What You Can Do to Prevent SIDS

Despite the widespread believe that SIDS is a baffling and unpredictable tragedy, there are ways you can significantly protect your baby. One thing that has been proven is that babies who sleep on their backs are less likely to die of SIDS than babies who sleep on their stomachs.  And so the “Back to Sleep” program was born in 1992, when the American Academy of Pediatrics (AAP) began warning parents of babies under 1 year old never to let their infants sleep on their stomachs. Since then, the rate of SIDS has dropped by over 50%.  In addition to this, Dr. Sears explains that there is a combination of many factors that lead to death: immature development of cardio-respiratory control mechanisms, defective arousability from sleep in response to breathing difficulties, medical conditions that compromise breathing, and unsafe sleeping practices.

The main risk factors for SIDS are:

• Prematurity or low birth-weight
• Smoking or taking illegal drugs during pregnancy
• Smoking around baby after birth
• Putting baby to sleep on their stomach
• Infants who are not breastfeeding
• Having little or no prenatal care
• Unsafe sleeping environment
• Overheating from excessive sleepwear and bedding
• There is no correlation between immunizations and SIDS.

Therefore, parents should follow the AAP recommendations for reducing the risk of SIDS:

• Place your baby on a firm mattress to sleep.
• Do not put your baby to sleep on a pillow, waterbed, sheepskin, couch, chair, or other soft surface.
• To prevent rebreathing (where the baby inhales the same air he just exhaled), do not put blankets, comforters, stuffed toys, or pillows near the baby.
• Make sure your baby does not get too warm while sleeping. A good temperature is one where an adult would be comfortable in a short-sleeve shirt. Do not over-bundle or over-swaddle your baby.
• Do not smoke, drink, or use drugs while pregnant and do not expose your baby to secondhand smoke. Exposure to secondhand smoke doubles a baby’s risk of SIDS, while a mother who smoked during pregnancy triples the risk.
• Receive early and regular prenatal care.
• Make sure your baby has well-baby checkups regularly.
• Breastfeed, if possible. There is some evidence that breastfeeding may help decrease the incidence of SIDS.
• If your baby has GERD (reflux), be sure to follow your doctor’s guidelines on feeding and sleep positions.
• Put your baby to sleep with a pacifier during the first year of life. If your baby rejects the pacifier, don’t force it. Pacifiers have been linked with lower risk of SIDS.

Attachment Parenting

Dr. Sears also advocates a style of caretaking called Attachment Parenting. In addition to many benefits for you and your baby, Attachment Parenting greatly reduces the odds of your baby succumbing to SIDS. For more information, read these worthwhile articles:

• 4 Ways Attachment Parenting can Reduce the Risk of SIDS
• 3 Reasons Babywearing reduces SIDS)
• 8 Reasons Breastfeeding Reduces SIDS
• Co-sleeping SIDS
• Beware of Sleep Trainers

When Stomach Sleeping is OK

Having said all that, for some babies, it is actually recommended that they sleep on their stomachs.

Premature babies or babies with breathing difficulties are put to sleep on their tummies, since the still partially collapsed lungs of some prematures tend to expand better when front-sleeping.

If an infant has gastroesophageal reflux, it is also recommended that he sleep tummy down, at least for two hours after a feeding.  Some babies sleeping on their tummies also seemed to settle better and spit- up less after feeding.

Listen to Your Baby: If your baby is just not content to sleep on his back, is it OK to put him to sleep on his stomach?  Well, because of the new research it is best to try to get baby accustomed to sleeping on her back or side. Newborn babies tend to get in the habit of sleeping the way they are first put down.  Nevertheless, Dr. Sears says that unless advised to the contrary by your doctor, it is best to let your baby sleep in a position she prefers. This means that if your baby doesn’t settle down, or stay asleep on her back or side, front sleeping is fine.  Newborn babies DO tend to prefer their tummies. “If a baby repeatedly doesn’t settle in a certain sleeping position, this may be a clue that this position may not be the safest for this individual baby. This is just one example of how babies often try to tell us what is in their best interest. Parents should not be afraid to listen.”

