In light of news today of another infant death in St. Louis linked to bed-sharing, I wanted to bring back some tips I’ve shared in the past  about preventing Sudden Infant Death Syndrome (SIDS.)

SIDS, also known as “cot death” or “blue baby” is a devastating situation where a previously healthy infant dies in his or her sleep.  I know first hand how terrible SIDS can be; thirteen years ago I a lost a nephew to SIDS.  The good news is that SIDS is largely preventable!  The “ABC’s” of SIDS help us remember how to keep our babies safe while sleeping:

A: Babies should sleep ALONE.

B: Babies should sleep on their BACK.

C: Babies should sleep in a CRIB.

Rose CribI find that many parents have more questions about safe sleeping. What do I do when my baby learns to roll over?  How long should he sleep on his back?  What about bumpers and sleep positioners?  And so much more… I will answer these and other questions below.  Please feel free to continue this discussion with your own questions and comments.

“I like to sleep with my baby, especially when she needs to feed during the night. Is this safe?”

Sleeping with your baby in the same bed, or “bed-sharing” puts your baby at significant risk for suffocation. It is especially dangerous to sleep with your baby on a couch, a waterbed, or a bed with a comforter. Sadly, many babies die when they get wedged between a parent and a couch cushion or get their faces buried in bedding. As a breastfeeding mother myself, I know how hard it is not to co-sleep while breastfeeding. Breastfeeding itself reduces SIDS risk and has many other benefits to mother and baby, so please don’t let a fear of co-sleeping discourage you from breastfeeding! Bedside bassinets and other cribs can make life easier when your baby wakes frequently in the night for feeding. Be sure that your baby’s bed is SIDS safe, though. Many beds such as “Moses baskets” and beds with soft bedding and blankets are not safe. Several companies now make “co-sleepers,” three-sided cribs that abut the edge of a parent’s bed. Most co-sleepers meet safe sleeping recommendations. They are especially helpful for breastfeeding mothers.

“How long should my baby sleep on his back?”

The American Academy of Pediatrics recommends that babies sleep on their backs until they are one year of age.  As a mother, I know this is hard to accomplish!  Put your baby to sleep on his back from the time he is born and let him learn to be a back sleeper.  Do not let him sleep on his belly even if he is on your chest.  Do not let him sleep on his side.

“My baby rolls over when I put her to sleep on her back.  What should I do?”

Once a baby is able to roll from front-to-back and back-to-front, it is okay to let them sleep in whichever position they assume.  During the period when an infant is learning to roll over, it is especially important to be sure there are no blankets, bumpers, pillows or other suffocation risks in the crib.  It is also essential to put babies to sleep on their back, not their side.  Babies put to sleep on their sides learn to roll over onto their belly quickly, but often they are “stuck” and cannot roll onto their back.

“What if my baby spits up while he is sleeping on his back? Will he choke?”

No, neurologically healthy babies cannot choke on their own spit-up, even if they are sleeping on their backs. They may cough a bit but this is normal.

“I have a crib set with a bumper, blanket, stuffed animal and other matching pieces. Is it safe?”

No! Nothing goes in a crib except the baby and a tight fitting crib sheet! The “crib sets” marketed by many retail stores include many unsafe items. Never use a blanket in your baby’s bed except to swaddle the baby as described below. Bumpers are not recommended because many experts feel they are a suffocation hazard. Never put pillows, blankets, stuffed animals, or other objects in your baby’s bed.

“Can I swaddle my baby like they did in the nursery at the hospital?”

Yes, you may swaddle your baby tightly until he knows how to get out of his swaddling blanket, which usually occurs within the first month. “Wearable blankets” and swaddling blankets with Velcro closures are now highly recommended to keep your baby warm and safely swaddled. They can also help your baby sleep for longer periods of time at night, which means you get more sleep, too!   Be careful that your baby is not too warm.

“Can I use a sleep positioner or wedge?”

Sleep positioners and wedges are now considered suffocation hazards. Only a few years ago these were marketed as SIDS prevention devices, yet now they are known to be dangerous. If your baby spits up a lot or has been diagnosed with gastroesophageal reflux, you may consider raising the head of the crib mattress. Remember, nothing goes in the crib except the baby and a tight fitting crib sheet.

Additional resources regarding SIDS are available from SIDS Resources, a St. Louis-based not-for-profit network providing Missouri and surrounding counties with free bereavement services for Infant Loss and educational information relating to Sudden Infant Death Syndrome.