Not all parents are following safe sleep practices for their babies: What to know

A study found up to 2/3 of moms are not following safe infant sleep practices.

ByKatie Kindelan and Dr. Angela Ryan via logo
October 21, 2019, 12:08 PM

Nearly a quarter to two-thirds of moms are not following recommended safe infant sleep practices, according to a new study.

The result could be contributing to sudden unexpected infant deaths (SUID), according to the study released Monday by Pediatrics, the official journal of the American Academy of Pediatrics (AAP).

Researchers found that not all moms were following the AAP's four specific recommendation for babies' sleep safety: Placing infants to sleep on their back, room-sharing without bed-sharing, avoiding any soft objects or bedding and using firm sleep surfaces such as a crib, bassinet or pack-and-play.

The study evaluated data from a voluntary nationwide survey of postpartum women and found 78% of mothers reported most often using back sleep position, 57% always or often shared room without bed-sharing, 42% usually avoided soft bedding or objects and only 31% always or often used separate approved sleep surfaces.

The study did not evaluate data from fathers.

Around 3,500 babies die "suddenly and unexpectedly" each year in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC).

SUID is defined by the CDC as "the sudden and unexpected death of a baby less than 1 year old in which the cause was not obvious before investigation."

"SUID deaths usually happen during sleep or in the baby’s sleep area," notes the CDC, which is why safe sleep practices are the focus of campaigns to reduce the number of deaths.

PHOTO: A baby sleeps in a crib in an undated stock photo.
A baby sleeps in a crib in an undated stock photo.
STOCK PHOTO/Getty Images

The mothers who responded to the survey reported not always getting comprehensive advice from their health care providers on safe infant sleep practices.

The AAP offers these additional sleep safety recommendations for babies:

1. Until their first birthday, babies should sleep on their backs for all sleep times—for naps and at night. "We know babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides. The problem with the side position is that the baby can roll more easily onto the stomach. Some parents worry that babies will choke when on their backs, but the baby's airway anatomy and the gag reflex will keep that from happening. Even babies with gastroesophageal reflux (GERD) should sleep on their backs."

2. Use a firm sleep surface. "A crib, bassinet, portable crib, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC) is recommended along with a tight-fitting, firm mattress and fitted sheet designed for that particular product. Nothing else should be in the crib except for the baby. A firm surface is a hard surface; it should not indent when the baby is lying on it. Bedside sleepers that meet CPSC safety standards may be an option, but there are no published studies that have examined the safety of these products. In addition, some crib mattresses and sleep surfaces are advertised to reduce the risk of SIDS. There is no evidence that this is true, but parents can use these products if they meet CPSC safety standards."

3. Keep baby's sleep area in the same room where you sleep for the first 6 months or, ideally, for the first year. "Place your baby's crib, bassinet, portable crib, or play yard in your bedroom, close to your bed. The AAP recommends room sharing because it can decrease the risk of SIDS by as much as 50% and is much safer than bed sharing. In addition, room sharing will make it easier for you to feed, comfort, and watch your baby."

4. Only bring your baby into your bed to feed or comfort. "Place your baby back in his or her own sleep space when you are ready to go to sleep. If there is any possibility that you might fall asleep, make sure there are no pillows, sheets, blankets, or any other items that could cover your baby's face, head, and neck, or overheat your baby. As soon as you wake up, be sure to move the baby to his or her own bed ... Bed-sharing is not recommended for any babies."

5. Never place your baby to sleep on a couch, sofa, or armchair. "This is an extremely dangerous place for your baby to sleep."

6. Keep soft objects, loose bedding and other items out of the baby's sleep area. "These include pillows, quilts, comforters, sheepskins, blankets, toys, bumper pads or similar products that attach to crib slats or sides. If you are worried about your baby getting cold, you can use infant sleep clothing, such as a wearable blanket. In general, your baby should be dressed with only one layer more than you are wearing."

7. It is fine to swaddle your baby. "However, make sure that the baby is always on his or her back when swaddled. The swaddle should not be too tight or make it hard for the baby to breathe or move his or her hips. When your baby looks like he or she is trying to roll over, you should stop swaddling."

8. Try giving a pacifier at nap time and bedtime. "This helps reduce the risk of SIDS, even if it falls out after the baby is asleep. If you are breastfeeding, wait until breastfeeding is going well before offering a pacifier. This usually takes 2-3 weeks. If you are not breastfeeding your baby, you can start the pacifier whenever you like. It's OK if your baby doesn't want a pacifier. You can try offering again later, but some babies simply don't like them. If the pacifier falls out after your baby falls asleep, you don't have to put it back."