Just be sure to follow all the safety precautions listed above, such as placing baby on a firm mattress, not overheating the room, etc.

Another Possible Cause of SIDS

Sleep position may be important, but there is some evidence that SIDS may be related to the fire retardants in the baby’s mattress.  The reason this may be a culprit in SIDS is that an ordinarily harmless fungus (Scopulariopsis brevicaulis) consumes the chemicals used in the plasticized mattress cover. Baby’s drool, vomit, urine, and perspiration, combined with body heat, enable the fungus to grow rapidly.  When this occurs, neurotoxic gases are emitted. If baby breathes a significant amount of these odorless gases for a prolonged time, the central nervous system can shut down, causing death.

Using a mattress pad that is NOT made from polyvinyl chloride (PVC) would eliminate this tragedy.  For more information, read Is sleep position really important in SIDS? Also, read about mattress wrapping, which means wrapping baby’s mattress in a polyethylene cover, to prevent your infant from breathing the gases. You can also look into an organic crib mattress, made from all-natural fibers which have not be treated with flame-retarding chemicals.

Feature image from Delio: Organic Bedding for Baby

Car Seats & Strollers

• Convertable car seat: Buy a “convertible” car seat, instead of an infant car seat. While the infant car seats (for smaller babies only) are handy because you can transfer the baby from the car to the stroller to the house without waking her, a convertible seat will last you longer, until baby is 40+ pounds.

• Infant car seat: If you do buy an infant car seat, you don’t need to buy the whole expensive “travel system,” including stroller, that goes with it. You can simply buy a generic “snap n go” that is made to accommodate that type of car seat.

• Stroller: When looking for a stroller, you may think that the more expensive models are somehow of better quality. Instead, look at the lower end of a respected brand (such as Graco, Kolcraft, or Cosco). Look for something lightweight, that reclines, that can handle a bumpy road. Purchase extra accessories as you need them.

• Free car seat: Some community organizations, car dealerships, and muffler companies offer free loaner car seats.

Feeding Baby

• Breastfeed: If you decide to breastfeed, not only are you providing your baby with the optimal baby food, you can also save $2,000 a year, just in the cost of formula and bottles. (This amount increases a few thousand more if your baby is allergic to infant formula and requires hypoallergenic versions.) And if that’s not enough, you’ll also be reducing your baby’s chances of obesity, digestive issues, juvenile diabetes, cavities, and even needing braces later on! (Learn more about breastfeeding benefits.)

• Breast pumps: Do you really need a breast pump? If you are going to be home with your baby, let him do all the pumping himself! If think you need a pump, you can temporarily rent a highly efficient, hospital-grade pump until you’re sure you really need to own your own pump. And if you decide to buy one, a good breast pump can be yours for under $200.

• Bottles: It’s much cheaper to use reusable bottles and just wash them after use, than buying the more convenient disposable bottles. Buy bottles made of non-polycarbonate material with smooth sides that are easy to clean.

• Baby Food: When you’re baby is old enough for mashed fruits and veges, you can easily make your own… it’s not rocket science!  All you need to do is mash up a banana or a sweet potato, open a jar of unsweetened applesauce, or throw some cooked veggies in the blender!

With a new baby on the way, you often hear talk about decorating a nursery. Have you been busy buying baby paraphernalia (like cribs, mobiles, and crib sheets with matching curtains) and dreaming of your small bundle of joy smiling at the dancing bunnies overhead and she drifts off to sleep? In the USA, when most expectant parents think about nighttime, they imagine placing baby in a crib, dimming the lights, and tiptoeing out of the room, leaving a peacefully slumbering baby behind. Is this the way you picture your baby’s sleeping arrangements?

There is no right or wrong place for baby to sleep. We believe, and Dr. Sears agrees, that wherever all family members sleep the best is the right arrangement for you. But in contrast to the scenario above, over half the world’s population sleeps with their baby, and more and more parents in the U.S. are sharing sleep with their little one.

