Baby in the Bedroom: Keep that Crib in with Mom and Dad

From the American Academy of Pediatrics comes new recommendations for safe infant sleeping environments. Dr. Boyle shares the updated information from the leading professional pediatric organization. AAP was founded in 1930 and has the largest pediatric publishing program in the world. 

Safe Sleeping Recommendations

For years, health professionals have recommended that healthy infants sleep on their backs until age one. The tag for this suggestion is “back to sleep for every sleep.” This position reduces instances of SIDS (Sudden Infant Death Syndrome). Doctors aren’t completely sure why this position is best, but current thought points to the possibility of rebreathing expelled air that has a higher concentration of carbon dioxide and less oxygen when sleeping face down. A firm sleeping surface is also recommended. From the AAP Policy Statement:

A firm surface maintains its shape and will not indent or conform to the shape of the infant’s head when the infant is placed on the surface. Soft mattresses, including those made from memory foam, could create a pocket (or indentation) and increase the chance of rebreathing or suffocation if the infant is placed in or rolls over to the prone position.

Pediatricians also recommend that the sleep area be free of soft objects that may impede breathing. This includes bumpers, stuffed toys, quilts, or even blankets. A onesie of the appropriate weight for the ambient temperature is best to keep an infant comfortable and safe. It’s best to wait until after year one to add a favorite stuffed animal or blanket in the sleeping area.

AAP also provides recommendations on pacifier use, which may lower chances of SIDS. Most important might be when to start using a pacifier, specifically if the child is breast feeding:

Pacifiers also may help reduce the risk of SIDS. However, if your baby doesn’t want the pacifier or if it falls out of her mouth, don’t force it. If you are breastfeeding, wait until breastfeeding is well established, usually around three or four weeks of age, before using a pacifier. While sleeping on the back is important, your baby also should spend some time on her stomach when she is awake and being observed. This will help to develop her shoulder muscles and her head control, and avoid the development of flat spots on the back of her head.

The U.S. Consumer Product Safety Commission agrees. Check out these recommendations from the USCPSC.

Sleeping in the Same Room, Not the Same Bed

Here’s a big one: room-sharing can reduce SIDS rates by up to 50%. The first year, but especially the first six months is a crucial window in your child’s development. That first six months is also the period during which SIDS is most common. Anything that can have a positive impact on reducing that possibility is worth considering. With baby nearby in the same room, it is also easier to monitor, comfort, and feed. The AAP tells us:

The infant’s crib, portable crib, play yard, or bassinet should be placed in the parents’ bedroom until the child’s first birthday. Although there is no specific evidence for moving an infant to his or her own room before 1 year of age, the first 6 months are particularly critical, because the rates of SIDS and other sleep-related deaths, particularly those occurring in bed-sharing situations, are highest in the first 6 months. Placing the crib close to the parents’ bed so that the infant is within view and reach can facilitate feeding, comforting, and monitoring of the infant. Room-sharing reduces SIDS risk and removes the possibility of suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed.

Cons can be Pros

Sleeping in the same room certainly has its benefits. There are also some challenges when sharing a room. I’m going to suggest that these are positives in disguise. Here are a couple challenges that easily be seen as positives in light of the safety benefits of room-sharing.

1. You’ll hear EVERYTHING. Well…that’s the point, right? If your baby is in distress, you’ll know right away. My wife and I learned very quickly what sounds were important and what sounds were just normal baby sleeping sounds.
2. You may become a constant baby checker. See #1. With practice and experience, you’ll learn what requires attention and what doesn’t. And when the baby is in the same room, you can do this visually rather than getting up and heading down the hall. Your little one is right there!

The lead author on the AAP Policy Statement on Safe Infant Sleeping Environment is Dr. Rachel Moon. An expert in SIDS, Dr. Moon is a physician with the University of Virginia Heath System. Her research focuses on infant sleeping positions and variables that impact parental choice.

The AAP seeks to provide the best information they can based on quantitative and qualitative research, resulting in well supported recommendations. We share this info with our readers with a sincere desire to provide up-to-date info for consideration that may positively impact the safety of all those beautiful babies out there. For more info on room sharing, check out this NPR article or this Huffington Post article on the AAP recommendations.