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Archive for the ‘Safe Sleep for Infants’ Category

Sleep positioners were originally designed after the Safe Sleep community began urging parents to place infants on their backs in order to decrease the risk of Sudden Infant Death Syndrome (SIDS).  Sleep positioners come in a variety of different designs but their design purpose is to keep an infant on his or her back.

Unfortunately, the unintended consequence of this product was to introduce yet another soft device into an infant’s sleep environment increasing the risk of suffocation.

Safe Sleep experts have long held that sleep positioners only increase the possibility of an infant dying due to either SIDS or accidental suffocation caused by the soft product.

To reduce the risk of sleep-related infant deaths, including accidental suffocation and Sudden Infant Death Syndrome (SIDS), the American Academy of Pediatrics recommends that infants sleep on their backs, positioned on a firm, empty surface. This surface should not contain soft objects, toys, pillows, or loose bedding.

Once an infant can freely roll, he should be allowed to adopt whatever sleep position he prefers.

 

Parents and Caregivers have many ways to combat their concerns for SIDS

Safe Sleep Baby

Safe Sleep Baby

(Sudden Infant Death Syndrome) and sleep related infant deaths.  As research progresses and we get nearer to finding the mechanical cause of sudden death in apparently healthy babies, we have identified many behaviors that parents and caregivers can use that dramatically reduce the likelihood of a sleep related infant death.

Patents can now feel empowered rather than frightened.  Remember to keep your babies safety first.

 

AAP   Recommendations

1: Back to sleep for every sleep2: Use a firm sleep surface

3: Room sharing without bed-sharing

4: No soft objects, loose bedding in crib

5: Prenatal care for pregnant women

6: Avoid smoke exposure

7: Avoid alcohol and illicit drug use

8: Breastfeeding

9: Pacifiers

10: Avoid overheating

11: Immunizations12: Avoid commercial devices marketed for SIDS reduction

13: No home cardiorespiratory monitors for SIDS reduction

14: Tummy time for awake infant

15: Endorsement of recommendations by providers, nurses, child care

16: Media and manufacturers follow safe sleep guidelines

17: National campaign on reducing all sleep related deaths, focus on minorities

18: Research and surveillance

Slumped babyInfant swings, cradle swings and travel swings are all included in the new safety standards issued by the Consumer Product Safety Commission.  Swings are stationary juvenile products with a frame and powered  mechanism that enables an infant to swing in a seated position. An infant swing  is intended for use with infants from birth until a child is able to sit up  unassisted.

The new federal standard requires:

  • a stronger, more explicit warning label to prevent slump-over deaths. The  warning advises consumers to use a swing in the most reclined position until an  infant is 4 months old and can hold up its head without help;
  • the cradle swing surface to remain relatively flat, while in motion, and  while at rest;
  • electrically-powered swings to be designed to prevent battery leakage and  overheating.;
  • toy mobiles to be designed to ensure that toys do not detach when pulled;
  • swings with seats angles greater than 50 degrees to have shoulder strap  restraints; and
  • a stability test that prevents the swing from tipping over;
  • a test that prevents unintentional folding;
  • tests on restraint systems, which are intended to prevent slippage and breakage of the restraints during use;
  • dynamic and static load requirements to ensure that the infant swing can  handle specified loads without breaking.

These new requirements will become mandatory on all swings manufactured after May 7, 2013.

Parents are encouraged to place the infant in the most reclined position available on their particular swing until the infant is able to hold his/her self up.  Do not use any blankets or other products to prop the baby in the swing (as shown in the picture).

Tummy Time Tip5The American Academy of Pediatrics recommends placing babies on their backs to sleep and their tummies to play as part of a daily routine. Just a few minutes a day, a few times a day, can help your baby get used to Tummy Time and help prevent early motor delays. If you begin early (even from just a few days old) and maintain a consistent schedule, your baby will learn to love Tummy Time. This helps develop the muscles in their back, neck, and trunk, on their way to meeting all their infant development milestones.

