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Posts Tagged ‘Safe Sleep for Infants

Today I am remembering my own personal guardian angel, my sister Becky.  She died 22 years ago today, when I was 4.  I’m having a particularly tough time this year, and I’m not entirely sure why.  My mother says it’s because I’m only just starting to comprehend this with my adult brain. 

Molly & Becky

Molly & Becky


Part of me thinks that is ridiculous.  I remember my sister with vivid detail, and this isn’t something that I woke up with when my frontal lobe was fully formed.  I remember my grandmother holding Becky at my 4th birthday party, and—in my typical 4 year old way—I decided it was time for a musical interlude.  I serenaded Becky with some absolutely preposterous song that had no tune or real story because while I sang, her eyes never left my face and she smiled at me while I did.  Baby sisters make the best audience. 

So it’s not as if I don’t remember my sister or didn’t understand that “dying” meant I would never see her again.  I knew that.  I was angry about it.  I knew it meant my parents were sad.  I knew it made my dad cry, something I had never seen before.  I also knew it was wrong; my baby sister wasn’t supposed to die.  That’s not how things worked. 

But at the same time, there are things I didn’t understand.  The day after she died was Halloween, and my mom said I begged her to take me trick-or-treating.  One of my aunts took me to my preschool Halloween party because I refused to miss it.  I was still 4 and couldn’t miss the chance to dress up.   

Years later, I would get so frustrated with my parents.  Fall is my favorite season, and I take any opportunity to decorate the house, but my mom never wanted to get out the fall/Halloween decorations.  In my narrow teenage mind, I thought it was because my mom doesn’t have any Martha Stewart home décor skills (she doesn’t).  Now I look back and wonder how I could be so completely blind.   

I understood from a child’s perspective, but now I can identify with my parents.  I watch my friends balloon up with their own little bundles of joy and it’s such an incredible (and weird!) process.  One of my friends lets me touch her adorable little baby bump all I want, and I just keep touching it.  How fascinating to grow a human inside of you.  I have no idea how my parents woke up in the morning or kept breathing.  I worry about my future children and my friends’ children too. 

It’s weird to have a child’s grief inside of me as well as an adult’s grief.  I miss my sister for the baby that she was, smiling at my stupid songs, and for what she should have been, my friend and my enemy and my confidant and helping me torture our youngest sister.  As an adult, I’m not sure how I feel about heaven, but I will never shake the thought of heaven as a tea party, covered in pink teacups, balloons, and cakes, completely a 4 year old’s vision of what the perfect world would be. 

 I very rarely dream of Becky, but when I did, she was always a playmate, a fellow child.  Last summer, I dreamed of Becky how she was before she died, a small, warm body with those dark blue eyes.  I was an adult and held her in her old room, rocking her to sleep.  I woke up crying but happy.  It’s weird… this child’s memory mixed with now-grown emotions. 

So while 22 years isn’t a milestone or a particularly special year, I’m having a rough time.  I think as adults we are somewhat dismissive of children’s memories and feelings because they are so fluid.  The stories they tell show us exactly how they remember events, and we giggle more often than not because it’s a very different event than we remember.  Their emotions swing so quickly; one moment they are losing their minds and the next they are playing happily.  But I remember dropping barbies on the ground when we heard the sirens.  I remember seeing my parents cry.  I remember seeing my cousins lined up at the end of my Nana’s bed as she led them in prayer for Becky.  And now, as an adult, I try to just remember my sister.

Last Weekend Together

Last Weekend Together

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.

Last week on Private Practice one of the doctors had a new baby.  Unfortunately, the depiction of the baby’s crib was very unsafe.  This just frosts me!  Safe Sleep practices have been well documented and countless hours are spent by health professionals and not-for-profit organizations trying to spread the word to new parents about the importance of placing baby on his back, alone in a safe crib with no soft bedding.  Then, one television show comes along and wipes out much of that good work.

