In 2016, 306 babies died in Arkansas before their first birthday. Approximately one in every four infant deaths were sleep-related. Unsafe sleep environment deaths are preventable. Here’s what parents need to know.
Infant sleep tips
The American Academy of Pediatrics (AAP) updated their recommendations in 2016 to help reduce the risk of sleep-related deaths. Their recommendations include:
- Infants should not sleep in their parents’ bed. However, sleeping in the parents’ room, close to the parents’ bed, but in their own crib is recommended. Infants should have a separate surface designed for infants, ideally for the first year or at least for the first six months.
- Use a firm sleep surface in a crib, bassinet or play yard that is approved by the U.S. Consumer Product Safety Commission. Mattress should fit snugly with no gaps or spaces between mattress and crib frame.
- Place infants on their back every time they sleep until the child is one year of age. Side or stomach sleeping is not safe and not advised.
- Do not allow soft objects, toys, loose bedding, blankets, pillows or crib-bumper pads in an infant’s sleep area. They can cover the infant’s face, head or neck and cause suffocation, entrapment or strangulation.
- Do not cover the infant’s head and be sure that sleepwear does not over-heat the infant. Use a sleep sack or wearable blanket if extra warmth is needed.
- Do not let an infant sleep in a carrier, sling, car seat or stroller because it increases the risk of suffocation.
Follow the ABCs of infant safe sleep and save a life:
- Back sleeping only
There are several risk factors for sleep-related deaths that can be caused by parents’ or caregivers’ behaviors. Those include smoking, drug use (including over-the-counter medications) or overdressing the baby when he’s sleeping.
Factors that protect against sleep-related deaths include breastfeeding, getting baby vaccinated and using a pacifier without strings or attachments.
Don’t expect your baby to have a regular sleep-wake cycle until about six months of age. Typically, newborns sleep 16 hours a day, but they may only sleep one or two hours at a time.
Swaddling is a technique that some parent use to calm their baby. A blanket or other cloth is wrapped snuggly around the baby, including the arms, so only the head is uncovered. The AAP recommends NOT to swaddle after the baby is two months old. There is an increased risk for babies older than two months, if swaddled, to roll over to their side or stomach and suffocate. If the blanket comes unwrapped, it could cover baby’s face and increase the risk of suffocation. Swaddling also increases the risk of overheating. Baby is too hot if you notice sweating, damp hair, flushed cheeks or rapid breathing. Swaddling too tightly can cause problems with a baby’s hips called hip dysplasia. Straightening a baby’s legs tightly for too long increases the risk of abnormal formation of the hip joint cause the thigh bone not to be held firmly in the hip socket. Hips should be able to move freely. Finally, swaddled babies may have a harder time waking up, increasing their risk of sudden infant death syndrome (SIDS).
The AAP also cautions new parents about buying products that claim to reduce the risk of SIDS. These can include wedges, positioners and special mattresses or sleep surfaces. None of these items have been shown to reduce the risk of SIDS.
Parents may worry about baby developing a flat spot on the back of the head from back sleeping. Even if a flat spot develops, it will round out as the baby grows and sits up more. Other ways to reduce the chances of a flat head include alternating which end of the crib you place baby’s head, alternating the side she feeds on during feeding (breast or bottle fed). Be sure baby has some tummy time when awake and being watched to strengthen his muscles. This prepares him for crawling. Limit the time spent in swings, bouncy chairs and car seats because they put added pressure on the back of the head.
Safe sleep for toddlers
After baby’s first birthday, the risk for SIDS is very low. However, for toddlers – ages 1 to 3 years – there are several points to remember to ensure toddlers sleep safely, too.
Toddlers are explorers and often try to climb out of their cribs. Keep the mattress on the lowest setting and the rails up. Avoid putting anything in the crib that a toddler can use to climb out. When your toddler can climb out easily of his own, it’s time to move to a bed. Between the ages of 18 months to 3 ½ years, toddlers can move to a toddler bed or a twin bed. A side rail can add more protection.
Just as you placed baby’s crib far away from window-blind cords, curtains or other ways to get tangled up, continue to keep them away from the toddler’s new bed.
Pillows, blankets and stuffed toys no longer pose the same dangers for a toddler.
Toddlers can sleep in any position, including stomach or side. Let him pick the position that’s most comfortable.
Waking up at night is a common phase for toddlers. It’s a temptation for sleep-deprived parents to let a toddler fall back asleep in the parents’ bed. If this becomes a habit, parents usually regret it. It will run its course if you gently guide the toddler back to his own bed and help him get back to sleep on his own. Rubbing his back or singing a lullaby often helps. Make sure he knows his parents’ bed is not where he should sleep.
Maintaining your patience with night-time wakening ends the problem quicker by teaching the toddler to get back to sleep on his own. Here are some tips: don’t rush into his room immediately when you hear him stirring. He may be able to get himself back to sleep without you. If the crying continues or is in earnest, check on him but, at first, don’t pick him up or talk too much. After he calms down, leave the room before he falls asleep. Gradually increase the time between awakening and going into his room.
Being consistent with this message is very important. Allowing a toddler into your bed one night but not the next sends confusing messages to a young child. With a consistent message, night awakenings should end in about a week.
Be sure to establish a bedtime routine and stick to it, down to the last detail, including the time of day for bedtime and naptime. It can be as simple as warm bath, quiet story, hugs. Leave the room before your toddler falls asleep. Some children respond well to a white noise machine or small fan in the room if outside noise is awakening him.
The reasons a toddler may be awakening in the night include not feeling well (teething, ear infections, stuffy nose) or being frightened by a nightmare or storm. If your toddler snores loudly, this may be caused by obstructive sleep apnea. It is often caused by enlarged tonsils or adenoids, according to the Centers for Disease Control and Prevention. Fears or anxiety may also cause awakenings. Life changes such as a new baby in the house, a move, toilet training or a new daycare situation can cause a toddler’s imagination to wake him up. A final reason for awakening at night is sleeping too much during the day. What parent hasn’t been dismayed when the caregiver greets the parent with, “He took a four-hour nap today!” You know that toddler is not going to sleep much tonight. And the opposite can happen. They get so wound up and excited they are too tired to sleep. Toddlers need 11 to 14 hours of sleep per day.
Get to know your toddler’s sleepy signs. They may have changed since he was an infant. They can include crying over nothing, being hyperactive, loudness, thumb-sucking, droopy eyes or crankiness. Try to get him to sleep before exhaustion sets in.
Toddlers still need daytime naps. Some take one long nap and others do better with a short morning and afternoon nap. If he is generally cheerful all afternoon until bedtime, you’ve found the right amount of sleep for your child.
A young child who can fall asleep on his own and follows a healthy sleep routine is well on his way to having healthy sleep habits as an adult. A good night’s sleep is one of the most important adult health habits. It’s vital to both mental and physical health at all ages.
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