We see a lot of little babies in the Emergency Department when they get their first colds. They cough and are congested, have noisy breathing, gag and hack on mucus, and sleep miserably. When I talk to the parents about what to do, I ask, “So where does baby sleep?” I usually get a sheepish look and a guilty smile and mom admits, “with me.”
Then I take the opportunity to talk about sleep safety and Sudden Infant Death Syndrome (SIDS). I talk about how baby should sleep on his back and be in his own crib or bassinet, how sleeping in bed with others is a smothering risk. The parent often says that when baby is sick, they bring him in bed with them so they can watch that he is okay. Yes, I go on, that seems to make sense, but is the exact wrong thing to do with a sick baby.
October is SIDS Awareness Month. The CDC, the American Academy of Pediatrics, and many other experts are getting the word out- keep baby safe! SIDS happens when babies suffocate while sleeping. They smother when they are face down in thick bed clothes or regular mattresses. They smother when in parents’ bed by getting their faces stuck up against heavily sleeping adults, or when they slip between the mattress and a wall. Napping with babies on couches is dangerous too- there is even less room for the adult and a clear space for babies’ faces, and the cushions are even softer and easier to smother in. Babies can also smother in their own cribs if there is too much soft stuff with them- thick blankets, sheep skins, stuffed animals, pillows, or bumper pads.
When babies gets their faces into something too soft to breathe through, they suffocate. And babies under 6 months old cannot rescue themselves. They do not have enough arm control to push away from a smothering situation. They can’t do a push-up when face down on a thick mattress, blanket, or pillow. They can’t roll over purposefully yet. Their brains and nervous systems aren’t mature enough for such maneuvers.
What about our mom from above who brings her congested baby into her bed to watch him? If she is watching baby, doesn’t that protect him from smothering? Unfortunately not. Too often “watching baby” becomes “sleeping with baby.” You’ve seen the old comedy routine in movies or on TV, where the character must stay awake to watch something, only to be overcome by sleep, and then be caught snoozing. Well, this happens in real life when mom and baby are warm and snug in bed together.
This is one of those cases where what seems better is shown by science to actually be worse. Statistics show that sharing the bed with babies is much more dangerous, particularly when they are sick. So how do you watch baby without sharing the bed? Pull that bassinet up next to your bed! That way baby is safe in his own crib, and you can watch him from your bed.
Here are the rules then, to prevent SIDS. As above, baby sleeps in her own bassinet or crib. Baby sleeps on her back, face up. Baby sleeps on a firm mattress that is specifically designed for babies. Baby should sleep dressed in a onesie, so no pajamas shirts can ride up over her face. If you must put a blanket in bed with baby, make it a thin one that is tucked in at the bottom of the bed, again to minimize the chance of it riding up over baby’s face. And definitely no pillows, stuffed animals, or bumper pads. These things make baby’s bed cute, but they also are suffocation risks.
Some moms try to compromise on baby position by putting their babies on positioners or “boppy” pillows. Unfortunately, the safety of these has not been established. So play it safe with baby, keep baby in his own bed with minimal padding. Put baby to sleep on his back. You and baby may be more restless on a given night, but in the long run you both will sleep much more soundly. And safely.