We know from our research that parents are heavily influenced by advertisements, magazine articles and television shows depicting baby rooms.  When talking with new parents, we hear all about J-Lo’s twins cribs (YIKES), and now this.  Why is it so difficult to incorporate a safe sleep message into these shows.  As the saying goes – a picture is worth a thousand words.  Do you think that you might have noticed if Dr. Montgomery had placed her little Henry down in a crib without bumpers, blankets, pillows, stuffed animals and a hat on his head?

Kudos to the Consumer Product Safety Commision for writing such a well-done letter to those in charge at Private Practice.

By CPSC Blogger on May 1, 2012

Dear Dr. Addison Montgomery,

On last week’s episode of “Private Practice,” we saw that you have a new baby. Congratulations on becoming Henry’s mom! As you’re learning, parenthood is life altering.

You’re clearly a mom who researches and finds the best for her baby, even supplying breast milk from a milk bank. As an obstetrician, however, we would expect you to have researched the latest information about crib safety as well.

Henry's cluttered crib on the ABC TV Show "Private Practice"

This screen grab from “Private Practice” shows baby Henry in his crib

Those blankets and pillows in the crib have to go. Henry doesn’t need the cushioning. His baby needs are different than adult needs like yours. CPSC staff estimates that between 1992 and 2010 there were nearly 700 deaths involving children 12 months and younger related to pillows and cushions. Nearly half of the infant crib deaths and two-thirds of bassinet deaths reported to CPSC each year are suffocations from a baby being placed on top of pillows and thick quilts or because of overcrowding in the baby’s sleeping space.

We are disappointed with the lack of research that went into creating Henry’s nursery, so allow us to help. We have a great video here that can teach you about how to put Henry to sleep safely. While you rightly placed Henry on his back, we did a double take through the TV for all the loose blankets and clutter in Henry’s crib.

In Henry’s — or any baby’s crib — bare is best. As a respected obstetrician watched in millions of homes around the country, we expect better.

Henry needs a firm, flat surface and nothing else.

Even though the pillow in the back of Henry’s crib looks small, pillows are a big problem in cribs. Pillows can block babies’ noses and mouths and can cause them to suffocate. On average, there are 32 infant deaths each year on pillows used as a mattress or to prop babies’ heads. The majority of these deaths are to infants in their first three months of life, just like Henry.

We’re guessing that you covered Henry with all those blankets in a well-meaning way, worried about his temperature. If his room is cold, dress him in warm clothes like footie pajamas. Do not use thick blankets. Babies can and do get their faces stuck in thick blankets and suffocate.

Thanks for taking the time to read and learn about how to make Henry’s crib safer for him. We hope he starts sleeping through the night for you soon!


The U.S. Consumer Product Safety Commission’s Children’s Safe Sleep Team

Do you ever read the comments at the end of an on-line newspaper article?  I do.  Apparently, lots of people comment on newspaper articles.  Sometimes, those comments just make me want to scream.  I recently read an article from NPR entitled “Co-Sleeping is Back in the News”.

The author, Barbara J. King was commenting upon the fact that a baby died while sleeping in bed with his breastfeeding mother.  The cause of death was listed as “a co-sleeping accident”. This article was a fairly unbiased commentary on co-sleeping.  While there is much about this article that I would choose to comment on, I’ll pass by that for now and go directly to the comments.

nothing is forever  wrote:

responsible parents never roll over their babies it is not optimism but truth if it is not true humans would have been extinct by now…..from time immemorial babies slept with their parents that gives the parents and the child a bond which we is very important. When a baby dies with mother rolling over the baby it is news because it is very uncommon………….

WHAT!  Where do you get your information?  After nearly 20 years of working with newly bereaved parents whose infants have died, it’s not all that uncommon.  Every single day my fax machine will turn on with at least one death report for an infant.  When a baby dies due to an overlay or accidental suffocation, some parents are too grief stricken and guilt-ridden to tell the world.  It is a horrible accident.

