The unexpected death of an infant is a tragedy of the worst kind. According to the Centers for Disease Control and Prevention (CDC), there were 3,600 sudden unexpected infant deaths (SUID) in the United States during 2017. More than 900 of those were the result of accidental suffocation and strangulation in bed.
SUID occurs in babies less than a year old with no immediately obvious cause. Although statistics show fatalities from sudden infant death syndrome (SIDS) are down, the numbers also reveal sleep-related deaths are on the rise. Many of these could be prevented by following safe sleep practices.
Despite warnings from the American Academy of Pediatrics (AAP), co-sleeping or bed-sharing has increased over the last two decades. Reported by WebMD, the data shows the percentage of babies sharing a sleeping space with parents rose from 6.5% in 1993 to 13.5% in 2010.
Michelle Beebe, Perinatal Outreach and Childbirth Education Manager at Kettering Health Network, explains that recommendations for infant safe sleep have changed a great deal over time.
“For years, we were told babies should be laid on their stomachs or sides to help prevent choking, should they spit up,” she said. “But now, we simply recommend ABC. A – alone, B – on their back, and C – in a crib. ABC for sleep, supervised tummy time for play. Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).”
Soft bedding dangers
The natural impulse is to help the baby stay warm and comfortable with pillows, swaddling with blankets, and padded bumpers around the crib. However, all of these items can create dangerous obstacles to breathing. In addition, if baby is wrapped in blankets and becomes too warm, the risk of SIDS increases.
Babies simply are not strong enough to remove breathing obstacles. Even laying the baby face-down on a soft mattress or comforter can block an infant’s airway. By two months most infants can lift their heads and look around, but prior to about 16 weeks, the risk is greatest because they are unable to move enough to clear obstructions from their faces.
“Babies younger than 14 weeks can lift their heads, but it takes a great deal of effort. It’s a lot of work for them,” Beebe explained. “A newborn can lift her head for a moment, but then collapses.”
Sleeping in the proper location
Some parents incorrectly believe keeping the baby in bed with them will help keep them safe from SIDS. While it is true the risk of SIDS is lower if an infant sleeps in the same room as his or her parents, it increases if the baby is in the same bed as parents, siblings, or even pets.
Even more hazardous is when the baby shares the bed with two adults. Weight differentials between bed mates can increase the danger when the baby rolls toward the heavier person.
Outside of the home, when baby falls asleep in a stroller or car seat, the impulse often is to leave the child alone, in an effort to avoid waking him or her. However, this situation increases the risk of a sleep-related death. It’s always best to transfer a baby to his back in a crib or bassinet as soon as possible.
Beebe also emphasized the fallacy that cribs cause infant deaths. In fact, the danger lies not with the piece of furniture itself, but instead in the features of the sleep environment. Pillows, blankets, padded bumpers, and stuffed toys can easily become a fatal hazard should they cover the baby’s face in any way.
Parents-to-be are cautioned to beware advice from unsubstantiated internet sources, as well. “Be careful what you read online,” Beebe said. “There is a great deal of conflicting information out there, and some of it still hasn’t caught up with today’s recommendations.”
The internet is also rife with do-it-yourself inventions by well-meaning people trying to find a way to help keep baby more comfortable than safe. Stores are full of so-called “safe sleep” items, as well, but remember anything designed to go inside the crib adds to the danger.
When in doubt about safe sleeping advice for your baby, consulting your physician is always the best line of defense. You can also be ready before baby arrives by participating in educational classes offered by Kettering Health Network on topics such as baby care and infant CPR. Learn more and sign up for classes by visiting www.ketteringhealth.org/maternity/.