New Sleep Guidelines for Infants and Parents
The American Academy of Pediatrics just released a new and improved set of guidelines on safe sleep for babies. These guidelines affirm much of what was stressed in the last edition from 2011, but focus more on the sleep environment as a whole and acknowledge the reality of what happens sometimes when parents are exhausted: bedsharing.
The updated 2016 recommendations for safe sleep still encourage the ABC’s of sleeping, A being for “alone,” B for “back sleeping” and C for “uncluttered crib.” Babies must sleep by themselves on a surface designed for infant sleep. Babies must be placed on their backs to sleep all the way through their first year, whether sleeping with or without a swaddle. Babies also must sleep in a crib with a tight fitting mattress and tight fitting sheet. Parents are to avoid bumper pads, blankets, stuffed animals, and any other cushy objects in the crib. Additionally, the guidelines suggest that babies should sleep in their parents’ rooms on a separate firm surface for a full year, and if that cannot be accomplished, at least six months. This decreases the risk of SIDS, sudden infant death syndrome, by 50%.
What has many pleased is recognition of unsafe habits that happen when parents are exhausted and falling asleep while trying to feed or soothe their babies. While the study encourages breastfeeding as one way to decrease the risk of SIDS, it also suggests that if parents are not wakeful and in danger of drifting off, it is safer to nurse on the bed than on the couch or in an armchair. Couches and armchairs are some of the least safe sleeping environments for infants due to how soft they are. But we have been told that bedsharing is a risk for SIDS, so what are sleepy breastfeeding parents to do? According to the guidelines, feed in bed and when the parent is ready to fall asleep, place the baby in their bassinet or crib.
While 60% of parents bring their baby into bed with them at some point whether they plan to bedshare or not, they can be comforted in knowing that this is in fact better than falling asleep on a couch or chair. However, with a high percentage of infant deaths occurring with bedding or soft objects over the head, the guidelines also dictate that wherever the baby is, including the bed, there should be no pillows or blankets that could overheat or suffocate the baby close by. The 2016 guidelines also maintain that bedsharing does put babies at risk for sudden infant death syndrome, particularly the longer it is practiced and with the most risk before four months of age.
What else can parents do to decrease the risk of SIDS? Be ultra vigilant when sleeping in environments outside the home. There is also reduced risk when babies are offered a pacifier- after breastfeeding has been established- during naptime and bedtime. Supervised tummy time is also recommended as being beneficial for building strength.