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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?

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?

I was reading an article from Australia where a coroner was making an impassioned  plea for parents to stop bed sharing with their infants.  This coroner had handled a number of recent infant deaths.  In all his cases the infants had been sleeping in the same bed with the parents on the night that the baby died.  The coroner ruled these deaths accidental suffocation.  He was pleading with the parents in Australia to stop putting their infants, especially those less than 6 months old in the adult bed with the parents.  His recommendation was to place the baby in a crib near the parent’s bed so that the baby could still be easily tended but keep baby in his or her own safe sleep space.

Breastfeeding is Best for Baby

This article was quickly responded to by a group of breastfeeding advocates.  The argument made by the advocates was “It’s not THAT dangerous”.  Holy smokes!  My head almost blew off.  Really, it’s not THAT dangerous!  Is that the best argument that you can make in response to numerous babies dying?  How many babies have to die before it’s considered “that dangerous”?As a mother who successfully, exclusively breastfed 3 babies, I am strongly in favor of breastfeeding as the best food for baby.  As a working mother, I completely understand how exhausting and  challenging it can be to breastfeed.  It takes real commitment. There is no question that it’s hard work.  Rewarding, but hard work.  As a parent, I get to make all the decisions for my baby.  As a parent, my primary responsibility is to keep my baby safe.  All else is secondary.

How many babies have to die before breastfeeding advocates rate bed sharing as dangerous enough?  I have heard from many parents who have successfully raised their babies through infancy while sleeping together.  They say, “It’s not dangerous.  I did it and my children are fine.”  That makes you lucky.  Not right.  It feels like these parents believe that they are somehow better, smarter, richer….something more than those poor parents who had a baby die.  Those unfortunate parents must be overweight, drug addicted, alcoholics.  Something must be WRONG with them.

Is it possible that we are putting the comfort of the mother ahead of the health and safety of the baby?  Remember, this is not a situation where the consequences for being wrong are minor.  The consequences for being wrong is your babies life!  I cannot figure out why any parent would risk their infants life when there is an inexpensive, simple alternative – a crib in the parent’s bedroom.

There are some pediatricians and anthropologists who argue that bed sharing with your baby is essential to bonding.  Baby must be alive to bond.  They quote lots of statistics about how mothers and babies have slept together from millennium.  Mothers, you have to understand that sometimes through evolution some behaviors are no longer necessary.  We no longer sleep in caves where we have to use our bodies to provide heat for our babies and keep them safe from maurading animals.  Our beds are now soft surfaces filled with more soft items like pillows, duvets, comforters and pillow toppers and more.  Don’t let talk of “co-sleeping” confuse you into thinking that bed sharing is safe.  The research is clear that room sharing is safe.  Bed sharing is not.

There are many barriers for some mothers to surmount in order to successfully breastfeed.  Room sharing is not one of them.

SIDS has been every new parents nightmare since biblical times.  No more.  Parents now have the tools to keep  their babies safe. The goal to keep baby safe begins when you’re pregnant.

  1. Moms get early prenatal care.  See your doctor often when pregnant.
  2. Create a healthy lifestyle while pregnant.
  3. Don’t smoke while pregnant or let anyone smoke around you and your baby.
  4. Don’t drink or use drugs while pregnant.
  5. Plan to breastfeed as long as possible.

Getting the nursery ready is simplier than ever.  Remember, less is more.  Decorate the baby’s room.  Not the baby’s crib.  All you need is a safe crib, a firm mattress (read hard) and a fitted sheet.  That’s it.  Your crib should be manufactured after June 28, 2011 to ensure that it meets all the latest safety guidelines.  This is a place that you will leave your baby unattended for hours so don’t cut corners here.  Don’t borrow an old crib or buy one at the second hand store.  If you plan to use a portable play yard as your baby’s crib, there are new safety standards that will go into effect December 2012.  Place the crib in your room for the first 6 months of baby’s life.

Unsafe Crib

Unsafe Crib

Bumpers, quilts, pillows and stuffed animals should never be in baby’s crib.  They are all too soft and fluffy for an infant. and they pose a suffocation hazard for your baby.  When your baby is old enough to be put in the toddler bed, you can start allowing soft items.  Recently, the Juvinille Products Safety Commission admitted that it could not show any proof that bumpers keep a baby safe from getting arms or legs stuck in the crib slats nor could they prove that bumpers keep baby safe from head injury.  Unfortunately, the Consumer Product Safety Commission and SIDS researchers can prove that bumpers have been directly responsible for the deaths of some infants.  They may be cute, but the are not worth the risk to your baby.

After baby is born, just a few more simple behaviors for parents:

  1. But baby on his or her back alone in the crib.
  2. Use a pacifier after breastfeeding is firmly established for sleep times.
  3. Do not cover baby’s head with hats or blankets.
  4. Put baby in a wearable sleep sack or feetie jammies rather than using blankets.
  5. Swaddle baby if needed, but only up to 6 weeks…and remember to dress baby lighter since you hold in body heat with the blanket.
  6. Get baby all recommended vacinnations.
  7. Never put baby on an adult surface like a couch or adult bed to sleep.

That’s it! You have all the tools needed to keep your baby safe from both SIDS and other sleep related deaths.  Oh, don’t forget that baby needs good tummy time when awake for proper development.  Enjoy your baby!

For more tips, follow me on Facebook.

 

Vulnerable Babies Sleep in Pepi-Pod

The 2011 Christchurch New Zealand earthquake created an immediate crisis for the regions vulnerable newborn babies.  There was no safe place for babies to sleep.  This was seen as a public health crisis and the Pepi-Pod was born.  (Pepi means Baby in Maori.) The pēpi-pod package was quickly assembled as an emergency response to the increased risks to babies, posed by disrupted living and sleeping conditions in families, and as support for their fearful parents.  A pepi-pod is a general purpose storage box that converts to a baby sized bed with the addition of an attractive cover, fitting mattress and bedding. It offers babies a safe space when they sleep in, or on, an adult bed, on a couch, in a makeshift setting, or away from home. These are situations with a higher risk of accidental suffocation for babies.

Face Up, Face Clear

Volunteers from all over the country started sewing the covers needed for creating these pods.  Each volunteer used whatever fabric they had available. A complete package of pod, mattress, cover, 2 base sheets, 2 wrap around ‘settling’ sheets, and a double layer merino blanket for each needy family.  Blankets needed to be provided because heat was uncertain in post-quake Christchurch.   Each family receiving a Pepi-Pod received  a thorough safety briefing reinforcing the need to sleep babies on their backs with their faces clear of blankets, smoke-free environment and in their pepi-pod for every sleep.

While I have some concerns about placing these pods in the adult bed, this was a brilliant solution to an immediate public health crisis for infants.  Placing an infant in a pod such as these was certainly safer than placing them on a mattress with the entire family in post-earthquake New Zealand and best of all, to get one, the parents had to have one-on-one safe sleep training.


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