For 22 years, parents of newborns have been given Back to Sleep campaign information. They have been told to put babies to sleep on their backs, in a proper sleeping location devoid of any suffocation or strangulation hazards.
When researchers at Penn State College of Medicine videotaped parents putting their children to bed when their babies were 1 month old, 3 months old and 6 months old, I’m sure that they did not expect to discover what they did ina new study published by the American Academy of Pediatrics last month.
The 160 children were all healthy newborns in a fairly affluent area of Pennsylvania. About 85 percent of their parents were college educated. Their parents agreed to be videotaped and knew when the taping was happening.
Yet, when the babies were 1 month old, 21 percent were placed on nonrecommended sleeping surfaces such as a car seat or in a baby swing or with their parents in bed or on a couch; 14 percent were placed in a position other than on their backs; 91 percent had loose or nonapproved items by their sleeping surface such as loose bedding, bumper pads, pillows, stuffed animals and sleep positioners.
At 3 months old, 10 percent were on nonrecommended sleeping surfaces; 18 percent were not placed on their backs; and 87 percent had hazardous items near them.
By 6 months old, 12 percent were on a nonrecommended sleeping surface; 33 percent were not placed on their backs; and 93 percent had hazardous items near them.
Even babies who started out on safe sleeping surfaces didn’t end up that way: 28 percent of 1-month-olds moved locations during the night, as did 18 percent of 3-month-olds and 12 percent of 6-month-olds. Most were moved to unsafe locations, particularly in bed with Mom or Dad.
So what’s happening here? Why would parents, especially when they know they are being videotaped, put a baby to bed unsafely?
It has to be more than just exhaustion, says Dr. Shimona Thakrar, the director of inpatient pediatrics and newborn nursery at Baylor Scott & White Medical Center — Round Rock. She has even seen friends in the medical profession who know better post pictures of their sleeping babies in an unsafe environment.
They buy the cute, frilly bedding and crib bumpers and decorate baby’s room with it. They worry that baby will be cold and so they give him a blanket. They think baby will be lonely at night and so they put a stuffed animal with him.
People think that if they go to Babies ‘R’ Us and find cute crib bedding that it must be safe, she says. “There’s a lot of confusing stuff out there,” she says. Always check the label to see if it is approved by the American Academy of Pediatrics. Even if it is, was it meant to be placed with the baby in bed?
The truth is babies can get tangled up in blankets and crib bumper ties and be strangled or suffocate. They can wedge themselves against crib bumpers and stuffed animals and not be able to turn their heads to be able to breathe. And those bed positioners — unless medically approved by a doctor — can suffocate babies as well.
If you swaddle baby, make sure it’s an approved swaddler or blanket that he can’t get out of. If he can, it creates an unexpected hazard. Also make sure that baby is not too hot because there is evidence of the risk of sudden infant death syndrome increasing in a baby who is too hot. The risk also increases in babies who are around people who smoke.
Co-sleeping, of course, brings advocates for and against it. Thakrar, though, has treated children in the hospital with long-term brain injuries from being oxygen-deprived while sleeping with their parents as infants.
When she sees a mom in the hospital asleep in bed with the baby beside her, she takes that moment to educate the mom. “It’s safe to say there’s no good time to co-sleep,” she says. “Babies need to be protected and be in a safe environment.”
Thakrar is not insensitive to the ease of co-sleeping and the exhaustion on the part of parents. She has a 9-month-old. She used a bedside bassinet to easily access the baby, nurse her and then put her right back into the bassinet so they could both drift off to sleep in their own, safe spaces.