The American Academy of Pediatrics has just come out with expanded guidelines for infant sleep safety and SIDS reduction, so I thought it would be a perfect time to talk about sleep.
I have to admit that prior to my son’s birth I had very little appreciation for how important sleep is to new parents. . . or all parents for that matter. In residency we had maybe one or two sleep lectures that mainly focused on the Ferber method, and I read a number of parenting books prior to starting practice, but let me tell you I had NO IDEA. Sleep is the holy grail of parenting. Since our son’s birth I have, at various points, been pretty obsessed with sleep- his, ours- and for various reasons. Given my newfound interest in this topic, I’ve been spending a lot more time talking with families about it and have learned a lot. What I’ve learned will probably fill a number of posts, but today I’ll focus on the newborn period.
Parents of newborns are really, really tired. During the first 7-8 weeks of our son’s life I was more tired than during residency. When I teach residents now I tell them to think of it as being on call “q1”, or every night. So, when I talk to parents of newborns at that first visit, I try to keep it relatively simple and focus on safe sleeping. Here are a few thoughts.
-Babies should sleep on their backs. The Back to Sleep campaign has done amazing things for decreasing risk of SIDS- rates are down greater than 50% since the campaign began in the early 1990’s.
-One of the only other proven risks for SIDS is environmental tobacco exposure. Knowing that you are keeping your baby safe might be the motivation for family members to finally be able to quit.
-Overheating is also a risk factor for SIDS. Babies should not be over-bundled.
-If you can, breastfeed! Breastfeeding babies who sleep in the vicinity of their mom actually have lower risk of SIDS because their breathing and arousal patterns are in sync.
-Immunize your child. We know that at least some cases of SIDS are associated with preceding infection.
-In addition to SIDS, overlying and suffocation deaths are also of great concern. The AAP recommends sleeping in the same room with your baby, but not the same bed. This is especially important if either parent smokes, or has consumed drugs or alcohol, all of which increase risk greatly.
-The baby’s bed should be “bare”. That means no pillows, bumper pads, blankets, or stuffed toys.
-Finally, studies show that about 50% of families admit to co-sleeping at least some of the time. There are many cultures around the world in which this is the norm. And, their are many families for whom there is either not enough space or money for a crib. The goal is to make the safest sleeping environment possible for the baby. A breastfed baby sleeping next to their mother, without any surrounding blankets or pillows, is probably a great deal safer than sleeping on a futon or bean bag chair.
For more information on newborn sleep and the new AAP Guidelines, check out the Healthy Children website summary.
Thoughts? Did you follow the AAP sleep guidelines with your newborn? Did you find practical challenges?