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Infant sleep safety: Can gadgets or certain sleep habits help?

The American Academy of Pediatrics recently updated its guidelines on infant sleep safety, but didn't elaborate on the effectiveness of gadgets and other sleep habits. Here's what you need to know here.

The American Academy of Pediatrics recently updated its guidelines on infant sleep safety. These guidelines are based on new evidence obtained from studies of sleeping habits of infants and the risk of Sudden Unexplained Infant Death.

So now parents have information on which habits are safe and which are not. This leaves a few devices, gadgets, and sleep habits that have no clear recommendations and send competing or confusing messages to new parents. I will offer my thoughts on these, but first let me review why all this is important.

What causes SUID in bed? There are three situations:

1. Suffocation from parent rolling over or from bedding also called Accidental Suffocation and Strangulation in Bed.

2. Sudden Infant Death Syndrome, in which the death is investigated fully and no cause is found during the first year of life. This usually occurs in the first four months and thought to be related to a possible genetic or prematurity related defect in the ability of the brain to stimulate breathing in the face of low oxygen and high carbon dioxide. This accounted for 44 percent of SUID cases in 2014, according to the Centers for Disease Control and Prevention. The other two causes are almost evenly split after this.

3. Unexplained causes. The investigation is not full and no cause is found.

We have known for several years that these habits protect babies:

  1. sleeping on the back

  2. avoiding loose clothing and bedding

  3. using a firm mattress with fitted sheets

  4. sleeping in a separate crib (not co-sleeping with parent)

  5. using pacifier at night

  6. avoiding exposure to tobacco

  7. alcohol and drugs

  8. breastfeeding

  9. receiving immunizations

The new guidelines build on this list of protective sleep habits. They found sleeping in a separate crib, but in the same room as parents for the first six months, preferably for the first year of life is also protective.

Now there are other devices, gadgets, and sleep habits that may leave parents confused about their effectiveness. Here are my thoughts on them:

1. Baby monitors and cameras: These are not useful due to the fact the sleeping in the same room has been shown to be superior and safer. They also often fail, disconnect and give false alarms.

2. Baby heart or breathing monitors: These are extremely problematic and should never be used without medical supervision for a specific medical conditions. They cause anxiety due to false alarms, send the wrong message that a baby is likely to stop breathing, and are notoriously unreliable

3. Devices that claim that they prevent SIDS. These are false claims as no device has been proven to do just that.

4. Sleeping in car seats is problematic as the position promotes spit up and possible choking from milk coming up.

5. Wedges and positioners that claim to keep babies in a safe sleep positon (on the back). These are not proven to help prevent SIDS. They may fail, leaving the baby in a precarious position. They also may keep the head in such a fixed position that leads to flattening of the skull on the sides, a condition known as plagiocephaly.

6. Swaddling is a common practice in hospital nurseries and parents may think it is recommended for sleep safety. I think it is fine for the first month as long the swaddle is not too tight to prevent hip and chest movement. In older infants, swaddling may be less helpful and even dangerous as it may prevent them from recovering their position after rolling over. It certainly should not be used in any baby known to be able to roll over.

7. Internet connected devices: Never use these. You do not want your baby to be hacked!

My final recommendation is to concentrate on habits shown to prevent SIDS and not focus on devices or gadgets not proven to do so. It is the baby sensible thing to do!

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