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How to create a safe sleeping environment for infants

16 June, 2016
Safe sleeping – babies
When it comes to developing healthy sleeping patterns for babies, the amount of information and advice available can seem a bit overwhelming. With many parents focusing on getting their baby to sleep well and through the night, it can be easy to overlook safe sleeping practices, even though it’s likely to be more important. 

There are a few things you can do to create a safe sleeping environment for your baby, starting with placing them on their back. In 1985, it was reported that SIDS was rare in Hong Kong, where it was common to lay babies on their back to sleep. Paediatricians in the Netherlands then started a campaign advising parents to place their newborn infants to sleep on their backs instead of their stomachs and Australia followed suit. 

In 1991, SIDS and Kids launched its own official campaign after discovering that infants who sleep on their backs have lower arousal thresholds and less slow-wave sleep (SWS). Slow-wave sleep, which consists of stage 3 and stage 4 non-rapid eye movement sleep (NREM), appears at two months of age. It’s thought that some infants have a brain-stem defect which increases their risk of being unable to rouse from this state. An infant death deemed sudden and unexpected may, by this theory, be the result of a dangerous sleeping pattern. 

What research tells us

A lack of answers is part of what makes sudden infant death syndrome (SIDS) so frightening. SIDS (once referred to as “cot death”) is the leading cause of death among infants one month to one year old, claiming the lives of 130 Australian infants every year. Of those, around 60 per cent are boys. 

People once suspected SIDS to be caused by things such as choking, parental neglect or accidental smothering, but the real cause is still unknown. There are no consistent warning signs to alert us to the risk of SIDS. While some babies have been found with minor infections, they are not considered enough to have caused death. 

What we do know is that the number of babies dying suddenly and unexpectedly has reduced dramatically in Australia. The Australian Bureau of Statistics has found the incidence of SIDS has fallen by as much as 84% since 1990. The incidence of sudden unexpected death in infancy (SUDI), which includes 3000 stillbirths every year, is also on the decline. This comes down to safe sleeping. 

What is safe sleeping?

    Safe sleeping for babiesResearch has identified some key infant care practices that contribute to safe sleeping. These include:
    • Putting your baby on their back from birth. 
    • Ensuring your baby is sleeping with their head and face uncovered. 
    • Keeping your environment smoke-free before and after birth.
    • Placing your baby in their own safe sleeping place in the same room as an adult caregiver for the first six to twelve months.
    • Breastfeeding.
    • Using a cot that meets Australian standards.
    • Choosing a firm, clean and well-fitting mattress.
    • Ensuring the bottom sheet sits flush with the sides of the cot/bassinet.
    • Removing all quilts, doonas, pillows, loose bedding and soft toys.
    • Keeping the sleeping area free of hazards, such as dangling cords and electrical wires.
    • Removing clothing with ties (like bibs) or hoods before putting baby down to sleep.
    • Avoiding overheating your baby. As a general rule, babies should be dressed in one more layer than an adult would feel comfortable in.
    • Ensuring your baby gets regular “tummy time” to minimise the development of plagiocephaly (also known as flat head syndrome).
    It's important that any person caring for your baby is familiar with these safe sleeping practices. 

    What about co-sleeping?

    Co-sleepingThere has been a lot of talk surrounding “co-sleeping” of late, with many parents and professionals believing sleeping in the same bed at night will make a baby feel a deeper connection to their parents, so they will grow up feeling safe and loved. Some talk suggests parents feel less exhausted by sharing a bed with a baby that wakes during the night and recent studies have even suggested that co-sleeping can aid breastfeeding. 

    But while these benefits may indeed be true, co-sleeping with your baby can be dangerous. SIDS and Kids recommends the safest place for your baby to sleep is in a cot or bassinet beside your bed, rather than in your bed with you. If you do decide the benefits outweigh the risks for your family, consider a three-sided cot that can attach to the side of your bed, or use the following guidelines to make co-sleeping safer:
    • If your baby lies on his/her side to breastfeed, they should be moved onto their back again to sleep.
    • Make sure the mattress is firm and flat.
    • Make sure bedding can't cover the baby’s face or overheat them.
    • Sleep your baby beside one parent only, not sandwiched between both.
    • Make sure your partner knows your baby is in your bed.
    • Try not to share bedding, instead placing your infant in a sleeping bag.
    • Refrain from wrapping your baby.
    • Put your mattress on the floor, so your baby can't fall out of bed. Don’t push the bed up against the wall, as babies have been known to slip into the crack and be unable to breathe.
    • Don’t share a bed with other children or pets.
    • Don’t leave your baby alone on an adult bed.

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