Leah  wrote:

I slept in the bed with all three of mine when they were babies and never rolled on any of them. The elephant in the room here is the *size* of the parent, I’d wager.

Wow!  That’s certainly judgmental.   Having your children survive might just make you incredibly lucky – not right. Why is it necessary to vilify parents who experienced a horrible tragedy?  In order to separate yourself (you’re right and they are wrong), it’s apparently necessary to make them fat, drug using, alcoholics.  Research has shown us that some of the reasons that you should NOT bedshare are using  drugs (even over-the counter drugs like cold medication), alcohol,  smoking and being overweight.   But the list is actually much, much longer.  No one wants to be
the bed room police. The Academy of Breastfeeding Medicine actually has protocols for breastfeeding mothers to co-sleep.  You can check them out here.

Brow Master wrote:

You don’t need a doctors opinion on this just listen to your own mother or grandmother.

I’m sure that your mother would be happy to hear that you believe she is always right; however, changes in childrearing occur because research
continues to give us more information, new products are discovered and even our children change. I’d wager that your mother did not put her children in a car seat.  There was probably lead paint on the crib that she used.  I played on construction sites, drank out of garden hoses and ate white bread with butter and sugar for lunch, but I certainly wouldn’t want my grandchildren to do that.

Jerry wrote:

From an evolutionary perspective, survival requires co-sleeping. For most of human history, sleeping away from your parents would most likely result in your becoming food for predators.

I wonder if the any of the studies factor in the size of the mother. There are some women walking around here even I wouldn’t feel safe sleeping next to.

Excellent point – Evolution. Defined as  1. any process of formation or growth; development. 2. A product of such development. 3. Biology.
Change in the gene pool of a population from generation to generation by such processes as mutation, natural selection, and genetic drift. 4. A process of gradual, peaceful, progressive change or development, as in social or economic structure or institutions.

In short, evolution means change.  I can’t speak for everyone, but in my neighborhood, I don’t have to worry about lions eating my children.  We have heat in our home so I don’t have to keep them close for heat.  I sleep in an America style comfortable bed, not on a dirt floor.  Sometimes, we outgrow our evolutionary history.  Some call that progress.  As to the other point about a woman’s weight – that’s just mean.  Most women who have recently given birth to a baby are carrying a bit of extra weight.

Candida  wrote:

I am sorry for this mother though it may be that the baby would have still passed or passed sooner had it been in a crib. The majority of the worlds culture co-sleep.

Back to that.  I don’t live in a third-world country (most of the world’s population).  Also, please don’t ever say something like
that to a bereaved parent.  We all die eventually but you have no way of knowing that this baby would die under other circumstances.

jpett88 wrote:

“3 million years of human evolution have prepared you for it.”

My favorite product of millions years of human evolution is the frontal cortex of the brain, which allows [most] humans to think rationally. It’s why we buckle our seatbelts in cars. Why we avoid drinking antifreeze. And probably why we shouldn’t sleep in the same bed as our babies, given the evidence. Bed-sharing is probably on par with opting out of vaccinations. Low risk but
high stakes. It’s a parenting choice, of course.

There are no right answers. Just safer answers.

AMEN! Excellent answer!  There are no right answers.  Just safer answers.  As a parent, you get to decide for your family what works best for you.  Consider, are you putting the comfort of the parents ahead of the safety of the child?   Babies are dying – unnecessarily.  As the parent, you get to chose what is right for your baby and for your family.  Make an informed choice and don’t for a minute think that it only happens to “bad” people.  It happens in every racial, ethnic, economic group.  It happens to loving parents who desperately wanted a baby.  Luckily, it doesn’t happen to most of us.  But, most people do know someone who has had a baby die.  That family deserves your sympathy, empathy and support.  Not your judgment.

