Practice Safe Sleep!
Ok, let’s talk about safe sleep practices for your baby. You will find a number of things out there that will make you think it isn’t a big deal. From products you will see on store shelves to all the noise in the great divide between those who co-sleep and those who don’t.
But let me just say, unsafe sleep shouldn’t be a debate, nor should it be something you celebrate or boast about. You’re not a badass mom when you give a little winky face and whisper “I put my baby to sleep on his tummy, but shhh don’t tell!”
What is “Safe Sleep?”
If you’re a new parent, you may have heard that there are a set of rules you should follow before letting your baby go to sleep at home. If you’re like me, this is something that I ended up stumbling into once I had my baby at home and found myself Googling about all the nightmarish things that come with being a new mom.
Safe sleep practices are a set of guidelines recommended by the American Academy of Pediatrics to ensure your baby’s sleep environment is safe for him/her. The AAP makes these recommendations based on scientific studies that describe the best way to prevent sleep-related injuries and death.
Now you might wonder how in the world your little one could get injured if she can’t really move yet, and she’s surrounded by pillows on a soft bed, but this is actually the exact cause of infant injury/death. Babies can wind up in very dangerous situations because they haven’t developed muscles, physical coordination, or brain function to know what is unsafe and how to maneuver out of an unsafe position or circumstance.
Safe Sleep Guidelines
Babies should sleep on a firm, flat surface.
Babies should sleep alone.
Babies should sleep on their backs.
Babies should room share with the parents for the first 6 months of life. Ideally, for the first year of life.
What Happens If I Don’t Follow The Rules?
An adult mattress, for example, is much softer than an infant crib mattress. If your baby sleeps on soft bedding, he may not get enough air circulation. If he rolls over, he can suffocate.
Toys are for awake, supervised time. They are not intended to be left alone with a baby. Strings or threads can come off (strangulation hazard, circulation hazard). Babies can sleep too close to a toy and not get enough air to breathe.
Babies don’t know how to use a blanket. It can cover their face and cause issues breathing. It can tie around their neck or wrap around their arms or legs so they can’t move and find a safe position.
If you use a mattress that isn’t designed to be used in a product (Pack n’ Plays, for example), there can be fit issues and your baby can slip into the side and suffocate.
You can roll over on your baby. Your baby can roll off the bed. You can accidentally push sheets, pillows, blankets onto your baby.
Statements that are not true
If I am watching my baby, he can’t possibly get into trouble.
FALSE: If your baby is in trouble, say he is in a reclined position, his airway can be blocked, and he won’t be able to raise his head to adjust. This is silent.
If I co-sleep, I will hear him or feel him if he gets into a bad situation.
FALSE: It’s possible, but I’m sure you’ve slept through an alarm clock before…
If I am watching him, it’s OK if he has toys or a blanket in his crib.
FALSE: You never know what your baby’s safety or comfort threshold is. If your baby overheats or has a plush toy too close to his mouth causing him to breath carbon dioxide, there won’t be any obvious signs.
He is six-months-old, rolling over, and crawling. I think it’s fine to use blankets [or insert any other no-no]
FALSE: Even though the SIDS rate significantly drops at six-months-old, babies don’t have the coordination or understanding when asleep to safely sleep with a blanket or a toy.
I am not on drugs or drinking any alcohol, so I can co-sleep with my baby.
FALSE: No one should co-sleep with their baby — especially if someone is on drugs (even prescription or over-the-counter medicine) or drinking alcohol. But even if you are sober and as alert, it’s still unsafe for your baby.
He fell asleep in the car, so I can just keep him in the car seat inside the house for his nap.
FALSE: As annoying as it might seem to interrupt your baby’s nap when you get home, babies should not sleep at an incline. Young infants don’t have head and neck control and cannot make sure their airway is open and clear.
He fell asleep in the swing or bouncer [or any other inclined device], so I’m just going to let him take his nap.
FALSE: Most swings and bouncers are both plush and put the baby in an inclined position. Your baby can overheat. And your baby may not be able to adjust himself if his airway is blocked.
