Summary of information via Jugoslava and the Admin team at Safe Sleep and Baby Care - Evidence Based Support on Facebook. This is a basic overview of the four concepts, I recommend joining the SSBC group for more detailed information.
A new baby in the house brings much love and joy to young parents and grandparents. But the care of a newborn can be overwhelming. One of the most stressful parts is getting the baby to sleep safely. Safe sleep guidelines have changed since I was a baby, and since I had my babies in the 1990s. Whether you are a new parent or a new grandparent, there are significant facts about safe infant sleep to learn.
Table of Contents:
1. Safe Sleep, SUID, and SIDS
In the late 1980s, SIDS was defined as the sudden death of any infant or toddler that is unexpected and postmortem examination does not define any cause. When I was a babysitting teen, the worry about “crib death” as it was called then led me to check the baby’s breathing twice an hour or more. Crib death was thought to be an unlucky tragedy. SUID (Sudden Unexplained Infant Death) is the current term used, and it includes SIDS.
When I had my own children in the 1990s, studies showed increased SIDS risk for babies sleeping on their stomachs, so the “Back to Sleep” campaign began. So I placed my babies on their backs. In the US, there was a more than 50% reduction in the rate of SIDS within just a few years of the “Back to Sleep” efforts.
More studies have led to the ABCs of Safe Sleep: Alone, on their Back, in a Crib. If SIDS is the initial COD listed on the death certificate, half the time it will be changed to “suffocation” after medical review. Only 1.5% of SUIDs (55 cases out of 3625 included in the ten-year retrospective study listed below) were categorized as unexplained with NO unsafe sleep factors.
"SIDS as a concept is coming to an end because most SIDS deaths are actually unsafe sleep deaths. Let’s make unsafe infant sleep deaths a thing of the past as well, by ensuring every sleep is a safe sleep." (Tess, SSBC)
2. The 4th Trimester
Pregnancy is divided into 3 nine-week trimesters. No one tells you about the 4th trimester: the first 9+ weeks you are home with the newborn. It’s going to be hard: plan to get through without falling into unsafe sleep practices.
Get help – both day and night. Both parents should split the feedings, so each can get a few uninterrupted sleeps of at least 4 hours. Even a working parent should expect to take a turn during the night. This is where grandparents can come in handy – day relief, so parents can get in a nap. My mother came to stay with me, and she was a huge help.
Newborn babies become overtired quickly, so keep the awake times to 1–2 hours. Remember that babies less than 6 weeks old don’t sleep for long intervals during the day or night. I know that magical, almost mythical goal of “baby finally sleeping through the night” is what every parent dreams about, but it probably won’t happen during the 4th trimester. Newborns falling asleep late at night is normal, so adjust accordingly. Also, infants can have an active sleep, stirring or making noise. Resist the temptation to pick them up, often the baby will relax and fall back asleep.
3. Unsafe Sleep Products
AAP recommends against using any commercial pulse oximeter at home
Will fail to alarm for 1 in 4 babies
Dock a Tot
Sales banned since June 2022
Unsafe for sleep, per the Consumer Product Safety Commission
Handmade or Hand-me-down Crib
Not regulated or tested
Will not meet current standards
Baby’s ability to move freely is crucial to respond to hypoxia
Doesn’t pass safety standards as a bassinet while the positioner is in place.
Rock N Play
Recalled since 2019
Over 100 baby deaths recorded
Swings & Carseats
Never safe for sleep due to positional asphyxiation
car seats are safe for transporting baby; swings are only safe for awake supervised use, never for sleep
4. Survivor Bias
Many readers may be saying, "We bedshared, and our baby was fine." Or even, "I slept in a crib with a drop-down side and I'm still here."
Survivor Bias is the tendency to believe that a choice is correct if it didn't cause personal harm while ignoring evidence that shows risks, even significant risks. It's easy to understand this bias around the principles of safe sleep. Before studies showed that there was a correlation between infant sleep and SIDS, parents considered crib death as an unavoidable and unpreventable loss.
Science shows safe sleep saves lives - regardless of personal experiences and beliefs.
"For all race/ethnicity groups combined, SUIDs occur at a rate of 88.9 per 100,000 live births during the first year of life. This is significantly higher than the peak risk per 100,000 population for each of the leading causes of injury death for those under 22 years, including: motor vehicle-related crashes (19.1), firearm homicide (11.6), drugs and opioid-involved overdose (10.7), and suicide (14.2). Conclusion: The risk of SUID in the first year of life is far greater than that of all the leading causes of injury death in the late teen years." (Jugoslava SSBC)
Source: AAP Council on Injury, Violence & Poison Prevention, 2019
Resources for Safe Sleep
The Safe Sleep and Baby Care - Evidence Based Support. Hands down, the best resource out there. Moderators will check the baby's sleep space to be sure it is safe, and there are daily accountability checks. The Files contain extensive material, including a sleep training document.
The American Academy of Pediatrics has a section on its site with videos and documents.
Healthy Sleep Habits Happy Child: A New Step-by-Step Guide for a Good Night's Sleep
(5th Edition), Dr. Marc Weissbluth
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