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2018 Feb

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I remember my early days of parenthood vividly. I walked around with blurry-eyed exhaustion, fantasizing that I could sneak off alone to a hotel room and just sleep for days. My son never seemed to sleep. I mean, I guess he did, but never long and not much at night. He seemed to rest well when I rocked him or carried him, but when I would try to lay him down, he would wake up. So, there I would sit, in an uncomfortable wooden rocking chair, trying not to nod off.

I’d be tempted to take the baby in bed with me so that perhaps I could get a few glorious minutes of sleep, but I didn’t. I knew how dangerous co-sleeping could be. There are approximately 3,500 infant deaths yearly in the United States related to sleep, including SIDS (Sudden Infant Death Syndrome) and accidental suffocation. Those statistics were staggering enough to keep me awake.

The American Academy of Pediatrics (AAP) recommends room sharing (but NOT co-sleeping) ideally for a year, but at least for the first six months. Room sharing means you share your bedroom with your infant, but not your bed. This involves placing your baby on his or her back in a crib or bassinette in your bedroom. According to the AAP, room sharing decreases the risk of SIDS by 50 percent.

Co-sleeping (taking your infant into your bed) is not recommended. Never put the baby in your bed. It increases the risk of accidental suffocation or SIDS. It’s unfortunate that each year infants die due to an exhausted parent falling asleep in bed (or sofa) while holding an infant and accidentally rolling over on the baby. Our mattresses are too soft and have suffocation dangers such as blankets and pillows. Even sofa and chairs are too soft for an infant to sleep upon.

Having a firm sleep surface, like a bassinette or a firm crib mattress with a tight sheet is ideal. The crib should be bare. Don’t place any pillows, blankets, toys, or bumper pads in the crib. Sleeper PJs or sleep sacks (without additional blankets) are ideal to keep the baby warm, but not increase the risk of suffocation. Avoid overheating your baby. Be careful not to swaddle the hips too tightly, as they need to be able to move comfortably. Swaddling too tightly can lead to hip problems called dysplasia. The hips need to be able to lie in a flexed position like they were in the womb.

Remember, it’s back to sleep for babies. Infants should be placed to sleep on their backs when they are full, dry, and drowsy. Put them in their crib drowsy, but awake, so they learn to go to sleep, rather than rocking them all night (a mistake I clearly made). The AAP has recommended the back to sleep position since 1992, and the rate of SIDS dropped over 50 percent.

Even though infants should sleep on their backs, they need routine tummy time to strengthen their muscles. Tummy time should be done when the baby is awake and supervised and then only on a firm flat surface (where they cannot fall). If they fall asleep while on their tummy, roll them to their back and place them in the crib. Side sleeping is no longer recommended or considered safe.

Breastfeeding has shown to decrease the risk of SIDS. Other recommendations to decrease the risk of SIDS include offering a pacifier for sleeping, not using wedges or positioners, avoiding home monitor systems, and getting your infant fully immunized. Avoid exposing your baby to smoke and using alcohol or drugs while caring for an infant. These substances increase the risk of unintentional injury to your baby.

Remember these important tips:
• Room share but don’t co-sleep.
• Back to sleep in a bare crib.
• Avoid smoke, alcohol or drugs.
• Use pacifiers for sleep.
• No wedges or positioners.
• Get your child immunized.
• Breastfeeding reduces the risk of SIDS.

Keeping your baby safe while sleeping is crucial. Good night and sleep tight.

Read more about safe infant sleep in Raising Today’s Baby. Special thanks to the AAP for the policy statement “SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.”

Dr. Melanie J Wilhelm is a Doctor of Nursing Practice, and a Certified Pediatric Nurse Practitioner at Pediatric Specialists in Norfolk, as well as a lecturer at ODU. Her book, Raising Today’s Baby, is available on Amazon.com or at RaisingTodaysChild.com. Email her at raisingtodayschild@gmail.com. 

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