As a parent (and probably a new one at that), I’m sure you’ve heard your share of safe sleep talks. Or maybe you haven’t heard enough of it. I remember when I was pregnant and going to all the new parent classes at the hospital there was hardly any information on safe sleep and what it means. There was ONE slide that just said to leave your baby alone on their back in the crib. While yes that’s entirely true and the basis of safe sleep, it’s not enough information for a new parent who is in the heat of exhaustion and hormones.
WHAT ARE THE ABC’S OF SAFE SLEEP?
A - Alone
This means that your baby should be completely alone in a crib or bassinet. There should be no pillows, stuffed animals, pillows, loose blankets, crib bumpers of any kind, etc. Your baby can be wearing a swaddle or sleep sack that it not loose enough to be able to cover your baby’s face.
The only exception to this rule is a pacifier. It is safe for your baby to have a pacifier in the bed. The AAP actually suggests that pacifier use at night can reduce the risk of SIDS. Things that are weighted or are intended to hold the pacifier in your baby’s mouth. Your baby needs to be able to spit out the pacifier if needed while sleeping.
B - On their Back
The reasoning behind this rule is to reduce the risk of positional asphyxiation. Positional asphyxia happens when a person can't get enough air to breathe due to the positioning of his/her body. This happens most often in infants, when an infant dies and is found in a position where his/her mouth and nose is blocked, or where his/her chest may be unable to fully expand.
When we place our babies on their backs, it allows their airways to be in the position needed to fully expand. This is why inclined sleepers and positioners are unsafe for sleep, supervised or not. The thing about positional asphyxiation is that it happens before you even realize what has happened.
The question that always comes up is this: What do you do when your baby starts to roll over? It’s a very simple answer. Always put your baby down on their back initially, but once they begin to roll over, it is usually safe to leave them. When they reach the point of being able to roll, they typically have the head and neck strength to move and turn when needed.
C - In the Crib
This means that your baby should be sleeping in a crib or approved bassinet, preferably in the room with you. Be aware of the products that are marketed as safe for sleep but do not openly and explicitly state that they are not safe for sleep. These are products like the Dockatot, SwaddleMe Organic, and any inclined sleepers. These products have been deemed unsafe for any kind of sleep, supervised or unsupervised.
So what do you do if you end up bed sharing?
Did you know that 60-75% of parents will end up bed sharing at some point? Even if they did not initially want to. Desperate times call for desperate measures, but let’s talk about how to do it in the safest way possible.
I’m not here to shame you or make you feel bad in any way about bed sharing with your kids. Many parents choose this out of necessity or simply because it works for them. When bed sharing, there are significant risks if not done in the safest way possible. The U.S. has one of the highest rates of SIDS in the world.
Since so many parents are choosing this way of sleeping, the AAP has released what they call “The Safe Sleep Seven”. These are seven things to help create the safest environment for safe sleep.
Bed sharing should only be done under these circumstances. You need to be:
1. A nonsmoker
2. Sober and unimpaired
3. A breastfeeding mother and your baby is:
4. Healthy and full-term
5. On his back
6. Lightly dressed
and you both are:
7. On a safe surface
There are a few things to remember when practicing the safe sleep seven or safe sleep in general. Prevention measures don’t stack. So let’s just say that being a non-smoker gives you a 45% reduction in the chances of SIDS and being sober gives a 55% chance. This does not mean that doing both of these things will give you a 100% reduction of the chance of SIDS. There is still always a chance and a risk, just as there is if you practice completely safe sleep. Having your baby sleep alone is greatly safer than co-sleeping, but there is always risk no matter what you do. Every situation is different. Life is never 100 percent safe. And everyone balances risk and benefits differently. Take the information we present and use your mother-wisdom to decide what’s best for you, your baby, and your family.
As a certified sleep consultant though, I can not recommend anything other than practicing safe sleep with baby alone in a bassinet or crib.
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