September is National Infant Mortality Awareness Month. So what better time to discuss how to make your home safe and comfortable for your new little one?
Most newborn babies thrive and joyfully celebrate their first birthdays with their families. However, infant death during the first year continues to be a concern in the United States, which currently ranks 38th in the world for infant mortality. According to the Centers for Disease Control and Prevention, for every 1,000 babies born, six will die during their first year. Birth defects, preterm birth, pregnancy complications, Sudden Infant Death Syndrome (SIDS) and injuries are the most common reasons for infant death in the first year of life.
Bringing a new baby home from the hospital is a joyful time, but new parents often worry about their baby’s safety and health. Sleep is probably the single most significant concern for new parents, and ensuring that infant sleep practices are supportive of a safe sleep environment is critical. Each year in the U.S., approximately 4,000 infants suffer sudden, unexpected deaths (SUID) due to accidents, illnesses and other causes. About half of these unexpected deaths are attributed to SIDS, where the cause of death is unknown.
To promote safe sleep for babies, the American Academy of Pediatrics advises that babies always sleep on their backs, in a safety-approved crib, with a fitted sheet and no blankets, pillows, bumpers or toys in their sleep area. These recommendations have saved many babies’ lives over the past two decades, with SIDS and other sleep-related deaths decreasing more than 50 percent.
Many parents wonder if placing their babies on their sides for sleep is as safe as the back position. Side sleeping is not considered as safe because babies can more easily roll from their side to their stomachs. Positioning babies on their back every time they go to sleep is the single most important thing parents can do to reduce SIDS risk.
Swaddling, or snugly wrapping your infant in a blanket, is an effective method used by sleep-deprived parents worldwide to help calm distressed newborns. Research suggests swaddling can help newborns with sleep awakenings, and may reduce crying and help babies have more restful sleep.
A recent study has raised concerns in the media and among parents that swaddling infants may increase the risk for SIDS. While experts agree that more research is needed, the authors reported SIDS risk doubled for stomach and side sleep positions when infants were swaddled, suggesting that current recommendations to avoid side and tummy sleeping are especially true when infants are swaddled. Infants older than 6 months were also at greater risk for SIDS when swaddled, perhaps because they were more likely to roll from their sides to stomachs. There was also a very small increased risk for swaddled babies when placed on their backs.
Parents are now asking if swaddling is safe. Swaddling is an effective tool for parents trying to calm and sooth a crying baby, along with other techniques such as rocking, positioning and the use of soothing sounds, all of which can be a benefit for exhausted parents.
Whether swaddling your baby for sleep or not, always place your baby on their back. Most experts now recommend discontinuing swaddling after 2 months of age or when your baby begins to show signs of rolling over. Overheating can also be a risk factor for SIDS, so it is important to notice if your baby seems warm and make adjustments in room temperature, swaddling or clothing.
Exposure to cigarette smoke, either during pregnancy or through second-hand exposure, is the second-largest SIDS risk factor. According to the American Academy of Pediatrics, one-third of SIDS deaths could be prevented if all maternal smoking during pregnancy was eliminated.
Other risk factors for SIDS include bed-sharing and allowing babies to sleep on sofas, chairs, pillows and other furniture.
One of the best things a mother can do to promote her infant’s health is to breastfeed. Babies who are breastfed have been found to have lower rates of SIDS. Breastfed babies sleep more lightly than formula-fed babies and suffer fewer infections, both of which may play a role in SIDS prevention.
For additional information about creating a safe sleep environment, visit the American Academy of Pediatrics at healthychildren.org.
Connie Morrow, Ph.D., is a licensed psychologist, director of the UM Healthy Start Program and the associate director of the Perinatal CARE Program at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.