Sleep Guidelines from the Experts
Earlier this week, the American Academy of Pediatrics came out with new guidelines on safe sleep. Many of these guidelines aren't new, but there are a few changes and clarifications The Chicago Doulas knows you'll want to know about. Keep in mind, these guidelines specifically apply to babies under one year.
Back to Sleep
Babies should be put on their backs on a firm mattress covered with a fitted sheet. No soft bedding, crib bumpers, or other objects should be present on the sleep surface. Be sure to keep dangling cords, such as those used to adjust blinds, away from the sleep surface.
Sitting devices, such as carseats or swings, are not recommended for routine sleep, particularly for infants under 4 months of age.
Feeding & Pacifiers
Any breastfeeding at all, whether exclusive or partial, offers prevention of Sudden Infant Death Syndrome (SIDS).
Although it is not yet known why, the pacifier offers protection from SIDS. Breastfeeding families can introduce a pacifier once breastfeeding is well established, and bottle-feeding families can introduce the pacifier right away. It is not necessary to re-introduce the pacifier if the baby spits it out once asleep, and parents need not be concerned if their baby is uninterested in the pacifier.
Bed Sharing and Co-sleeping
Although frequently used interchangeably, bed sharing and co-sleeping are two different practices. Bed sharing involves actually sharing the same sleep surface with the baby whereas co-sleeping is when the parents and baby share the same room but not the same surface.
Infants should co-sleep, or sleep in the parents room, close to the parents bed, for at least 6 months, but preferably a year. This recommendation is new! Previously, it was recommended that infants remain in the parents room for just six months.
The AAP acknowledges that new parents are fatigued, and that although they cannot recommend bed sharing as safe, one of the most important changes in their sleep recommendations are some provisions for minimizing unsafe sleeping situations when adults sleep with their babies, either by choice or by accident. These guidelines include:
- Sleeping in a bed with a firm mattress rather than a couch or chair. Many SIDS deaths are related to infants becoming wedged in between soft cushions. If you are sleepy but need to feed your baby, it is safer to lay in bed with them than risk falling asleep elsewhere!
- The bed should be free of extraneous pillows and blankets, both to minimize the risk of suffocation as well as overheating.
- Bed sharing is absolutely contraindicated for smokers and those who are sedated, extremely fatigued, or under the influence of alcohol. Other siblings should not be present in a bed where an infant is sleeping.
- Bed sharing is more risky for preemies and babies under 4 months of age.
- Crib sharing is not approved for twins; it is recommended that twins each have their own sleep surface.
Bed-sharing is a controversial topic that our clients often struggle to make a decision about, particularly in the early days. Dr. James McKenna (not affiliated at all with this AAP) statement has dedicated his life's work to researching bed-sharing for breastfeeding women and their babies.
Avoiding smoke exposure, alcohol, and drugs both during pregnancy and once the baby is born are obvious choices that confer SIDS prevention. Regular prenatal care also helps to prevent sudden infant deaths.
Dress your baby appropriately to avoid overheating and loose blankets. While there is no specific temperature guideline that has been deemed appropriate for baby's sleep environment, the baby can be dressed in one more layer than the adult. A light swaddling blanket such as the Aden and Anais organic swaddlers or a sleep sack are both convenient options. There is no evidence that swaddling helps to prevent SIDS, but it is a safe choice as long as the baby is not yet rolling over. There should be plenty of room for the baby to move their hips and legs in the swaddle. Once the baby begins to show signs of rolling, swaddling needs to be discontinued.
Tummy time enhances your baby's development and prevents plagiocephaly, or a flat head, in babies.