American Academy of Pediatrics expands sleep safety guidelines

Creating a sleep environment for a child is much more than choosing a pretty blanket; it truly can be a life-or-death decision.

"Sleep is extremely important for all of us, but especially for infants. It's when kids grow. The nervous system gets a chance to rest and assimilate all the new experiences and information the baby has learned throughout the day," said Lisa Martin, MD, Loyola University Health System pediatrician and associate professor of pediatrics at Loyola University Chicago Stritch School of Medicine. "Having a comfortable and safe sleep environment for infants can't be overemphasized."

According to the Centers for Disease Control, Sudden Infant Death Syndrome (SIDS) remains the leading cause of death for children younger than one. Though the number of SIDS deaths has dramatically dropped since the American Academy of Pediatrics recommended all babies be placed on their backs, other sleep-related deaths including entrapment, suffocation and asphyxia have increased. Encouraged by the success of the Back to Sleep campaign, the American Academy of Pediatrics (AAP) expanded their sleep safety guidelines.

"These new guidelines will help enlighten parents about what items and behaviors can lead to infant sleep-related deaths," said Martin. "Infants, especially young infants, are completely dependent on their caregivers to provide a safe sleep environment since they don't have the ability to roll away from objects that are restricting their breathing."

In addition to placing infants on their backs every sleep time, the AAP recommends that babies be placed on a firm sleep surface and that the crib be free of items such as bumper pads, loose bedding, stuffed animals and pillows.

"There are numerous products out there that are not necessary and could even become deathtraps for a baby. Items like bumper pads and sleep positioners have not been shown to prevent injuries and the concern is that an infant can get trapped and suffocate," said Martin. "Babies don't care if they have a boring crib; they do care if it's safe. The more objects in a sleeping space, the more dangerous it is for a baby."

To keep kids warm Martin says a good rule of thumb is one additional layer of baby clothing above what a parent is wearing. For instance, if a parent is wearing two layers a baby will need three.

The guidelines also recommend parents and infants share a room, but not a bed.

"Mattresses that are safe for babies need to be flat and very firm, which can be uncomfortable for adults. Also, we usually have pillows, blankets and sheets that are not safe for infants," said Martin.

Other AAP recommendations include:
•Avoid covering the infant's head to prevent overheating
•Infants should have supervised, awake tummy time every day
•Parents should not smoke
•Pregnant women should receive routine prenatal care
•Infants should receive all vaccinations
•Breastfeeding is recommended
•Offer a pacifier at nap and bedtime

"Pacifers have been shown to protect against SIDS but if a mother is planning on breastfeeding wait to offer it until the baby is three or four weeks old and make sure breastfeeding habits have been established," said Martin.