Injury Prevention

Safe Sleep Practices Protect Babies

By: Amy Watkins, MPH

Safe sleep environments are critical to protect babies from harm. Each year in the United States, approximately 3,500 infants die unexpectedly during sleep. This can happen from accidental suffocation, sudden infant death syndrome (SIDS) or unknown causes. Connecticut Children’s recently teamed up with U.S. Senator Richard Blumenthal to remind parents and caregivers of proactive steps they can take to keep babies safe during sleep.

Hazards Posed by Infant Rockers and Other Products

The U.S. Consumer Product Safety Commission (CPSC) and Fisher Price are alerting consumers to at least 13 reported deaths between 2009 and 2021 of infants in Fisher Price Infant-to-Toddler Rockers and Newborn-to-Toddler Rockers. Additionally, Fisher Price’s Rock ‘n Play Sleeper has been linked to eight more infant deaths since it’s recall in 2019, and overall has been linked to over 100 deaths.

Parents and caregivers should never use inclined products such as rockers, gliders, car seats, soothers, and swings for infant sleep and should not leave infants in these products unsupervised, unrestrained, or with bedding material, due to the risk of suffocation. Rockers are toys meant for entertaining children. They are not designed for safe sleep.

The CPSC advises that sleep products that incline more than 10 degrees are not safe. A baby’s head is heavy and their necks are not strong enough to adequately hold it up. When a baby is seated, its head can fall forward and cause difficulty breathing or even suffocation. That’s why rockers and even car seats (outside of moving cars) are not safe for naps or overnight sleep during the first year of life. This same risk holds true for babies in upright strollers and baby swings.

If a baby dozes off in a rocker, car seat, or other sitting device, be sure to move them to a crib or other flat, firm sleeping surface as soon as is safe and practical.

The Importance of Providing a Safe Sleep Environment

Although there’s no guaranteed way to prevent SIDS, research tells us that a safe sleep environment can help reduce a baby’s risk of SIDS. To prevent unintentional suffocation and strangulation in bed, the American Academy of Pediatrics (AAP) recommends that all infants sleep on flat and firm surfaces. Babies should sleep by themselves, without any bumpers, soft bedding, pillows or stuffed toys. 

Additionally, the AAP recommends that babies be put to sleep on their backs. The problem with the side position is that a baby can roll more easily onto its stomach. A baby’s airway anatomy and their gag reflex will keep them from choking while sleeping on their back. Even babies with gastroesophageal reflux disease should sleep flat on their backs.

Once babies can roll over on their own, which usually happens around age 4 to 7 months, they are able to choose their own sleep position and often don’t stay on their backs all night. At that point, it is safe to let babies pick a sleep position on their own. However, it is still recommended that infants be placed for sleep on their back for every sleep by every caregiver until the child reaches 1 year of age.

To maintain a safe sleep environment, remember these tips:

  • Place infants on their backs in their own sleep space with no other people. 
  • Use a crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet. Soft, plush sleep surfaces are dangerous due to the risk of suffocation.
  • Avoid putting a baby to sleep on a couch or armchair, or in a seating device like a rocker, swing or car seat (except when riding in a car). Infants who fall asleep in an inclined or upright position should be moved to a safe sleep environment as soon as possible.
  • Keep loose blankets, pillows, stuffed toys, bumpers and other soft items out of the sleep space. 
  • Finally, talk with your pediatrician if you have any questions or concerns about the safety of your baby’s sleep environment.

Amy Watkins, MPH, is the director of Safe Kids Connecticut, which is a program of Connecticut Children’s Injury Prevention Center.

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