The New AAP Recommendations
New
AAP revised recommendations press
release
(please see First Candle
comments below)
A recent article about
the recommendations
here
Resources
Keep
Your Baby Safe A brochure in
PDF
Safe
Sleep for Your Baby A brochure for Parents
of Babies in the NICU in
PDF
Safe
Sleep for My Grandbaby A brochure in
PDF
SIDS Mid-Atlantic no longer sells
the HALO™ SleepSack™ wearable blanket (but we still like it!) Click
here.
Comments for
parents and caregivers from First Candle
Comments
from First Candle/SIDS Alliance in regard to concerns surrounding
the recent revision of the AAP policy statement in regard to reducing
the risk of SIDS as it relates to tummy sleeping, bed sharing and
pacifier use:
Most important to note is that the information contained in the
First Candle recommendations is meant to provide guidelines by which
parents and caregivers can make informed choices on caring for their
baby. There is still much we don’t know about SIDS and we
know that following these recommendations faithfully will not prevent
ALL SIDS and accidental infant deaths. But we do know that eliminating
challenges in a babies sleep environment can, and does, prevent
certain babies from dying.
By “certain” babies, we mean that there is a population
of babies that have an abnormality in their brainstem that makes
them more vulnerable to die of SIDS. The scary part is that, at
this time, we have no way to determine which babies are most vulnerable.
What the research tells us is that if we can get these “vulnerable
babies” through the first six months to year of life as “stress
free” as possible, they “outgrow” this abnormality
and go on to survive and thrive.
In addition to the obvious hazards of the adult bed (suffocation,
overlay, wedging and falls) there are two more “invisible”
challenges in the sleep environment that can trigger a SIDS death
in a vulnerable baby. Rebreathing carbon dioxide (exhaled air) and
overheating.
Rebreathing can be caused by tummy sleeping and soft bedding or
other items in a baby’s sleep area that traps the carbon dioxide
around the baby’s face. Rather than breathing clear, fresh
air, they “rebreathe” the exhaled air. A normal, healthy
baby would react to these challenges and cough, cry or otherwise
get themselves out of the stressful situation. To a baby predisposed
to SIDS, their brain does not tell them there is a problem and they
continue to sleep through the problem - which in turn can trigger
them to die suddenly and unexpectedly. The same holds true for overheating
- the baby’s brain does not respond to the rise in temperature.
This helps explain why some babies can sleep on their tummy and
live and others can’t; why some babies can bed share and live
and others can’t, etc. It is our hope that the next research
breakthrough will be a way to identify these vulnerable babies so
parents can exert extra care in getting them through the critical
first months of life when the SIDS risk is the highest.
We understand that parents make choices about sleep environments
for many different reasons. While First Candle does recommend a
safety-approved crib, we encourage parents to duplicate our vision
of a “safe crib” no matter where they choose to place
their baby for sleep in order to provide the greatest protection
against SIDS, suffocation and accidental infant deaths.
Vision of a Safe Crib: Babies should be placed to sleep on their
back, in a safety- approved crib with a firm, tight fitting mattress
covered with only a sheet. All soft bedding and other soft items
should be removed from the sleep area, including pillows, blankets,
soft or pillow-like bumpers, positioners, stuffed toys and sheepskins.
This safe sleep area should be placed alongside the adult bed or
sofa for at least the first six months. Use a wearable blanket or
other type sleeper to keep your baby warm and safe without the use
of loose blankets. For a complete list of the recently revised First
Candle recommendations (Tips for Parents and Caregivers: Help Your
Baby Survive and Thrive), please visit www.firstcandle.org.
The majority of SIDS, suffocation and accidental infant deaths are
occurring in unsafe sleep conditions and those numbers are on the
rise. Unsafe sleep environments can include tummy sleeping, cribs
with blankets, pillows and/or other soft bedding items and toys,
sofas, adult beds and other unsafe arrangements. The numbers of
babies that die while sleeping on their back in a “safe”
crib (i.e. firm, snug fitting mattress covered with only a sheet
and everything else removed from the crib) are very low.
The reality is that an adult bed is not designed for sleeping babies
- many have soft, padded mattress tops and there are pillows, blankets
and bodies that can trap that exhaled air around the babies face
(even while on their back) and cause overheating (again, things
that a normal baby would respond to, but a vulnerable baby would
not.)
The conditions under which parents bed share in other countries
are very different from the U.S. - in Japan, where SIDS rates are
the lowest, Mom and baby sleep on a mat on the floor.
It is important to note that there is NOT consensus on whether there
is a way to bed share that would be safe for all babies. There is,
however, research showing that babies sleeping in close proximity
to their mother IS protective against SIDS. First Candle has joined
the growing consensus of infant health proponents worldwide, even
among many once-staunch supporters of bed sharing, that babies should
be placed for sleep alongside the adult bed or sofa in a separate,
safe, sleep area for at least the first six months of life. (This
timeframe ranges internationally from 3 months to one year.)
This would seem the best way to minimize the dangers (rebreathing,
overheating suffocation and accidents) and maximize the benefits
(facilitate breastfeeding and less periods of deep sleep) of sharing
a bed with your baby for sleep. Bring your baby into bed with you
to feed, bond and cuddle, but when it’s time to go to sleep,
your baby will be safest in his/her own sleep area placed along
side your bed. Again, by eliminating as many of these dangers as
possible no matter where you decide to have your baby sleep, will
provide the greatest protection against SIDS and accidental infant
deaths.
Pacifier Use:
For reasons that as yet are unknown, research has conclusively shown
that using a pacifier at sleep time (following a breast feeding
or bottle feeding session) can significantly reduce the risk of
SIDS during the first year of life. The evidence in this regard
has been mounting for some time, and it is now recommended as an
option for parents. The following guidelines are offered to ensure
the best outcome:
1. Breastfed infants should not be offered a pacifier until one
month of age to ensure that breastfeeding is firmly established.
2. Pacifiers should not be forced on babies that reject them.
3. Pacifiers do not need to be reinserted once the baby falls
asleep.
4. Pacifiers should not be coated in any sweet solution.
5. Do not use a string or other device to attach pacifiers
around your baby’s neck or to clothing.
Experts feel that quite possibly the stimulation of the sucking
reflex by the pacifier keeps babies from falling into a deep sleep
and heightens their arousal response throughout the night.
To address concerns in regard to breastfeeding and long-term dental
problems, the AAP carefully evaluated existing evidence on these
issues. The evidence that it can help reduce the risk of SIDS far
outweighed evidence that it might interfere with successful breastfeeding
or cause long-term dental complications. In fact, according to the
American Academy of Pediatric Dentistry, non-nutritive sucking habits
are considered normal and, in general, sucking habits in children
to the age of five are unlikely to cause any long term problems.
Here is
our disclaimer.
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