Risky Infant Sleep Practices Still Common

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Harvard Medical School
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Risky Infant Sleep Practices Still Common

News Review From Harvard Medical School

May 5, 2014

News Review From Harvard Medical School -- Risky Infant Sleep Practices Still Common

Many parents are still following infant sleep practices that could put their babies at risk of sudden infant death syndrome (SIDS), two new studies conclude. One study looked at survey data for nearly 400,000 infants. About two-thirds of the babies born at term were put to sleep on their backs. This position reduces the risk of SIDS. Preterm babies, born before 37 weeks of pregnancy, have a higher risk of SIDS than those born at term. But the survey showed they were less likely than full-term infants to be put on their backs to sleep (60% to 63%). The second study included 1,250 mothers of babies 2 months to 6 months old. They were interviewed about sleep practices for their babies. Overall, 72% of the babies were put to sleep on their backs. But 22% of black mothers put babies to sleep on their stomachs. About 28% of Hispanic mothers put the baby to sleep in the parents' bed. This practice increases the risk of SIDs and suffocation. Both studies were presented at a conference. They have not been peer-reviewed for publication in a journal. HealthDay News wrote about them May 3.


By Henry H. Bernstein, D.O., M.H.C.M.
Harvard Medical School


What Is the Doctor's Reaction?

New babies sleep about 16 hours a day. How they are placed down to sleep is important. Where they sleep matters, too.

Babies must only sleep on their backs. Not on their sides. Not on their stomachs. They should always sleep alone. They should never share their parents' bed. If these sleep practices are not followed, young babies are at risk for:

  • Strangling
  • Choking
  • Smothering
  • Sudden infant death syndrome (SIDS)

Results from two new studies about how and where babies sleep were just presented at a meeting on pediatric research.

In the first study, more than 1,000 mothers from 32 different hospitals were surveyed online or over the phone. All of them were mothers of infants 2 months to 6 months old. They were asked if their babies:

  • Shared the bed with parents
  • Normally slept lying on their backs
  • Usually slept facedown

Almost 3 in 4 mothers (72%) put their babies to sleep on their backs. This was the good news. But the researchers also found that some of the reported sleep practices were worrisome.

  • Almost 1 in 5 mothers shared their bed with the baby.
  • About 1 in 10 let the baby sleep facedown.

Differences also were found based on ethnicity and race.

  • Many Hispanic mothers (28%) reported sharing the bed with their babies. 
  • Black mothers (22%) most often reported placing the baby facedown while sleeping.  

All infants should sleep on their backs because it lowers the risk of SIDS.

In the second study, researchers checked how almost 400,000 babies from 36 states were placed in the bed to sleep. The study included babies that were preterm (less than 37 weeks in the womb) and others who were born at term.

Researchers found that the number of mothers who placed their babies to sleep on their backs went up during the last decade. But that amount was still only about two-thirds of all term babies.

How many were placed on their backs to sleep varied from state to state. For example, only 1 out of 2 infants from Alabama were placed to sleep on their backs. Late-preterm babies were less likely to be put to sleep on their backs than full-term babies. This is a big problem because preterm babies are at even greater risk for SIDS than babies born on time.


What Changes Can I Make Now?

Too many babies die from SIDS each year. Unsafe sleeping practices put your infant at risk for SIDS and other sleep-related injuries. Follow these steps in order to keep your sleeping baby safe:

  • Put your baby on his or her back. The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs. Babies sleeping facedown are at risk of suffocation or SIDS.
  • Place your baby on a firm sleep surface. Never put your baby to sleep on a chair, sofa, waterbed or cushion. Car seats and other sitting devices also are not routinely recommended spots for sleep.
  • Avoid soft objects or loose blankets. Pillows, blankets, crib bumpers and toys can choke or smother your baby. Cover the mattress with a fitted sheet. Do not put heavy blankets, pillows or stuffed animals in the crib with the infant.
  • Share the room, not the bed. The AAP recommends that parents share a room BUT not a bed with their baby. Parents can roll onto babies. The baby can get tangled in the blankets.
  • Do not overheat your baby. Avoid covering your baby's head. Do not dress your baby in extra layers. You can use baby clothing that keeps babies warm without covering the head.
  • Do not use special products that are sold to lower the risk of SIDS. Heart monitors, wedges, positioners and special mattresses have not been proven to lower the risk of SIDS.

Keep these important tips in mind, too.

  • Breastfeed your baby. Breastfeeding lowers the risk of SIDS.
  • Keep your home and car smoke-free. Avoid smoking during pregnancy or after birth. Stay away from smokers and places where people smoke.
  • Let your baby play on her tummy when she is awake and you can watch her closely.
  • Stay up to date with your baby's shots.


What Can I Expect Looking to the Future?

We need to provide more education for parents about how and where babies should sleep. This is especially important for preterm babies. With 4 million births per year in the United States, we need to get the word out better. Expect the pediatrician to keep explaining safe sleep practices and proper sleep positions for your baby.


Last updated May 05, 2014

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