When you are a mother, you are never really alone in your thoughts. A mother always has to think twice, once for herself and once for her child.   Sophia Loren, from Women and Beauty

For years we have tried to educate new parents on the use of a “firm” sleep surface for baby.  Unfortunately, new research by Dr. Rachel Moon has demonstrated that many parents still equate “comfortable” with “soft”.

Parents, please listen.  We know that soft bedding such as pillows, bumpers, comforters and other items traditionally found in infant beds are suffocation hazards.  Please remove them from your infants crib.

That goes for your bed too if you are bringing your baby into bed with you.  Soft bedding is a hazard to a baby.

Read more:

The Huffington Post has a good article on what is referred to as the “Latino Paradox”.

According to the Huffington article, Infant mortality has received a bit more attention than lifespan because the data has long been available, and because the United States’ infant mortality rate ranking is 177th in the world, worse than the United Kingdom, Slovenia and Monaco.

Nationally, the white infant mortality rate was 5.6 per 1,000 births in 2007, the most recent year for which data are available. White Americans also have the nation’s highest average income and education levels, markers usually associated with good health.

Average Latino education and income levels are closer to those of African Americans. But the difference between the infant mortality rate for most Latinos (Puerto Ricans are the exception) and the black rate is vast. There were 5.5 per 1,000 Latino infants born in 2007 who died before their first birthday. That same year, 13.3 per 1,000 black children died in their first year.

There has not been enough research done on this particular area. Speculation is that the healthy diet of Mexican rich in fresh fruits and vegetables and low in fast food and the tight family structure may play a significant role in the lower infant mortality.

However, infant deaths do still occur within the Mexican population. As educators, it is our role to train new parents and caregivers in the most recent news in infant safety while being culturally sensitive.

In light of the rash of recent crib recalls, I am compelled to re-visit what you need to know about infant safe sleep if you are the parent of a newborn or have a new baby in your life.

The day you have waited for has arrived!  Finally!  You are getting ready to leave the hospital with your new baby to go home and begin this new phase of your life.  Diapers? Check.  Cute homecoming outfit?  Check.  Car Seat installed properly?  Check.  OK, ready to go.  But are you really?  Have you been given written and verbal instructions on Safe Sleep for your baby to help reduce the risk of SIDS (Sudden Infant Death Syndrome) and prevent accidental deaths due to suffocation, overlay and asphyxia.  Beginning January 1, 2011, all hospitals in Illinois will be required to provide written and verbal instruction on the safest way for your baby to sleep prior to you and your infant being released from the hospital.  These safe sleep recommendations from the American Academy of Pediatrics (AAP) are considered best practices.

  • Back to Sleep: Baby should be placed on his/her back for every sleep time; this includes nap time and night time.   Side sleeping is not a viable alternative for back sleeping because the side position is too unstable and baby could roll to tummy.
  • The safest place for baby to sleep is alone in a safe crib (make sure all nuts, bolts, screws etc. are tight and that crib is secure).  Mattress needs to be firm and fit snugly in crib.  The sheet must fit securely and be made for a crib mattress.  Never use a sheet from an adult bed – baby can get tangled and suffocate or strangle.
  • Do not have any soft items in crib with baby.  This includes bumper pads, stuffed animals, quilts, blankets or soft toys.  Blanket-free sleeping is the safest.  Dress baby in sleeper then use a sleep sack.
  • A separate but proximate sleeping environment is recommended such as having crib in parent’s room.  Bed-sharing during sleep is NOT recommended.  In Illinois, we are seeing a decrease in true SIDS deaths, but accidental sleep related infant deaths are on the rise due to unsafe sleep settings.
  • Do not smoke while you are pregnant and do not allow anyone to smoke around baby – ever.  Exposure to cigarette smoke has proven to increase the risk of SIDS.
  • Breastfeeding is best for your baby!  It is like special medicine only YOU can give your baby.  If you bring your baby to bed to nurse, make sure to put him/her back in the safe crib before you go back to sleep.
  • Tummy to Play: Baby needs to have quality tummy time every day for proper development and to prevent a flat spot on baby’s head.  Always supervise baby while he/she is on their tummies.

