Safe sleeping
Follow these strategies to keep your baby safe and sound while she's sleeping.
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(This article first appeared in Your Pregnancy, Dec 15/Jan16')

While you won’t be getting much sleep for the first three months of your baby’s life, a newborn does pretty little else but snooze. But there are certain things you need to keep in mind to keep your tot safe and content in their downtime.

WHAT YOU NEED TO KNOW ABOUT SIDS

It’s one of those things you don’t want to think of, but you need to know about SIDS (sudden infant death syndrome) so you can make the right choices about sleeping. “SIDS is the unexplained, unexpected death of a baby less than a year old, and because it usually occurs when the infant is sleeping, it’s commonly known as 'cot death',” says Chiedza Mavengere, assistant director of Childsafe South Africa. Worryingly, it can occur in a baby that seems perfectly healthy.

“The infants at biggest risk for SIDS are between four and six months,” says Petro Thamm, regional director (Africa) of the Association of Professional Sleep Consultants, and founder of Good Night sleep consultancy. It occurs most commonly in babies who are placed to sleep on their tummies, those who are born to mothers who smoked during pregnancy, occurs more frequently in cold weather and affects more boys than girls, says Petro. Sounds scary, right? But there are things you can do to avoid it.

Close to 20 years ago the American Academy of Pediatrics (AAP) made a recommendation that parents should put their infants to sleep on their backs, rather than their fronts.

MAKE SAFE CHOICES: Sleep position

The statistics have shown that putting your baby to sleep on their back is the way to go – the number of SIDS cases there has fallen by more than 50%.

Don’t listen to your gran’s advice on this one – the stats speak for themselves. “Always place your baby on his or her back to sleep, for naps as well as at night,” warns Petro. This is relevant for the first year of a baby’s life. “While you may be worried that a baby sleeping on its back is more likely to choke on vomit or spit-up, babies will cough up or swallow fluids on their own while sleeping.”

However, warns Petro, if your infant has been diagnosed with gastroesophageal reflux disease (GERD) or certain upper airway problems, she suggests you consult your doctor about back sleeping.

Sleep position is key. “When you place your baby down to sleep, ensure their airway is not obstructed. This means that your baby should never have his or her chin on their chest and their nose needs to be open and unobstructed.

This goes for when they are in car seats, slings and even when breastfeeding,” Petro says.

Side sleeping with sleep wedges?

What about side sleeping? There are mixed reviews on this one. A study conducted by the US Department of Health and Human Services showed that the side sleep position is unstable “and increases the chance that infants will roll onto their stomachs”. But, if used with sleep wedges, then baby is supported in this position.

There is conflicting advice about whether or not to use sleep wedges to support side sleeping. It is not advised with premature babies, but discuss it with your paediatrician to find the best approach for your baby. If using wedges, make sure to place wedges under the cot sheet so they don’t dislodge and work their way up to baby’s face, says midwife Catherine Rodwell.

A study in the American Journal of Epidemiology also indicated that babies who are used to sleeping on their backs, but who are then placed on their tummies or sides to sleep, are at higher risk for SIDS. So make sure your baby’s caregiver is aware of your preferred sleeping position as approximately 20 percent of SIDS deaths occur while the infant is in the care of someone apart from the mother.

A recent study in the journal Pediatrics also confirmed that low birth weight and preterm babies are at higher risk for SIDS, making it essential they sleep on their backs when they return home from hospital.

Oxygenation while in hospital is better when placed on their stomachs, which is why your medical team may make this decision in the NICU.

BABY WON’T SLEEP!

It’s true that some infants who lie on their backs do not sleep as deeply as those who sleep on their tummies. However, research published in Respiration Physiology showed the absence of deep sleep is believed to help protect infants against SIDS.

Babies who sleep on their tummies sleep more deeply, are less reactive to noise, experience less movement and are less able to be aroused, says the US Department of Health. Swaddling your baby will help you calm them, but has not been shown to reduce the incidence of SIDS. The use of a dummy has been associated with decreased SIDS risks and will also help your baby calm themselves while asleep.

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