Tummy Time should begin from the time baby is brought home from the hospital. Try these simple tasks:

  • Create a habit of alternating baby’s position (not location) at least every 20 minutes when baby is awake.
  • Carry baby in arms rather than in a car seat.  Sometimes use the “foot ball” hold and carry baby tummy side down.
  • When changing baby’s diaper, flip him over onto his tummy for 30 seconds  to one minute.
  • Place baby on his tummy on your lap to burp or soothe. A hand on his bottom will help to keep him steady.
  • If bottle feeding, alternate arms to create a more natural hold for baby.
  • When you are awake and alert, lie down and place baby on your tummy or chest.  Until baby can lift her head, alternate her head position for her.  Make sure you keep  your hands on baby at all times.
  • Get down on the floor at eye level with baby.  Be sure to position yourself in different locations around baby to encourage head turning.

Babies don’t always like Tummy Time in the beginning because they have no ability to lift their heads.  However, if you are consistent about doing Tummy Time for short periods all throughout the day, every day, baby will learn to love it!

For additional information on Tummy Time activites and Infant development.  See www.Pathways.org.

Do's and Don'ts of Sling Safety

Do’s and Don’ts of Sling Safety

The Consumer Product Safety Commission has warned parents and caregivers about using a sling for infants younger than 4 months of age, preemies and twins. 

 

Slings can pose two different types of suffocation hazards to babies. In the first few months of life, babies cannot control their heads because of weak neck muscles. The sling’s fabric can press against an infant’s nose and mouth, blocking the baby’s breathing and rapidly suffocating a baby within a minute or two. Additionally, where a sling keeps the infant in a curled position bending the chin toward the chest, the airways can be restricted, limiting the oxygen supply. The baby will not be able to cry for help and can slowly suffocate. 

 CPSC recommends that parents and caregivers make sure the infant’s face is not covered and is visible at all times to the sling’s wearer. If nursing the baby in a sling, change the baby’s position after feeding so the baby’s head is facing up and is clear of the sling and the mother’s body. Parents and caregivers should be vigilant about frequently checking their baby in a sling.

Cultures throughout the world carry babies in slings but correct positioning is crucial.  Follow these simple guidelines:

  1. Always be able to see your baby’s face.
  2. Nose and Mouth should be clear.
  3. Baby’s chin should be up.

When baby is in a sling, baby shares your body heat and has the additional covering of the sling.  Make certain that baby is not too warm.  His or her head should be uncovered.

Enjoy having your baby close!

Safe Sleep14Last year, the Consumer Product Safety Commission (CPSC) focused their efforts on creating a safe sleep environment for infants.  This year, they continue that effort by focusing on portable play yards.  As of February 28, 2013 all play yards manufactured for sale in the United States must meet mandatory federal safety standard for the first time.

Portable play yards are used by parents, home childcare providers and hotels to provide a safe place for babies to sleep when no full-size crib is available.  Therefore, it is important that portable cribs manufacturing rules be brought into safety compliance also.  The new guidelines will require:

  • Side rails that do not form a sharp V when the product is folded. This prevents a child from strangling in the side rail.
  • Stronger corner brackets to prevent sharp-edged cracks and to prevent a side-rail collapse.
  • Sturdier mattress attachments to the play yard floor to prevent children from getting trapped or hurt.

To ensure that  your baby is in the safest environment possible while left unattended, check that the date of manufacture on your play yard is February  28, 2013 or later.

Thanks to KIDS in Danger and the CPSC for all their hard work in making this new rule.

Exhausted New Mom

Every new mother has a treasured photo like this one. Exhausted from childbirth, sometimes medicated we are given our precious new baby for “rooming in”.  We hold tightly to this little miracle that has just arrived and fall deeply asleep exhausted from our bodies hours of hard work. Unfortunately, it’s a dangerous, sometimes deadly trap.

Since the early 90’s, the world health organizations have been urging parents to practice Safe Sleep techniques with their babies.  Place baby on his or her back, alone in a safe crib.  Yet, in hospitals all over the United States, exhausted, sometimes medicated women are being left with their fragile newborns to care for them in a practice called “rooming in”.

Hospitals want to encourage breastfeeding and bonding between mom and baby.  New Moms want to see, touch and hold their precious babies allowing their brains to absorb that they really created these miracles.  It’s a connundrum.  But, hospitals must take a leadership role in modeling the behavior that we want new mothers to follow when they arrive home just a short 48 hours after birth.