He won’t fall asleep in his crib, and it feels like cardboard. He needs a plusher surface so we can all sleep.
FALSE: Babies don’t need the plush surface like us old people do. Babies will sleep just fine on a hard surface. In fact, if it feels comfortable to you, that is a red flag that it’s not safe for your baby.
He won’t sleep on his back, but if I place him on his belly, he sleeps wonderfully, so it must be OK.
FALSE: While you’ve clearly tested the belly sleeping with this statement, this is no longer recommended. When the AAP started the safe sleep campaign that “Back is Best!” They have this for a reason. SIDS has since declined by…since parents started putting their babies to sleep on their backs.
I bought this Dock-a-Tot and use it only for nap time. I see it everywhere, so it must be safe.
FALSE: You might see this in every mainstream baby store, but it’s plush and warm and the sides resemble a crib bumper. If the baby were to roll over, it would be against a plush surface. If the baby were to overheat, this increases the risk of SIDS.
What Products are Safe?
Safe products have specific naming conventions that let you know if it pasts safety standards for actual infant sleep. The product will be named one of the following:
Pack N’ Play
In the United States, a safe sleep surface must pass standards in order to be named crib, cradle, bassinet, or pack n’ play.
What products are unsafe?
Any product that is NOT labeled as a crib, cradle, bassinet, or pack n’ play. Unsafe products typically are named:
These are unsafe and have not passed safety standards. Confusing, right?
Many people assume that if an item is sold in big name store like Target, Walmart, or Buy Buy Baby, it is safe to use. If a product says “napper” it’s safe to use for a baby to nap. Unfortunately, that’s all marketing, which means moms-to-be, new moms, friends and family that may care for your baby should educate themselves accordingly.
The following products are not safe for sleep (both naps and nighttime sleep)
- Rock n’ Play (These are recalled. Do not use these at all, at any time).
- Infant sleep positioners
- Baby Lounger
- SwaddleMe By Your Side Sleeper
- car seat
- Rocker Napper
What are these standards?
If you’re into specifics and want more information on the standards, I’ve listed them out here.
Bassinets and cradles: 16 CFR Part 1218
The main ASTM provisions for bassinets and cradles include the following:
- The spacing of rigid components/fabric-sided enclosed openings – intended to prevent entrapment between slats or other rigid components that are under the fabric sides.
- Static load – intended to ensure the product is structurally sufficient to hold the intended occupant
- Stability – intended to address incidents where a sibling, looking into the bassinet, might tip it over.
- Sleeping pad thickness and dimensions – intended to prevent suffocation or asphyxiation as a result of gaps between the sleeping pad and non-rigid sides of a fabric or mesh bassinet.
- Side height – intended to prevent falls from the product.
- The flatness of segmented mattresses – intended to prevent asphyxiation of an occupant lying face down in a segmented mattress joint.
- Rock/swing angle – for products that swing or rock, this requirement is intended to prevent entrapment due to the swing angle.
- Warnings – intended to alert the caregiver to infant fall and suffocation hazards when using bassinets and cradles
- Flammability – intended to ensure the product meets the flammability requirements of 16 CFR Part 1610
Full-Size Baby Crib: 16 CFR Part 1219
Non-Full-Size Baby Crib: 16 CFR Part 1220
Play yard bassinet attachment: 16 CFR Part 1221
Play yard (standard): 16 CFR 1223
As the CPSC says:
“You cannot tell from looking at a crib whether it meets the new standards. It is not likely that cribs in use before the Commission issued its crib rule in December 2010 will comply with the new standards.”
My sister, a pediatrician, called me in the morning on her way home from her night shift. She said she had come into the hospital for her shift in the Emergency Room, bright-eyed, caffeinated, and ready– only to find everyone silent. The nurses told her, you don’t want to go into that room. She said she will never be able to shake the image of the 2-month-old on the exam table; the parents sobbing uncontrollably. They were cosleeping and woke up to their baby not breathing.
Doctors obviously see it all, but to me, this story (among many others) make you realize that this really does happen. As parents, we need to protect our babies. Think about their needs and how you can keep them safe.
Be your baby’s advocate. Practice safe sleep!