Dr. Bill Sears’ simple definition of co-sleeping: Mother and baby sleeping within arm’s reach of one another. The closer that mother and baby can sleep together the healthier it is for both of them. Here’s why:

1. Babies sleep better

Sleep-sharing babies usually go to sleep and stay asleep better. Being parented to sleep at the breast of mother or in the arms of father creates a healthy go-to-sleep attitude. One of our goals of nighttime parenting is to teach baby learns that going to sleep is a pleasant state to enter.

Put yourself in your baby’s shoes. A baby passes from deep sleep into light sleep as often as every hour. For a small baby, this is a vulnerable period for nightwaking, and it is difficult for baby to resettle on his own into a deep sleep. You are a familiar presence, whom baby can touch, smell, and hear. Your presence reassures baby that “It’s OK to go back to sleep.” A familiar touch, perhaps a few minutes’ feed, and you comfort baby back into deep sleep without either parent or baby fully awakening.

Explains Dr. Sears:

Many babies need help going back to sleep because of a developmental quirk called object or person permanence. When something or someone is out of sight, it is out of mind. Most babies less than a year old do not have the ability to think of mother as existing somewhere else. When babies awaken alone in a crib, they become frightened and often unable to resettle back into deep sleep. Because of this separation anxiety, they learn that sleep is a fearful state to remain in (not one of our goals of nighttime parenting).

2. Mothers sleep better

Many mothers and infants are able to achieve nighttime harmony: babies and mothers get their sleep cycles in sync with one another.

Martha Sears notes: “I would automatically awaken seconds before my baby would. When the baby started to squirm, I would lay on a comforting hand and she would drift back to sleep. Sometimes I did this automatically and I didn’t even wake up.”

Contrast sleep-sharing with the crib and nursery scene. Baby awakens alone out of touch. He first squirms and whimpers. Finding himself still alone, baby’s cry escalates into a piercing wail that jolts mother awake and sends her staggering reluctantly down the hall. By the time mother reaches the baby, baby is wide awake and upset, mother is wide awake and upset, and the comforting that follows becomes a reluctant duty rather than an automatic, nurturing response. It takes longer to resettle an upset solo sleeper than it does a half-asleep baby who is sleeping within arm’s reach of mother. And mother may be wide-awake by now and too jittery to fall back asleep herself.

Dr. Sears explains: If, however, the baby is sleeping next to mother and they have their sleep cycles in sync, most mothers and babies can quickly resettle without either member of the sleepsharing pair fully awakening. Being awakened suddenly and completely from a state of deep sleep to attend to a hungry or frightened baby is what leads to sleep-deprived parents and fearful babies.

3. Breastfeeding is easier

In order to preserve sanity, most veteran breastfeeding mothers have learned that sharing sleep makes breastfeeding easier. They often wake up just before the babies awaken for a feeding. By being there and anticipating the feeding, mother can breastfeed baby back to a deep sleep before baby (and often mother) fully awakens.

(Note: Breastfeeding mothers find it easier than bottlefeeding mothers to get their sleep cycles in sync with their babies.)

Dr. Sears explains:

Mothers who experience daytime breastfeeding difficulties report that breastfeeding becomes easier when they sleep next to their babies at night and lie down with baby and nap nurse during the day. We believe baby senses that mother is more relaxed, and her milk-producing hormones work better when she is relaxed or sleeping.

4. It’s contemporary parenting

Sleep-sharing is even more relevant in today’s busy lifestyles. As more and more mothers, out of necessity, are separated from their baby during the day, sleeping with their baby at night allows them to reconnect and make up for missed touch time during the day. As a nighttime perk, the relaxing hormones that are produced in response to baby nursing relax a mother and help her wind down from the tension of a busy work day.