Even proponents of bedsharing warn that babies should never sleep in a bed with a parent that is excessively tired or on medication.  Nor should the adult bed be filled with pillows and other soft bedding.  Hospital beds can be especially dangerous.  They were not designed for infants.  The beds are frequently set up so that mom is reclining rather than laying flat.  They put the side rails up to keep a medicated mother from falling out of bed, but the side rails are not designed for infant safety.  The baby has a hospital bassinet to sleep in but mothers rarely place the babies back into it before they doze off.

Hospital policy should require doctors, nurses, lactation consultants and all hospital healthcare staff to impress upon the new mother and any of her visitors that mom cannot be left alone with the baby in her arms unless she is fully awake and unmedicated.  The new mother cannot be expected to make safe decisions when she is in the haze of new motherhood hormones and after-birth exhaustion.

As a Safe Sleep Educator, I’ve been preaching this message for years.  It starts at the hospital!  Now, unfortunately, the worst has happened and a lawsuit has been filed against the hospital that allowed a post-C-Section mother on heavy pain medications to fall asleep with her baby only to wake up to find that the baby had died due to an accidental overlay.  I am not generally in favor of law suits but perhaps this will make hospitals sit up and take notice.  You cannot be a “Baby Friendly” hospital just by withholding free formula.  You must also look out for the health and safety  of the baby.  That includes taking steps to keep baby safe while mom gets  her well deserved recovery time.

Do you agree?

 

Breastfed infants are 80% less likely to die before age 1 year than those who never breastfed, even controlling for low birth weight.  Breastfeeding is the most effective way to insure your baby’s health and survival.   That’s a pretty impressive, yet globally, only 40% of babies under six months are exclusively breastfed.

Breastfeeding is also really good for Mom’s health.  Women who breastfeed for more than twelve months during their lifetime tend to have lower risk of high blood pressure, high cholesterol, heart disease, and diabetes. Breastfeeding has also been shown to reduce the risk of breast, ovarian, and endometrial cancer in a mother’s later life and may reduce the risk of osteoporosis. Perhaps best of all, breastfeeding women use the weight (fat stores) they accumulated during pregnancy to produce breast milk. Breastfeeding mom’s burn an additional 500 calories a day.  Wow!  A simple, relatively easy way to lose baby weight.

Baby benefits from breast milk too.  It is the food least likely to cause allergic reactions; it is inexpensive; it reduces the risk of SIDS; it is readily available at any hour of the day or night; babies accept the taste readily; and the antibodies in breast milk can help a baby resist infections.

Breast Milk is the Best Food for Baby

 

If both Mom and Baby benefit from breastfeeding, then what’s the problem?  While baby instinctively knows exactly what to do, for Mom breastfeeding has to be learned.  Many women need support and advice as they begin breastfeeding.  Some women experience nipple pain and fear that baby won’t get enough milk. Once past those initial challenges, more than half the mothers of infants will return to work.  While companies are supposed to provide a clean place (not the bathroom) for a working mom to pump, breastfeeding friendly companies are still relatively rare.

It is possible to work full-time and successfully breastfeed but it takes commitment and planning.  The best time to work through a breastfeeding plan is actually before the baby is born.  Find out what the company’s policy is for supporting breastfeeding moms.  Talk with other working moms and healthcare providers about the options for pumping.  There are lots of different types of breast pumps available both for rental and purchase. There is a breast pump that fits every mother’s needs.

Finally, don’t go into breastfeeding with the belief that it’s all sunshine and fun.  Breastfeeding is an evolving activity.  Mom and baby develop a rhythm over time.  Ultimately, breastfeeding is one of the most satisfying, enjoyable activities a mother will every do with her infant.

 

Tummy Time is important for baby because the amount of time baby spends on their tummy is reduced by back sleeping and car seat usage.  The average baby now misses out on several hours of natural tummy time every day.  The lack of tummy time can result in serious consequences for baby’s development.  Flat head (Plagiocephaly), Wry neck (torticollis) as well as social, emotional and developmental delays can all be linked to a lack of tummy time.  However, all these issues can be avoided by parents and caregivers by giving baby an appropriate amount of snuggle time (carried) and tummy time every day starting from birth.

