A concerning number of babies are still being put to bed in unsafe sleep environments despite all the information we now have about SIDS, new research shows.
During the US study, which filmed the night-time routines of more than 100 babies at home, about 90 per cent of infants were put to sleep with loose or soft bedding, stuffed animals, bumper pads, pillows and sleep positioners.
This is despite widespread campaigns warning that soft bedding in the sleep environment is “the most common risk factor seen in sudden and unexpected infant deaths that occur in infants” aged under four months.
Jill Green, SIDS and Kids General Manager Research Advocacy and Change tells Babyology she is not surprised.
“There was a similar study in Australia recently that showed parents were choosing pillows because they were more worried about flat heads than they were about safe sleeping,” Jill says.
“It doesn’t come as a surprise. What it says to me is parents do not understand the importance of our recommendations. They don’t see they ‘whys’ behind our simple messages.
“The potential hazard of using a pillow is a pillow pushes baby’s head forward, the chin goes to the chest – babies have low neck strength – and we actually can pinch off the airways and cause some asphyxiation, so suffocation.
“Also, when they start to roll, and they will eventually, if they roll into the pillow or soft fluffy bedding their little faces could get covered and again cause suffocation – the question is, ‘do the potential hazards beat the potential benefits’ and the answer is ‘yes’.”
Jill says parents make plans for the nursery, sleep and feeding before their baby arrives based on what they truly believe is best, but certain influences creep in “when faced with a lived experience”.
She says sleep deprivation and contrary advice from family, friends and peers are just two examples.
“We need to try and reinforce, as a community, the importance of these recommendations and the reasons behind them,” Jill says.
“We need to have those discussions with parents, every medical professional antenatally and postnatally need to discuss the ‘whys’ behind these recommendations.”
She says babies spend most of their first year sleeping and mostly unsupervised.
“This is why it needs to be a priority that the environment is safe and the way we put baby to sleep in that environment is the safest possible way as well,” Jill says.
The study, Nocturnal Video Assessment of Infant Sleep Environments published by The American Academy of Pediatrics, was aimed at examining the role of parenting in developing a baby’s night time sleep patterns.
Healthy full-term newborns were recruited to be videoed within their homes for one night at ages one, three and six months. The research prompted a secondary study to look at the sudden infant death syndrome risk factors captured in the videos.
Of the 160 one-month-olds, 21 per cent were first placed to sleep on non-recommended sleep surfaces and 14 per cent were placed non-supine (positions other than the recommended back with face upwards) and 91 per cent had loose non-approved items on their sleep surface.
The numbers changed slightly among the 151 three-month-olds, with 10 per cent placed on a non-recommended sleep surface at first, 18 per cent not placed on their backs and 87 per cent had potential hazards where they slept.
By six months, of the 147 infants that remained in the study, 12 per cent were first placed on non-recommended sleep surfaces, 33 per cent were not put to bed on their backs and 93 per cent had potential hazards such as loose bedding where they slept.
The hazards increased in most cases when the baby’s sleep location was changed through the night, usually with a parent bringing baby into their bed.
Safe sleeping tips for babies
More detail on safe sleeping for babies can be found on the Sids and Kids website but here are some key tips Jill says are important to consider.
- A safe sleeping environment is one out of reach of chords from curtains or appliances with a comfortable temperature and preferably next to parents’ bed.
- Within that environment, baby should be slept in a safe cot that meets the current mandatory standards. There are only three products available that have to meet the Australian and New Zealand mandatory standards, they include the household cot, the portable cot and the pram. But, with prams, baby should never be placed to sleep long-term or unsupervised.
- Basinettes are not covered by mandatory standards and some are made to a higher standard than others. Before using, cross-check it with ACCC product safety standards. Also remember once baby starts moving and rolling, the bassinette is no longer a safe option.
- A safe mattress needs to be firm, well-fitting, clean and flat. If something looks soft and fluffy, don’t use it.
- Do not add mattresses or soft bedding to portable cots.
- It is recommended babies should be laid on their backs.