5. Babies thrive

Dr. Sears explains: Over the past thirty years of observing sleep-sharing families in our pediatric practice, we have noticed one medical benefit that stands out; these babies thrive . “Thriving” means not only getting bigger, but also growing to your full potential, emotionally, physically, and intellectually. Perhaps it’s the extra touch, in addition to the extra feedings, that stimulates development (yes, sleep-sharing infants breastfeed more often than solo sleepers).

6. Parents and infants become more connected

One of your early goals of parenting is becoming connected with your baby. Infants who sleep with their parents (some or all of the time) during those early formative years not only thrive better, but infants and parents are more connected.

7. Reduces the risk of SIDS

New research is showing that infants who sleep safely nestled next to parents are less likely to succumb to the tragedy of SIDS. (Yet, because SIDS is so rare– .5 to 1 case per 1,000 infants– this worry should not be a reason to sleep with your baby. For in depth information on the science of sleepsharing and the experiments showing how sleep benefits a baby’s nighttime physiology, click here.)

image from cornerstork

Sleepsharing is an optional attachment tool. Co-sleeping does not always work and some parents simply do not want to sleep with their baby. You are not bad parents if you don’t sleep with your baby, but you should try it. If it’s working and you enjoy it, continue. If not, try other sleeping arrangements (an alternative is to place a crib or co-sleeper adjacent to your bed).

Dr. Sears explains:

New parents often worry that their child will get so used to sleeping with them that he may never want to leave their bed. Yes, if you’re used to sleeping first-class, you are reluctant to be downgraded. Like weaning from the breast, infants do wean from your bed (usually sometime around two years of age. Click here for tips on transitioning kids to their own bed). Keep in mind that sleep-sharing may be the arrangement that is designed for the safety and security of babies. The time in your arms, at your breast, and in your bed is a very short time in the total life of your child, yet the memories of love and availability last a lifetime.

Visit Dr. Sear’s website for more information on sleep-sharing:
Our Co-sleeping Experiences
Our Experiments
Co-sleeping Research
Stories From Co-Sleeping Parents
7 Benefits of Co-sleeping: Medical and Developmental
Arm’s Reach Co-Sleeper Bassinet
Co-Sleeping and SIDS
Co-sleeping Safety
Sleep Safety

The one thing you’ll need to know when planning baby’s wardrobe is that babies poop often and generously! Since baby poo is runny, it tends to get on EVERYTHING! You may find yourself changing baby’s outfit a few times a day… (and doing lots of poopy laundry, oh joy!)

Layette

10-15 bodysuits or onesies (wide head openings, snaps at bottom)

4-6 one-piece pajamas

2 blanket sleepers (for winter baby)

2-3 sweaters or jackets (for winter baby)

4-6 rompers or other outfits (preferrably with feet, as socks tend to get lost!)

4-7 socks or booties (shoes are cute but unnecessary until baby walks)

1-3 hats (broad-brimmed for summer baby, soft cap that covers ears for winter baby)

No-scratch mittens

Bunting bag or fleece suit (for winter baby)

Swimsuit for (summer baby)

Nursery

Crib, cradle or bassinet
• Slats no more than 2 3/8 inches apart
• Corner posts no more than 1/16 of an inch above frame
• Top rails at least 26 inches above mattress

Firm, flat mattress fit snugly in crib (less than two fingers should fit between mattress and crib)

2-3 washable crib mattress pads

Bumper pads covering inside perimeter (secured by at least six ties or snaps, with all extra length removed)

2-4 fitted crib sheets

4-6 soft, light receiving blankets

1-2 heavier blankets (for colder climates)

Rocking or arm chair

Music box, sound machine or CD player

Crib mobile with black and white images (remove when baby can support self on hands and knees)

Baby monitor

Nightlight (good for night-time feedings and diaper changes)

Dresser

Toy basket

Swing or bouncy chair

Changing

Changing table or cushioned changing pad for low dresser or bureau, with safety strap or railing

Changing table pad

4-6 washable changing table pad covers

Diaper pail & liners

Diaper cream

Unscented baby wipes (although for Baby’s sensitive skin, rinsing over the sink works best!)