The key to effective tummy time is consistency.  Every day when baby is awake, alert and supervised, the caregiver can place baby on his or her tummy for small amounts of time.  A newborn baby is recommended to be placed on his or her tummy around 5 times a day for no more than 3 minutes each time.  As baby grows and gains strength and skill, that time should increase until by three months of age, baby is spending an hour a day of awake time on their tummy.

There are several simple ways to integrate tummy time into baby’s day without adding an additional or time consuming routine.

  1. You can place baby on their tummy on your lap for burping.
  2. Place baby on your tummy while lying down so that he or she can look you directly in the eye.
  3. Get down on the floor and put your face at baby’s level.  Place interesting toys all around baby so that she reaches in different directions.

When the baby is on his or her back, it is easy to develop a flat spot on the head because the skull is so soft.  A bald spot on baby’s head is the clearest early warning sign that baby is spending too much time in a certain position.  Altering the position that baby holds their head while on their back will help prevent both flat head syndrome and wry neck; a condition where the neck muscles on one side of the neck shortens and the opposite side lengthens.  The key is to recognize that baby prefers to turn his or her head to look at the parent or the door (where the parent comes in).  Here are a few simple tips:

  1. When diapering, alternate the baby’s head direction for each diaper change.  Then, flip baby over onto their tummy for a moment.
  2. When bottle feeding baby, alternate the arm in which baby is held just like a breastfeeding mother would.
  3. Put baby to in a safe crib on her back for every sleep time, but alternate the orientation of her head between the head of the crib and the foot of the crib.

Perhaps the most important thing that parents and caregivers can do to positively affect baby’s social, emotional and developmental progress is to carry the baby in arms rather than in a car seat.  When baby is held, he or she is getting lots of sensory input, eye contact and bonding in addition to lots of muscle usage.  As a newborn, keep baby’s head, neck and back well supported; but as baby gains skills and develops, you can begin to use a less supporting position.

For more information on tummy time, go to www.pathways.org or schedule a Tummy Time workshop from Borchardt Consulting.  If there are concerns about baby’s development, consult your pediatrician.

Newborn babies have been swaddled from birth since ancient times but in the last several years swaddling has become somewhat controversial.  

Let’s look at the positive reasons for swaddling.

  1. Many babies take comfort in being swaddled. Swaddling is an effective technique to help calm infants.
  2. Swaddling helps baby to successfully back sleep by decreasing startling.
  3. It has been suggested (though no research proves it) that  swaddling will delay the back sleeping baby from rolling to tummy.
  4. Swaddling increases baby’s time sleeping.

The negative of swaddling are:

  1. Swaddling incorrectly can cause hip dislocation;
  2. Too tight swaddling can inhibit baby’s ability to expand his lungs;
  3. Risk for SIDS increases significantly for infants swaddled and placed on their tummies. Swaddled infants that are placed on their backs but roll to their tummies are also at greater risk for SIDS.
  4. Swaddling can increase baby’s body temperature causing overheating especially if baby’s head is also covered. Overheating can be avoided by adjusting the clothing underneath as well as avoiding covering baby’s head.
  5. Swaddling decreases baby’s spontaneous waking. While this sounds like a positive, it’s a serious concern with regards to SIDS.

Many cultures and hospital newborn nurseries have traditionally used swaddling as a strategy to soothe infants.  Some experts suggest that if swaddling helps babies get to sleep, parents and childcare providers won’t be so frustrated that they put baby on his or her tummy to sleep.   

Swaddle Arms In or Out

A Halo® Sleep Sack with swaddler is recommended since using a blanket to swaddle baby can result in a loose blanket in the crib.  Halo® Sleep Sacks are sleeveless wearable blankets with an attached “cape” that swaddles baby between shoulders and hips.  This negates the concern for hip dislocation by leaving babies legs free to kick.

Pediatricians generally agree that some babies can benefit from swaddling during the first 6 weeks of life.  For swaddling an infant longer than 6 weeks, talk with your pediatrician.  In Illinois, childcare providers are forbidden to swaddle infants without a doctor’s order.

Ultimately, it’s up to the parents to determine if swaddling is an effective sleep strategy for their baby.  If swaddling, do it consistently and be sure to place baby on his or her back, in a safe crib with no bumpers, pillows or quilts in the crib.

What do you think?  Do you plan to swaddle your baby?


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