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No matter where you have your baby sleep, be
sure you provide a safe sleeping environment. If you decide to share sleep with
your baby, and this arrangement is working for your family, observe these
precautions:
DOS:
Take precautions to prevent baby from rolling out of bed, even though it is
unlikely when baby is sleeping next to mother. Like heat-seeking missiles,
babies automatically gravitate toward a warm body. Yet, to be safe, place baby
between mother and a guardrail or push the mattress flush against the wall and
position baby between mother and the wall. Guardrails enclosed with plastic
mesh are safer than those with slats, which can entrap baby's limbs or head. Be
sure the guardrail is flush against the mattress so there is no crevice that
baby could sink into.
Place baby adjacent to mother, rather than between mother and father.
Mothers we have interviewed on the subject of sharing sleep feel they are so
physically and mentally aware of their baby's presence even while sleeping, that
it's extremely unlikely they would roll over onto their baby. Some fathers, on
the other hand, may not enjoy the same sensitivity of baby's presence while
asleep; so it is possible they might roll over on or throw out an arm onto baby.
After a few months of sleep-sharing, most dads seem to develop a keen awareness
of their baby's presence.
Place baby to sleep on his back.
Use a large bed, preferably a queen-size or king-size. A king-size bed may
wind up being your most useful piece of "baby furniture." If you only have a
cozy double bed, use the money that you would ordinarily spend on a fancy crib
and other less necessary baby furniture and treat yourselves to a safe and
comfortable king-size bed.
Some parents and babies sleep better if baby is still in touching and
hearing distance, but not in the same bed. For them, a bedside co-sleeper is a safe option.
DON'TS:
Do not sleep with your baby if:
1. You are under the influence of any drug (such as alcohol or tranquilizing
medications) that diminishes your sensitivity to your baby's presence. If you
are drunk or drugged, these chemicals lessen your arousability from sleep.
2. You are extremely obese. Obesity itself may cause sleep apnea in the
mother, in addition to the smothering danger.
3. You are exhausted from sleep deprivation. This lessens your awareness of
your baby and your arousability from sleep.
4. You are breastfeeding a baby on a cushiony surface, such as a waterbed or
couch. An exhausted mother could fall asleep breastfeeding and roll over on the
baby.
5. You are the child's baby-sitter. A baby-sitter's awareness and
arousability is unlikely to be as acute as a mother's.
Don't allow older siblings to sleep with a baby under nine months. Sleeping
children do not have the same awareness of tiny babies as do parents, and too
small or too crowded a bed space is an unsafe sleeping arrangement for a tiny
baby.
Don't fall asleep with baby on a couch. Baby may get wedged between the
back of the couch and the larger person's body, or baby's head may become buried
in cushion crevices or soft cushions.
Do not sleep with baby on a free-floating, wavy waterbed or similar
"sinky" surface in which baby could suffocate.
Don't overheat or overbundle baby. Be particularly aware of overbundling if
baby is sleeping with a parent. Other warm bodies are an added heat source.
Don't wear lingerie with string ties longer than eight inches. Ditto for
dangling jewelry. Baby may get caught in these entrapments.
Avoid pungent hair sprays, deodorants, and perfumes. Not only will these
camouflage the natural maternal smells that baby is used to and attracted to,
but foreign odors may irritate and clog baby's tiny nasal passages. Reserve
these enticements for sleeping alone with your spouse.
Use common sense when sharing sleep. Anything that could cause you to sleep
more soundly than usual or that alters your sleep patterns can affect your
baby's safety. Nearly all the highly suspected (but seldom proven) cases of
fatal "overlying" I could find in the literature could have been avoided if
parents had observed common sense sleeping practices.
If your baby sleeps
in a crib, follow these safety suggestions:
DO:
Look for a Consumer Product Safety Commission label or a Juvenile Products Manufacturer's Association (JPMA)
label stating
that the crib conforms to safety standards.
Check the space between the bars of the crib rail. The bars should be no
more than 2-3/8 inches (6 centimeters) apart, so that babies can't get their
heads caught between them. The bars of cribs made prior to 1979 may have wider
spacing that does not conform to these standards.
Be sure the mattress fits the crib perfectly. An undersized mattress will
leave a gap along the side or end of the crib where an infant's head can get
caught, causing suffocation. To check the fit of a crib mattress, push it to
one corner. There should be no more than a 1½ inch (4 centimeter) gap between
it and the side or end of the crib. If you can fit more than two fingers
between the mattress and the crib, the mattress is too small. Remember, the
firmer the mattress, the safer. Beware of hand-me-down or secondhand cribs in
which the mattress may be different from the one designed to fit the crib.
