Safe Sleep Guidelines
By Marot Byer, owner Sleep Haven Sleep Consultation
When I give presentations to parents on “Getting Started on Good Sleep”, I always include some information on sleep safety. Thanks to the “Safe to Sleep” campaign, most parents are familiar with the A,B, C’s of safe sleep promoted by the Canadian Pediatric Society, American Academy of Pediatrics, First Candle and Baby’s Breath:
- A = alone. Baby sleeps in her own sleep space, free of loose blankets, stuffed animals or pillows. Avoid use of bumper pads which increase the risk of baby re-breathing carbon dioxide or becoming tangled in ties.
- B = on her back. Put baby down to sleep on her back. We know that some babies are more sensitive to carbon dioxide levels that accumulate when they are face down. When she starts to roll on her own, you don’t have to reposition her in the night if she turns onto her tummy. Don’t use wedges or positioners to keep your baby on their back – baby can move in the night and become stuck in an unsafe position.
- C = in a crib or other certified safe sleep surface. Make sure the mattress is firm, in good condition and manufactured after September 1986. Cover it with a tight-fitting bottom sheet. Check out Health Canada’s Consumer Product Safety website to find out if your child’s sleep equipment meets current safety standards. Never put your child down to sleep on a pillow, sofa, armchair or waterbed – with or without an adult. It is too easy to become drowsy and find baby has slipped off or into a crack in the furniture.
These recommendations developed as investigators became better at identifying factors at tragic death scenes that contributed to Sudden Unexpected Infant Deaths (SUID’s) – including overlying, suffocation, strangulation and Sudden Infant Death Syndrome or SIDS (death not explained by other causes).
Other ways to support a safe sleep environment:
- Avoid over-heating baby. Keep the room temperature comfortable (between 16 – 20° C) and use a well-fitting sleeper or sleep sack to keep baby warm. If you choose to swaddle, account for the extra layer and dress baby in a lighter sleeper or onesie. Don’t cover her head – it’s how she regulates her temperature. If you use a blanket, keep it lightweight, pull it up to her chest only and tuck it under the mattress to keep it firmly in place.
- Quit smoking. And, until you’ve kicked the habit, don’t smoke in the house or around baby. Keep your smoked-in clothing out of the bedroom.
- Share a room. Continue to share your bedroom with baby until she is 6 months old to reduce the risk of SIDS. Baby can sleep in a bassinette, crib or co-sleeper in/attached to the adult bed.
- Breastfeed if you can. Breast milk is protective and exclusive breastfeeding for the first 6 months has been shown to decrease the risk of SIDS.
- Talk safe sleep. Make sure that other caregivers are following the same safe sleep guidelines.
What about Bed Sharing?
Many parents assert that sharing a bed with their baby has been a natural practice for centuries, and that the close sleeping arrangement strengthens the natural bond between a mother and infant as she comforts and breastfeeds her baby. A mother is thought to be more aware of and responsive to her baby’s needs. Babies spend less time in deep sleep and naturally arouse more often – considered a protective factor against SIDS.
Other parents are adamant that they will not bedshare with their baby as they are planning for her arrival – but once she is on the scene and fussing throughout the night, decide to sleep together to catch the best sleep possible. I call this “reactive bedsharing”.
So, whether you are making the choice to bedshare or are sleeping in the same bed as your baby out of desperation to get some sleep – how can you still set your baby up for safe sleep?
Reduce the Risk: the Safe Sleep Seven
Le Leche League International has released 7 recommendations designed to maximize the safety of bedsharing.
If you are a
- Sober (no drugs, alcohol or medications that make you drowsy)
- Breastfeeding exclusively
And your baby is
- Full-term and healthy
- Positioned on her back when not breastfeeding
- Unswaddled and dressed in a light onesie or sleeper
And you are both on a
- Safe sleep surface (a firm mattress, no extra pillows and a light blanket)
… then you can be confident that you have reduced the risks associated with SUID or SIDS and provided your baby with the optimal bedsharing sleep environment. Make your bed even safer:
- Put your mattress on the floor, in the centre of the room away from walls or furniture.
- Make sure both parents are aware of where baby is in the bed. Sleep on your side in a “C” position with baby’s face at the level of your breast.
- If your partner is a heavy sleeper, then sleep between baby and your partner.
- Don’t bring other children or pets into your bed with your bedsharing baby.
As in so many areas of parenting, you need to be informed, discuss your questions with a trusted healthcare provider, weigh the risks and arrive at a decision you can live with happily.
Margot Byer is the owner of Sleephaven Sleep Consultation. She is a Pediatric Occupational Therapist and trained Gentle Sleep Coach. She believes that sleep is a learned skill. Just like walking and talking, getting to sleep and returning to sleep after normal partial awakenings in the night takes practice – and often consistent support from parents. An abundance of sleep training systems are available today. The Gentle Sleep Coach philosophy was developed by Kim West (LCSW-C) because she found so many parents had difficulty following through with sleep coaching programs that they feared would damage their child emotionally.
The Gentle Sleep Coach approach offers gentler alternatives for families who want to teach their child to develop healthy sleep habits. It encourages consistent, loving and responsive parenting. The parent stays with and responds to their child, offering physical and verbal reassurance without putting the child to sleep. Some crying is inevitable as children deal with changes, but the Gentle Sleep Coach approach aims to minimize distress. This supports the development of secure attachments between parent and child while helping children discover the vital life skill of putting themselves to sleep.
Margot embraces the Gentle Sleep Coach philosophy because of its sensitivity to each unique child and family. She works with you to create an individualized, step-by-step sleep plan that will factor in your parenting philosophy, your child’s age, health and temperament, mother’s well-being and important family dynamics. Most importantly she will support and coach you through the process from beginning to end – for both night sleep and naps. My goal: to come alongside to help your tired family sleep.