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Babies should always be placed on their backs to sleep

Q: I heard that an infant sleeper had been recalled because it wasn’t safe. What is the safest way for babies to sleep?

Fisher-Price just recalled 4.7 million Rock ‘n Play Sleepers due to 32 infant deaths associated with their use since 2011. The deaths were due to infants rolling over while being unrestrained, or being unable to breathe secondary to their positioning in the sleeper. These infants died of sudden unexpected infant death (SUID).

SUID occurs when an infant dies suddenly and unexpectedly, and the cause of death may be known or unknown. This includes the category of sudden infant death syndrome (SIDS), when an infant dies suddenly and from no known cause. An infant death is categorized as SUID if it can be determined that the child died from suffocation or asphyxiation, entrapment, heart problems, trauma (both unintentional and child abuse), infection, metabolic disease, or an ingestion. This determination is made after a thorough investigation that includes an autopsy, evaluating the medical and clinical history, and investigation of the scene. If, after this very thorough evaluation, no cause of death is identified, then the death is determined to be from SIDS. SIDS is the leading cause of death in U.S. infants between the ages of 1 month and 1 year, and is the third leading cause of death overall in kids less than 1 year of age behind congenital abnormalities and prematurity. In 2017, there were 3,600 deaths due to SUID, 1,400 of those from SIDS. Many of these deaths were due to unsafe sleep environments.

Since the launch of the Back to Sleep Campaign, now known as the Safe to Sleep Campaign, in 1994 by the American Academy of Pediatrics (AAP), SIDS Alliance (now First Candle), and National Institute of Child Health and Human Development (NICHD), the annual rate of death from SIDS has decreased by more than half. The aim of this campaign is to increase family and medical provider knowledge and awareness around preventing SIDS deaths through ensuring safe sleep environments and practices. While there are only a few, very specific situations in which an infant should not be placed on his or her back to sleep, the following recommendations apply to infants during their first year of life.

1. Place your baby on her back to sleep for every sleep. Side and tummy sleeping are not safe, even in babies who spit up frequently. If your baby rolls over on her stomach on her own and can roll from her back-to-stomach, and stomach-to-back, she may be left in that position. Stop swaddling her for sleep once she can roll.

2. Always place your baby on a firm sleep surface that is clear of soft objects and loose bedding. Cribs, bassinets, portable cribs, and play yards are all acceptable sleep surfaces if they conform to the Consumer Product Safety Commission (CPSC) standards. Stuffed animals, crib bumpers, quilts, pillows, comforters, sheepskins and loose bedding are not recommended as they can obstruct an infant’s nose and mouth, causing entrapment, suffocation, or SIDS.

3. Place babies to sleep in the parents’ room, on a separate sleep surface that is close to the parents’ bed, for the first 6 to 12 months of life.

4. Do not use sleep positioners, wedges, specialized sleep surfaces, or in-bed sleepers since there is insufficient evidence to support that they are safe. Also, the use of cardiorespiratory monitors is not routinely recommended since they have not been shown to decrease the risk of SIDS. For information about the safety and recommendations for use of specific products, visit www.cpsc.gov.

5. Avoid overheating of your baby since that can increase the risk of SIDS. Make sure the room is a comfortable temperature. You may dress him in an extra layer, avoiding over bundling and covering his head or face.

6. Avoid smoke exposure and use of alcohol and illicit drugs during and after pregnancy. Use of these substances can increase the risk of SIDS. Additionally, it is important to not allow anyone to smoke near your baby or in rooms or vehicles where she may spend time. Secondhand smoke can cause an increase in risk.

7. Offering a pacifier for naps and nighttime sleeping may lower the risk of SIDS.

8. Breastfeeding and regular prenatal care have been linked with lower rates of SIDS, as well.

For more information on safe products and recalls, visit SaferProducts.gov. For information on the recall of the Fisher-Price Rock ‘n Play Sleeper, call (866)812-6518 or visit www.service.mattell.com.

Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to her at melissaemason@gmail.com.

 

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