Soft washcloths

2-3 boxes disposable newborn-size diapers {or}

6-10 dozen cloth diapers and 6-8 diaper covers

Bath

Baby bathtub

Baby soap/shampoo

2-4 soft towels or hooded baby towels

Baby hairbrush

Soft washcloths (use a different color or pattern than your diaper washcloths!)

Feeding

For nursing moms:

2-3 nursing bras (Breasts swell following birth, so start with one size larger than your maternity bra. Wait until size settles down — about two weeks after birth — to purchase additional bras.)

Nursing pads

Nipple cream (lanolin)

Nursing pillow

Pump (even if you plan only to nurse, a pump will allow you to leave milk for baby if you want or need to separate)

Milk storage bags

Breast milk is the healthiest as well as most convenient food for new babies: no bottles, nipples, warmers, or formula needed! However if you will be unable to nurse, here’s what you’ll need:

10-16 bottles and nipples, both four and eight ounce (if fed strictly by the bottle, baby will go through about ten in the four ounce size per day)

Liners, for disposable bottles

Formula

Bottle warmer (cuts down on nighttime trips to and from the kitchen)

Bottle sterilizer (if your dishwasher doesn’t have one)

Bottle brush

Dishwasher basket for small items

4-8 bibs

Burp cloths (or cloth diapers)

High chair

2-4 pacifiers

Medicine Cabinet

Baby nail clippers

Cotton balls (don’t use swabs to clean baby’s nose or ears)

Baby thermometer

Bulb syringe/nasal aspirator

Medicine dropper or spoon with measurements

Infant acetaminophen (Tylenol)

Antibiotic cream

Saline nasal drops

Baby gas drops

Travel

Infant or convertible car seat

Stroller (reclining to almost flat for infants)

Diaper bag

Changing pad

Baby carrier/sling

For Mom

Ice packs (in case of tearing during birth or swelling after)

2-3 week supply of ultra absorbent sanitary pads

Panty liners

From Hawaiian beaches to garden tea parties, from dragons and unicorns to cowgirls and circuses, your choices are practically unlimited!  Unique Baby Gear has lots of creative ideas under “Girl Room Themes,” like this darling Beatrix Potter decor:

I also like this carousel horse theme:

For a modern, sophisticated look that is still pretty, you can decorate your nursery in pink and brown. Here are a few examples of how it can be done:

While themes like those above are colorful and exciting, some new parents want to keep the nursery decor simple. “For a baby and for new parents, serenity is key,” says designer David Netto on HGTV.com. See his 11 Ways to Create a Modern Nursery for tips on creating a peaceful sanctuary for your little one.  He suggests using subdued colors for the walls, floor and major furniture pieces, and adding bright accents with bedding, wall art, rugs, window coverings and accessories. He also advocates gender-neutral design and adaptable furniture (cribs that turn into toddler beds, basinettes that transform into toy baskets), streamlined peices with built-in storage and double-duty items (like a dresser wtih a chanaging table on top). He also advises keeping your child in mind: “Most of the furniture in the nursery should be scaled down for your child and low to the floor,” David Netto adds. “And hang pictures at her eye level–not yours.

ButterflyCraze.com has some pretty accents that will add interest to your nursery.  Hanging angels, giant daisies, and fluttering butterflies will turn her room into a fairy-tale land.

Browsing wall art for your new arrival is also fun! DistinctiveNurseries.com has lots of posters, prints, and wall hangings in every style and color. The cool thing about them is, if the price tag is too hefty you can get handy and re-create the same look yourself! Here are some that I like:

Well, this post could go on and on, but I’ll leave the rest of the Googling to you! Window dressings, cribs and bassinets, murals, rockers… Let the decorating begin!