Make a list for yourself with the name, model number, date and location of purchase for all of your big items (crib, portable play yard, swing, stroller, car seat, etc.) and make it a habit to check at least once a month to make sure none of the items you own have been recalled.

While researchers still do not know what causes SIDS, they do know that by following the safe sleep guidelines, you can reduce the risk of SIDS and also prevent accidental sleep related deaths.  Keep in mind, that there are many items you can purchase in stores and online that may say that they “prevent” SIDS.  Although various devices have been developed to maintain sleep position or reduce the risk of re-breathing, none have been tested sufficiently to show efficacy or safety.  Just because they sell it, doesn’t automatically mean it is safe.

Ultimately, as the parent(s), you get to choose how and where your new baby will sleep.  By educating yourself and anyone who will be caring for your baby on the safe sleep guidelines, you can make an informed decision that is right for you and your family.

The American Dietetic Association (ADA) has updated their position on breastfeeding of infants.  ADA recognizes the various factors that influence women and their families to choose a particular infant feeding method,” the authors write, “but ADA supports and advocates the position that breastfeeding is the optimal feeding method for the infant.

ADA releases updated position paper on breastfeeding.

On August 13, 2009 the Health Status webiste posted an excellent article on the benefits of breastfeeding entitled “Bottle-feeding or Breastfeeding: The Great Debate”.

Information to help expectant parents make an informed decision about what is best for their family and their new baby.

Expectant mothers often fret over whether they should breastfeed or rely on bottled formula for their baby’s nutrition. Although whether or not to breastfeed is a parent’s decision, it cannot be denied that breastfeeding has many advantages that bottle feeding does not offer. It is recommended that breastfeeding be the choice of nutrition for infants 0 to 12 month old.

The American Academy of Pediatrics (AAP), the American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) all unanimously recommend breastfeeding and breast milk instead of bottle feeding. Although there may be conditions that make bottle feeding more attractive, sticking to natural means is recommended when possible.

Ideal Nutrition

For one, breast milk is the perfect form of nutrition for newborns. This is because breast milk is naturally meant to meet the needs of human offspring. It is hard to find real challenges to the wisdom of nature. Commercial baby formula, while comprehensive and backed by the latest science has to offer, will lack some of the benefits breast milk offers.

Breastfeeding: The Advantages

1. Breast milk, aside from being a complete infant nutrition, also contains antibodies that help children develop immunity against illnesses such as infections, diarrhea, respiratory problems, and meningitis. Bottle-fed children usually exhibit lower immunity against these illnesses. Moreover, breast-fed children are less prone to developing allergies. This is one of the strongest reasons against bottle feeding.

Studies have shown that breast-fed infants are hospitalized less and are less sickly than their bottle-fed counterparts. Breast-fed babies show lower incidences of ear infections, constipation, diarrhea, sudden infant death syndrome.

Breast milk is still being studied closely by scientists. Breast milk seems to contain substances that are yet unidentified, and hard to produce. This leads the scientists to conclude that breast milk is indeed much more complex than first thought. Although the FDA requires formula makers to include all the known breast milk nutrients in their milk foods, formula makers still have a long way – although ever improving – to go to effectively imitate breast milk.

2. Breast milk is free and requires no preparation; it could even save you money. It doesn’t require pre-heating and is always available on tap. Breast-fed infants don’t get sick as often as their bottle-fed counterparts. This results in great savings. Bottled milk costs a lot. You could find yourself saving a few thousand dollars a year in formula and medical expenses. This alone could be a great reason to choose breastfeeding instead of bottle feeding.

3. Smarter Babies. Studies have shown that breast-fed babies have 5 to 10 more IQ points than those that are bottle-fed exclusively for the first six months of their life. Not only are these children smarter, they are healthier to boot. This is due to the completeness of the composition of breast milk resulting in earlier and better development of babies’ brains.

