Such a loaded word for parents with babies. Sleep is sought after, longed for and treasured beyond previous comprehension. Frustrated parents analyze sleep’s elusiveness as they calculate, connive and cajole their babies to sleep just a little more.
The messages new parents receive regarding sleep can be confusing.
“Sleep when the baby sleeps.” (How is that ever enough when baby only sleeps five minutes at a time?)
“Use the time when baby is sleeping to be an adult and actually get things done while your hands are free.” (Huh?!? My mind was too befuddled to even begin to think of anything that needed to be done, except perhaps to take a long, hot shower.)
“Put the baby on her back.”
“Babies must sleep on their sides.”
“Tummy time is good for the baby.”
“Isn’t your baby cold without blankets?”
“You should co-sleep so you can both rest.”
“Put the baby in another room so you won’t hear him – haven’t you heard of sleep training?”
“Shouldn’t your baby sleeping through the night by now?”
Everyone seems to have an opinion although no one seems to truly remember the exact details of their own experiences, let alone what the newest guidelines are regarding sleep positions and expectations. What are new parents to do?
The American Academy of Pediatrics (AAP) recently released an updated comprehensive set of guidelines regarding sleep for infants. The authors of the report claim to make evidenced-based recommendations that also take into consideration the actual needs and habits of real (sleep-deprived) parents. According to the AAP statement, their aim is to educate the public on how to best control infants’ sleep environment in order to promote healthy sleep (and therefore development) patterns and reduce the number of sleep related infant deaths such as SIDS, strangulation and suffocation.
In a nutshell, the AAP’s evidenced-based recommendations are as follows:
Babies need to be placed wholly on their backs to sleep by every caregiver, every time until they reach the age of 1. When babies are able to roll over, they may roll to the side or onto their tummies on their own without needing to be repositioned, but caregivers should continue to initially place them on their backs when they are put down to sleep.
Babies should sleep on a firm, flat surface. Mattresses should not indent (such as memory foam) and blankets, pillows, sheepskins or other soft surfaces should not cushion infants. Beds should be clear of all decorative items such as stuffed animals and blankets. Bumper pads are not necessary. Elevating the head of the mattress can cause a baby slide to the foot of the crib and may compromise breathing.
Babies should sleep in the same room as the primary caregiver(s) for six months to one year. Bedsharing is not recommended whether with an adult or with multiple babies.
Sleeping on couches and armchairs present a high risk of entrapment, suffocation and strangulation for infants. During night feedings when the caregiver is more likely to also drift off, feeding the baby in the bed is considered to be safer than sitting on a couch or arm chair. Blankets and pillows should be kept off infants and care should be taken to safely place the infant back in her own bed as soon as possible after feeding.
Sitting devices (car seats, bouncy chairs etc.) are not considered to be safe for sleeping infants. Sleeping babies should be transferred to a firm, flat surface as soon as safely possible.
Avoid overheating the baby during sleep.
Keep babies away from exposure to smoke, alcohol and illicit drug use both while pregnant and throughout the early childhood years.
Breastfeeding, using pacifiers and keeping up to date on routine vaccinations have also proven to be protective factors in infant health.
Provide supervised “tummy time” for infants on a daily basis and make sure to hold the baby upright when awake to promote optimal development and to prevent “flat head” from occurring.
All these guidelines may seem overwhelming and perhaps impossible to achieve for sleep-deprived parents of young babies. Some of us parents of older children may wonder how our offspring survived their infant years as we may have neglected to incorporate many of these recommendations.
However, knowledge is power, and when we know and understand basic safety requirements for our children, we can make informed decisions that best suit our family’s schedule and practices.
Two important facts that I learned through researching this new report from the AAP are as follows:
- “The ability to arouse from sleep is an important protective physiologic response to stressors during sleep, and the infant’s ability to sleep for sustained periods may NOT be physiologically advantageous.” Babies need to develop self-regulation and to wake themselves when they are too hot, or their airflow is restricted. Night waking is part of healthy development for my child and eventually, babies can learn to self-sooth and return to sleep on their own.
- There is no government oversight agency (such as the FDA for food) that checks and guarantees products for SIDS prevention. Any product that is promoted as reducing infant death is capitalizing on parent fears. We should not rely on such products, but rather, by following the guidelines listed above, we need to remain vigilant are care for our infants to the best of our abilities. Perhaps most importantly, new parents should feel supported in asking for help from other caring adults when needed.