recommendations will keep baby sleeping safely and you sleeping soundly.


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