4. Less Prone to Obesity. Breast-fed children are observed to be less prone to overeating and obesity. The special formulation of breast milk allows for the proper regulation of appetite and metabolism.

5. Skin-to-skin contact. Children that are breast-fed have better emotional adjustment than those that are not. This is due to the healing wonders of touch. Babies are also better attached to their mothers as a result. The intimacy of the activity also does wonder for the emotional health of both the mother and the child.

6. Breast milk is easier to digest and is less likely to cause constipation or diarrhea. The formula of breast milk is also easier to digest, which usually means babies feed more. Breastfeeding mothers will have to be prepared to breast-feed every 3 hours or so.

Although breast-feeding is still best for babies, baby formulas have been successful in at least narrowing the gap. However, breast-feeding is still the way to go for newborn infants up to one or two years, and should be the only choice unless the mother is suffering from any condition that prevents her from doing so. Some mothers claim they do not produce enough milk and this may be the case. However, consult with your doctor to see if anything can be done to allow breast-feeding in the immediate future.

Ultimately, choosing whether to breast-feed or bottle-feed is strictly the decision of the mother. It is recommended, however, that when possible mothers breast-feed their children instead.

For more great articles like this one, got to

NBC’s Today Show recently ran a story entitled “New study: Parent/child bed-sharing is OK”.  If you haven’t seen it, please watch the link.

NBC News chief medical editor Dr. Nancy Snyderman and psychiatrist Dr. Joshua Weiner talk about a new study that says it is OK for children to sleep in their parents’ bed at night.  The problem with this story is that the study was intended to demonstrate the long-term effects on children who bedshare with their parents. Unfortunately, this discussion wasn’t very clear on how unsafe the practice is for infants.

First, let’s be clear on terms.  The term bed-sharing is used when parents sleep in bed with their children.  It also is sometimes referred to as the family bed.  Adults and children (including infants) share the same sleep surface.

Room-sharing is the term used when infants and/or children sleep in the same room as the parents in close proximity but in their own bed or crib.

The term co-sleeping is the term used for both bed-sharing and room-sharing.  This term is rarely used by researchers because it is too general.

The American Academy of Pediatrics (AAP) and most SIDS related organizations do not recommend bedsharing for parents in the United States who use the typical bedding found in American bedrooms.  It has been well documented that the risk for a sleep related death increases dramatically for infants in the adult bed.  Their is a 40 times greater risk of death than for an infant in her own safe crib.

The greatest risks to infants actually occurs with what is called “chaotic bed-sharing”.  This is a term used for an unplanned sleep time where the infant is brought into the adult bed without the adult pre-planning the shared sleep space.  Every parent has experienced that night when she just needs to get a little sleep and the infant is not cooperating.  So, Mom or Dad brings the baby into bed out of desperation in order to just get a few minutes of sleep before another day begins.

There is plenty of conversations from anthropologists and bed-sharing proponents that tell us that parents have slept with their infants all over the world for centuries.  That is completely true.  However, sometimes our evolutionary habits outlast the need.  We no longer have to keep our infants close for fear of lions.  Nor do we have to keep them close to keep them warm.

In most cultures where bed-sharing is the norm, the bed does not resemble an American style bed.  Today’s parents generally don’t sleep on a thin pallet on the floor without the benefit of pillows and blankets.

When the parents sleep, that is the longest time that a helpless newborn is unattended.  Therefore, it is imperative that the newborn is in a safe microenvironment.  Studies of infant deaths confirm that sleep related deaths most often occur in unsafe sleep environments.

Do parents bed-share – Yes!  Do most babies live – Yes!  Do toddlers or children suffer pychological damage for bed-sharing – No!  But, sleeping with an infant in an adult bed is definitely risky behavior.  Can it be done without tragic consequences?  Yes!   But, unfortunately, accidents happen.  Parents have to consider the risks for they are real.

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