DON'TS:
Don't use loose-fitting plastic mattress covers or waterproof sheets that
can wrap around a baby's head and cause suffocation.
Frequently check the mattress support system by rattling the metal hangers
and by pushing the mattress on top and then from the bottom. If the hanger
support dislodges, it needs to be fixed or replaced. Be sure the four metal
hangers supporting the mattress and support board are secured into their notches
by safety clips.
To prevent choking, check crib toys, mobiles, pacifiers, and clothing worn
in the crib to make sure they have strings no longer than 8 inches (20
centimeters).
Make sure crib bumpers fit snugly around the entire
perimeter of the crib and are secured by at least six ties or snaps. To prevent
your baby from chewing on the ties and becoming entangled in them, trim off
excess length. Remove bumpers and toys from the crib as soon as the child
begins to pull himself or herself up on the crib rails, because they can be used
as steps for climbing over the rail.
Don't place breathing blockers in baby's crib (or baby's sleeping
environment). These include anything that could obstruct baby's breathing
passages or collect dust (which is an irritant that can lead to stuffy little
noses). Breathing hazards include: decorative pillows, fuzzy stuffed animals
and toys, string-toys, tiny chokable toys, straps or ties on bumper pads.
Don't place the crib in an unsafe area in the room. It should not be near a
heater, against a window, near any dangling cords from blinds or draperies, or
close to furniture that the infant can use to climb out of the crib. When the
baby gets older, give some thought to what could happen if your baby did climb
out. The crib should be placed so that your baby will not fall against any
sharp object or become entrapped, or possibly strangled, between the crib and an
adjacent wall or piece of furniture.
Don't use crib toys that are fastened between the side
rails and hang over the crib, giving baby something to look at and reach for.
These toys are recommended only from birth to five months and should be removed
when baby is old enough to push up on his hands and knees.
If your baby's crib is not in your bedroom or within hearing distance of
every room in the house, put a portable monitor nearby.
Besides the above crib safety
precautions, to increase your baby's chances of a safe night's sleep, observe
these do's and don'ts:
DO'S:
Place baby to sleep on her back or side, whichever way she seems to sleep
the best.
Spread sheets and under sheets smoothly and tuck them in tightly beneath the
mattress. This lessens the chance of wrinkles in the bedding that could
obstruct baby's breathing.
Be particularly vigilant when traveling , since baby
will be sleeping in an unfamiliar and potentially unsafe environment. Bring
along a portable crib or a roll-out safe-sleeping mat. These are safer sleeping
alternatives than soft adult mattresses, such as the ones used on sofa beds or
rollaways in motels. If you are using a hotel-provided crib, do a safety check.
Be equally vigilant when putting baby to sleep in a carriage . Observe the same precautions. Place infant to sleep on back or
side, and remove any potentially dangerous objects from the carriage.
Keep baby's environment as fuzz-free as possible, especially if your baby is
prone to respiratory allergies. Besides removing stuffed animals, avoid bedding
that is likely to collect lint, such as deep-pile lambskin
or fuzzy wool blankets. Hypoallergenic mattresses and mattress covers are
available for allergy-prone infants.
DON'TS:
Don't put infants under six months to sleep on their tummies, unless there
is a doctor-recommended reason for doing so.
Don't put baby to bed on a soft surface, such as a waterbed, beanbag, adult
foam mat, or any other squishy surface that could obstruct baby's breathing
passages.
Don't leave baby sleeping alone unsupervised in a carriage. An older child
may caringly, but unsafely, want to snuggle a teddy bear next to baby's head.
Carriage mattresses tend to be less cared for than other bedding, and they tend
to collect dust and other allergens. Clean them as needed. Carriages are a
common site of smothering in babies, second only to cribs.
Don't use deep-pile lambskin or other deep-pile (greater than 1¼ inches or 3
centimeters) sleeping mats. These not only collect dust and other allergens,
but also can obstruct baby's breathing passages, especially if they get wet from
drool or spit-up.
Don't cover baby's head after the first day or two. This is a baby's
primary path of normal heat loss. Covering the head risks overheating the baby,
which increases the risk of SIDS. (Very premature hospitalized babies often
need their head covered to maintain their body temperature, but the medical
staff monitors this.)
Never smoke in the room where the baby sleeps. Smoke
irritates baby's sensitive breathing passages.
AskDrSears.com is intended to help parents become better informed consumers
of health care. The information presented in this site gives general advice
on parenting and health care. Always consult your doctor for your individual
needs.
