Pittsburgh
And in what might be a surprise to many new parents, the American Academy of Pediatrics is urging that babies sleep in their parents’ bedrooms for at least the first six months, and, optimally, until the baby is 1 year old.
After reviewing research on sudden infant death syndrome, the AAP is reinforcing previous advice that the safest way to put an infant down to sleep is on the baby’s back and be in a separate bed near the mother.
A member of the task force that developed the AAP guidelines, Lori Feldman-Winter of Cooper University Hospital in Camden, N.J., said, “Studies were done showing you can decrease (SIDS) risk by 50 percent and they included infants up to 1 year,” she said. The highest risk of death by SIDS occurs in infants under 6 months old.
“We know from additional evidence, room-sharing facilitated breastfeeding,” Feldman-Winter said, adding that exclusive breastfeeding has been linked to reducing the risk of SIDS by up to 70 percent.
It’s the academy’s first update of safe-sleep guidelines in five years.
Key recommendations include:
Baby sleeps on his back, on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
The crib should be empty: no soft bedding, including bumpers, blankets, pillows and soft toys.
Put baby to sleep on a separate surface in the parents’ bedroom.
Skin-to-skin care should start immediately after delivery, for at least an hour.
Breastfeeding is recommended. After feeding, the baby should be moved to his or her separate sleeping surface.
Other recommendations from the academy include offering a pacifier at sleep time after breastfeeding is established, keeping a child up to date with vaccinations, regular tummy time while awake to help development and avoiding use of home monitors or other devices that claim to reduce the risk of SIDS.
“Just because these are marketed and being sold,” Feldman-Winter said, “doesn’t mean it’s safe for your baby.”
“Portable cribs are fine; playpens are OK as long as they have a tight-fitting mattress and tight-fitting sheet. We don’t recommend slings or bouncy sets or (Fisher Price) Rock ‘n Play or even car seats. With car seats there can be a problem with airway obstruction; it’s an unstable sleep position … the head tends to fall down and obstructs the airway. A flat sleep surface is recommended for that reason.”
SIDS-prevention devices aren’t helpful, she said. “That’s really sending the wrong message. It assumes the baby will be in a separate sleep environment.”
For parents concerned that a baby in their bedroom will disturb the adults’ sleep, Feldman-Winter said that is normal.
“Babies are supposed to feed through the night. Parenting is difficult. It is exhausting. This is just part of parenting. … We don’t know why room-sharing reduces the risk of SIDS. … You’re supposed to be with your baby. The baby is not supposed to be alone.”