October is SIDS Awareness Month.  SIDS stands for Sudden Infant Death Syndrome.  According to the Centers for Disease Control (CDC), SIDS is “a term used to describe the sudden and unexpected death of a baby less than 1 year old in which the cause was not obvious before investigation.  These deaths often happen during sleep or in the baby’s sleep area.”  In the USA, (which has the highest rate of SIDS in the world), approximately 3,500 infants die from SIDS each year.  It is difficult to track these deaths as investigations and reporting methods are not uniformly applied.

Childbirth educators not only have an opportunity, but a responsibility to talk about safe sleep environments, the protective factor breastfeeding or chestfeeding a baby offers, and how to reduce the risks of SIDS with the families they work with.  The Safe to Sleep® campaign and toolkit offers resources for educators and others to use that raises awareness about safe infant sleep.  Resources are available in Spanish and English, as well as additional materials designed for specific communities including African American and Indigenous/Alaska Native populations. Some of these resources include:

• A handout and video entitled, Breastfeed Your Baby to Reduce the Risk of SIDS
• Downloadable materials for caregivers, including handouts, brochures and door hangers. Many of these, as well as DVDs, can be ordered for free
• The Healthy Native Babies Project toolkit and guides, which provides videos, handouts and training for the American Indian/Alaska Native communities
• Resource links related to SIDS and to Sudden Unexpected Infant Death (SUID)

2019 has seen a lot of discussion and press about “inclined sleepers” such as the Fisher-Price "Rock ‘n Play" and "Kids II" which were linked to several dozen infant deaths with the numbers continuing to rise with further investigation.  Perinatal educators should have had this information on their radar for a while now.

Unfortunately, there is a new category of products that create a false sense of security with parents of infants and has been linked to infant deaths.  “In-bed sleepers” are being used by parents who want to “safely bed-share” in order to facilitate easier nighttime feedings and comfort for their babies.  Examples of popular brands of these products include “DockATot,” “Baby Delight Snuggle Nest Infant Sleeper.” and “SwaddleMe By Your Side Sleeper” which have all been linked to fatalities by the Consumer Product Safety Commission (CPSC).  None of these products (in bed or reclined) have been tested for sleep safety or approved for infant sleep.  There are no federal standards that guide the manufacture or use of any of these products for parents to use when making decisions about safe sleep products for their families.

Ben Hoffman, M.D., chairperson of the American Academy of Pediatrics’ Council on Injury, Violence, and Poison Prevention’s executive committee states that "in-bed sleepers" pose “an immediate and constant risk to a child sleeping in one of them.”

There is a proposal on the table to modify the federal safety rules so that all infant sleepers must meet strong safety requirements, but that has not yet been accepted.  13 different types of infant sleep products (over 6.5 million products) have been recalled in the past 20 years, for being linked to infant deaths.  Many of these products do not offer a flat sleep surface and the CPSC recommends that any infant sleep product not exceed 10 degrees of incline in order to provide the safest sleep environment.

Childbirth educators and the parents we work with can learn more about the dangers of in-bed sleepers and the reclined infant sleepers in this just published Consumer Reports article.  You can also share this link to the Consumer Product Safety Commission which provides information on product recalls for infant safety and other safe sleep information for parents, in English and Spanish.

Childbirth educators have a responsibility to talk to parents about safe sleep environments including safe bed-sharing.  Most exhausted parents will bring their babies into their bed at some point to feed or comfort (or both). For many cultures, this is just the norm.  For others, it is an attempt to get more sleep.  Parents must be informed on how to bed-share safely, and to avoid products such as "in-bed sleepers" that provide the appearance of reducing risks but have in fact been shown to increase the risk of their baby becoming the next statistic.  Childbirth educators *and* health care providers must talk about the realities of nighttime parenting with sensitivity, compassion, and offer safe solutions, otherwise parents “go underground” with their chosen preferences, such as moving to a recliner or couch for nighttime feedings which may often be more dangerous than they realize.

You may find some of my favorite safe sleep resources helpful:

• La Leche League International's Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family including the Safe Sleep 7 infographic.
• Dr. Kathy Kendall-Tackett including her "Safe Sleep for You and Your Baby A Guide for Breastfeeding Families" handout.
• Dr. Helen Ball
• Dr. James McKenna
• Academy of Breastfeeding Medicine Protocol # 6
• Safe to Sleep
• Accessing Safe Sleep Photos for Your Use to Help Families Reduce Unsafe Sleep Environments

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