Three's Not a Crowd When It Comes to Safe Sleep for Your Baby

November 21, 2016 Wilfredo Alejo, MD


Putting together the crib before your baby arrives? Better set it up in your bedroom--in a major announcement, the American Academy of Pediatrics now recommends that infants should sleep in the same room as their parents for at least the first six months of life, and ideally for up to a year.

"The new guideline is part of a sleep safety policy to prevent sudden infant death syndrome, or SIDS, as well as other sleep-related deaths such as strangulation or suffocation," says Wilfredo Alejo, MD, a board-certified pediatrician at St. Jude Heritage Medical Group. There are 3,500 of those deaths each year in America, and research estimates that infants and parents sharing a room can cut the risk of SIDS by about half. "The reasons for that aren't entirely clear, but it's thought that parents being so near to their infants allows them to keep a closer eye on the babies, and the parents can 'sense' a problem," Dr. Alejo says.

But Dr. Alejo emphasizes that room sharing must be done in a certain way to be effective and safe. "The academy's new policy says infants are safest sleeping in a crib or bassinet--and not sleeping in the parents' bed. That's because the ideal safe sleep environment for a young infant is a flat surface covered in a snug, fitted sheet. There should be no pillows, toys, blankets or other objects that could impede the baby's breathing. The normal bedding adults use simply isn't safe for babies."

Dr. Alejo adds that babies should continue to be placed on their backs to sleep, as they may not have the ability to turn their head if their breathing becomes blocked while laying on the stomach or side. Most SIDS cases occur before the age of 6 months, which is why the academy recommends babies share their parents' room for at least that long.

There are other components to the guidelines, which were last changed in 2011. The update, which incorporates previous recommendations along with the policy on room sharing, was issued because while SIDS deaths have gone down since the 1992 recommendation to put babies to sleep on their backs, the number of other sleep-related deaths have increased. The new policy also states:

  • Parents should avoid putting babies to sleep on soft surfaces such as couches or armchairs. "These pose a safety hazard, as the baby could suffocate or get stuck between cushions," Dr. Alejo says.
  • Breastfeeding is encouraged , as studies have suggested that breast milk can reduce the risk of SIDS by 70 percent. "Women should breast feed in bed, as that's considered safer than couches or armchairs in case the mother falls asleep," Dr. Alejo says. "However, pillows, blankets and other objects should be moved out of the way before feeding starts. And If the crib is nearby the parents' bed, the mom can nurse in her bed and then put the baby back in the crib afterward.”
  • Babies should sleep in a smoke-free environment.
  • SIDS prevention devices, such as special baby positioners, should be avoided. "These haven't been proven to prevent SIDS, and can in fact cause the baby to suffocate if he moves and gets his nose or mouth trapped in the positioner," Dr. Alejo says. "Again, you want nothing in the crib except your baby sleeping on the mattress."
  • During the day, when babies are awake, let them spend time laying on their bellies. "This will help them develop and strengthen the muscles they need to turn their heads, which can help them avoid the breathing problems associated with sleep-related deaths," Dr. Alejo says. "This tummy time should always be supervised." 

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.



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