I slept with my daughter until she was two and expecting my second child. Now I sleep with my 5-month old son and have no plans yet to move him out of my bed. When people comment on it, I reply that I like having him close by. Yes, it’s slightly uncomfortable to sleep with him next to me (my arm gets numb and tingly if it’s wrapped around him too long, my back hurts when I’m curled around him in a funny position, or when I fall asleep feeding him…) but for me that’s better than having to get out of bed and go to his room a few times a night to feed him. I like that he’s so close by I can sense him wriggling around and can feed him before he wakes up completely. I like to know he’s right there next to me and that he’s OK.

For those who are unaware of the facts, sleeping with your baby in bed may indeed sound like a dangerous practice. What if she falls off or gets stuck between the mattress? What if one parent rolls onto the baby, or she gets smothered by a pillow or blanket? But when you examine the reality of the situation, it’s apparent that sleeping with your baby in a safe manner may actually be healthier for her than putting her to sleep alone in a crib.

Dr. Sears points out that the incidence of SIDS is dramatically higher in a crib versus a parent’s bed. Although there are cases of accidental smothering and entrapment, such situations are very rare. The September/October 2002 issue of Mothering Magazine presents research done throughout the whole world on the issue of safe sleep. They conclude that not only is sleeping with your baby safe, but it is actually much safer than having your baby sleep in a crib. Infants who sleep in a crib are twice as likely to suffer a sleep related fatality (including SIDS) than infants who sleep in bed with their parents.

Instead of warning parents not to sleep with their babies, Dr. Sears advocates teaching parents how to sleep safely in bed with their babies. Much of this is common sense, but here are the guidelines he suggests:

• It is unlikely for baby to fall out of bed while sleeping next to mother. Dr. Sears compares it to a heat-seeking missiles; babies automatically gravitate toward a warm body. But to be on the safe side, place baby between mother and a guardrail or push the mattress flush against the wall and position baby between mother and the wall. Be sure there are no crevices that baby could sink into.

• Place baby adjacent to mother, rather than between mother and father. Many mothers feel they are so physically and mentally aware of their baby’s presence even while sleeping, that it’s extremely unlikely they would roll over onto their baby. Some fathers, on the other hand, may not enjoy the same sensitivity of baby’s presence while asleep; so it is possible they might roll over on or throw out an arm onto baby. After a few months of sleep-sharing, most dads seem to develop a keen awareness of their baby’s presence.
• Place baby to sleep on his back.
• Use a large bed, preferably a queen-size or king-size. A king-size bed may wind up being your most useful piece of “baby furniture.” If you only have a cozy double bed, use the money that you would ordinarily spend on a fancy crib and other less necessary baby furniture and treat yourselves to a safe and comfortable king-size bed.
• Some parents and babies sleep better if baby is still in touching and hearing distance, but not in the same bed. For them a bedside bassinet or co-sleeper is a good option. This arrangement gives parents and baby their own separate sleeping spaces yet, keeps baby within arm’s reach for easy nighttime care. Dr. Sears suggests the Arm’s Reach® Co-Sleeper® Bassinet (www.armsreach.com).

• Do not sleep with your baby if:
  1. You are under the influence of any drug, alcohol, or tranquilizers. If you are drunk or drugged, these chemicals lessen your arousability from sleep.
  2. You are extremely obese. Obesity itself may cause sleep apnea in the mother, in addition to the smothering risk.
  3. You are exhausted from sleep deprivation. This lessens your awareness of your baby and your arousability from sleep.
  4. You are sleeping on a cushiony surface, such as a waterbed or couch.
• Don’t allow older siblings to sleep with a baby under nine months. Sleeping children do not have the same awareness of tiny babies as do parents, and too small or too crowded a bed space is an unsafe sleeping arrangement for a tiny baby.
• Don’t overheat or overbundle baby. Be particularly aware of overbundling if baby is sleeping with a parent. Other warm bodies are an added heat source.
• Don’t wear lingerie with string ties longer than eight inches. Ditto for dangling jewelry. Baby may get caught in these entrapments.
• Avoid pungent hair sprays, deodorants, and perfumes. Not only will these camouflage the natural maternal smells that baby is used to and attracted to, but foreign odors may irritate and clog baby’s tiny nasal passages.