Sleeping together under any circumstances is not safe for children’s sleep, the American Academy of Pediatrics pointed out on Tuesday. the first update of safe sleep guidelines for babies since 2016.
“We know that many parents choose to share a bed with a baby, for example, perhaps to help with breastfeeding or a cultural preference or a belief that it is safe,” said Dr Rebecca Carlin, co-author. of the guidelines and techniques report of the AAP Task Force on Sudden Infant Death Syndrome and the AAP Committee on Fetus and Newborn, in a statement.
“The evidence is clear that (co-sleeping) significantly increases a child’s risk of injury or death,” said Carlin, assistant professor of pediatrics at Columbia University Irving Medical Center. “For this reason, AAP cannot under any circumstances support bed sharing.”
It is one of several recommendations provided by the AAP to pediatricians to help stem the tide of infant sleep deaths.
About 3,500 children, many of whom are in socially disadvantaged communities die each year from sleep-related infant deaths in the United States, the AAP said.
“Sudden infant deaths (SUID) rates among black and American Indian / Alaska native children were more than double and nearly triple, respectively, that of white children (85 per 100,000 live births) in 2010-2013. “, the AAP noted in a statement.
“We have made great strides in learning what keeps babies safe while they sleep, but a lot of work still needs to be done,” said in a statement Dr. Rachel Moon, lead author of the guidelines and professor of pediatrics at the University of Virginia.
Although the AAP strongly discourages sleeping together, its updated guidelines state that babies should sleep in the same room with their parents for at least six months on a separate surface with a solid, flat surface.
Based on the new Consumer Product Safety Commission regulations coming into effect this week, the only products that can be marketed for children’s sleep include cribs, cribs, playyards and bedside sleepers. Bedside sleepers are small cribs or separate cribs that attach to parents’ bed but allow children to sleep alone without bedding.
Parents shouldn’t use sleep products that aren’t specifically marketed for sleep, the AAP said.
Other sleep environments can also put babies at risk. Resting with a child on a sofa, chair, or pillow and falling asleep increases the risk of infant death by 67%, the AAP noticed. If the baby is preterm, born with a low birth weight, or less than 4 months old, the risk of dying while sleeping together on a bed, sofa, or other place increases five to 10 times, the academy said.
“A great way to check if a surface is too soft is to press your hand down and then lift it. If your hand leaves an indentation, it’s too soft, “said Alison Jacobson, CEO of First Candle, a national non-profit organization. committed to eliminating SIDS and other sleep-related infant deaths through education and advocacy.
Parents should always let children sleep on their backs on a flat, firm mattress covered with a fitted sheet, according to the AAP. Avoid all extras in the crib, including stuffed toys, blankets, pillows, soft sheets, sleep positioners, or crib bumpers, as babies can get trapped by such items and choke.
“Crib bumpers have been linked to more than 100 infant deaths in the past 30 years,” the AAP says on their consumer website, healthychildren.org.
These products are generally used by well-meaning parents who only want the best for their child and believe they are doing the right thing, said psychologist Carol Pollack-Nelson, a former CPSC employee who now studies how people use consumer products.
“When they see their little peanut crying and having a hard time settling into the big crib, they think, ‘Well, I need to get the crib fixed. My baby just came out of the womb, you know. ‘ So intuitively, that’s what makes sense, ”Pollack-Nelson said.
But babies don’t need any of those cushioned products to be warm and comfortable, Jacobson said. “Instead of a sheet or blanket, put the baby in a wearable sack or blanket.”
In fact, wearing excessive clothing or blankets on a baby, especially in a warm room, may be associated with an increased risk of SIDS, Jacobson said.
“Hats and any other headgear should be removed before putting the baby to sleep,” he said, adding that babies only need one more layer than an adult would normally wear.
Because the cradle slats are now adjusted to be close together, the bumpers are no longer needed, the AAP said. “Stores now sell mesh bumpers and vertical crib covers. But even these can break off and become a strangulation hazard. Babies can also get trapped between themselves and the crib mattress, “the academy warned.
The new CPSC regulations will ban all marketed baby sleep products that have an inclination greater than 10%. These include slant sleepers and sleep positioners, which are also called baby nests, docks, pods, cribs, swings, and naps, the AAP said. Some of the products may not be sold as sleep aids, but children often fall asleep while using them.
Many of these products on the market have an inclination of up to 30%, which can be dangerous because babies’ heads fall forward while they sleep, the APP said. This chin-to-chest position can narrow their airways, causing choking. Children can also get out of the devices and get trapped under them, the AAP warned.
The Safe Sleep for Babies Act, signed last year, bans the manufacture and sale of slant sleepers and crib bumpers.
Car seats, strollers, swings, baby carriers, and baby harnesses can also obstruct a child’s airways, the AAP said. So, when the baby falls asleep in them, which is inevitable, parents should move the baby to lie on his back on a flat, solid surface.
In its new guide, the AAP also warns against the use of commercial devices that claim to reduce the risk of SIDS or other sleep-related problems, including wearable monitors.
Also, don’t use home cardiorespiratory monitors – devices that monitor the baby’s heart rate and oxygen levels – as a way to reduce the risk of SIDS, because there’s no evidence they work, Jacobson said.
“Using products that claim to increase sleep safety can create a false sense of security” for parents that “could lead to a reduction in children’s safe sleep practices,” he said.