How to Create a Safe Sleep environment For your baby American Academy of Pediatrics Recommendations

American Academy of Pediatrics What you can do Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bedtime Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID Many infant die during sleep from unsafe sleep environments. The American Academy of Pediatrics recommends ways to Reduce the Risk of babies dying during sleep. We are going to look at each of these recommendations.

How should babies be placed to sleep during nap and night time? Stomach Side Back QUESTION

Babies should always be placed on their BACKS to sleep. ANSWER Babies up to one year of age should always be placed on their backs to sleep at nap time or night time. However, if your baby rolls from his back to his side or stomach on his own, he can be left in that position.

What if my baby chokes while sleeping on his back?

Back sleeping is best Back Sleeping Stomach Sleeping Stomach sleeping: the tube that the food goes down is above the windpipe so when the baby spits up, the food will go into the windpipe and the baby could choke. Back sleeping: the tube the food goes down is below the windpipe. If the baby spits up, then the food will stay below the windpipe and the baby will not choke. Back Sleeping Stomach Sleeping

What if my baby gets a flat head from being on his back all of the time?

Supervised Tummy Time Supervised, awake tummy time is recommended to help with development and minimize the occurrence of a flat head Supervised awake time spent on the belly can help your baby develop strong head, neck and shoulder muscles and promote certain motor skills The more time baby spends on supervised tummy time, the quicker he/she may crawl and roll over Start placing baby across lap 2-3 times daily for a few minutes. At 3-4 months up to 20 minutes a couple times daily.

What you can do Place your baby to sleep on a flat, firm sleep surface Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bedtime Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Always place your baby on a flat, firm surface to sleep A firm mattress with a fitted sheet Cribs, pack-n- plays and bassinets should conform to Consumer Product Safety Standards (cpsc.gov) Cribs with missing hardware should not be used. Use mattresses designed for that product; no gaps Do not use blankets or pillows between the mattress and the fitted sheet. Never put the baby to sleep on a couch, chair, water bed, cushion or sheepskin.

Not approved for sleeping These are NOT flat, firm sleep surfaces. Babies neck and back muscles are still developing and are not able to stay erect in a way that would allow their air passage to be open. That is why a flat, firm sleep surface is the best.

What you can do Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bedtime Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Which crib would be considered a safe sleep environment for a baby to sleep? Crib B? Crib A?

Answer: Crib B is the safest sleep environment for a baby. Pillows, quilts, comforters, bumper pads, stuffed toys and blankets can cause your baby to suffocate. The American Academy of Pediatrics (AAP) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) have found ways to help babies get the sleep that they need safely. Things we need to do to make sure that babies are sleeping safely and comfortably: Always place a baby on his/her back to sleep for naps and at night Use a firm sleep surface that is safety-approved with a fitted sheet (crib/bassinet/pack n’ play/portable crib) Your baby shouldn’t sleep in an adult bed, on a couch/chair, in a car seat or carrier swing and not with you or anyone else Keep soft objects and loose bedding out of your baby’s sleep area (bumpers/pillows/toys/blankets)

True or false? Babies should have their own separate sleep space?

ANSWER: True Babies need to have their own separate sleep space. Room sharing NOT bed sharing... The baby can sleep in the same room, but not in the same bed. Provide a separate sleep space for the baby (crib, bassinet or play pen) Keep the crib or bassinet within an arm’s reach of your bed. You can easily watch or breastfeed your baby by having him nearby. Babies who sleep in the same bed as their parents are at risk of dying of Sudden Unexpected Infant Death, suffocation or strangulation. Parents can roll onto their babies or their babies can roll into the parents or get tangled in the sheets or blankets.

Rethink your sleep position

What you can do Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let you baby get too hot Use a pacifier at nap time and bed time Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Keep your baby away from cigarette smoke. Smoking exposes the baby to harmful chemicals that can have a negative lifelong impact. If you smoke…try to quit (1-800-QuitNow). Keep your car and home smoke-free. This includes vaps. Don’t smoke or let anyone smoke inside your home or car and don’t smoke anywhere near your baby, even if you are outside.

Effects of tobacco exposure on an infant Reduce Exposure Prematurity Low birth weight Under-developed lungs Addiction Behavioral Reduce Exposure Limit number of cigarettes per day Timing breast feeding Smoking away from infant Avoid 3rd hand smoke Withdrawal symptoms (fussy, shaking, irritability, sleep problems), formula fed vs. breastfed (colic, feeding issues, failure to thrive, etc.). Mom isn’t always able to quit…let’s reduce the effects by reducing the exposure.

What is second hand smoke?

second hand smoke Combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. Contains 7,000 chemicals (70 cancer causing). This is just as harmful

Third Hand Smoke This consists of pollutants that remain on surfaces and in dust after tobacco has been smoked Third hand smoke can be found on your hair or clothes when you go outside to smoke. It can be found anywhere someone has smoked…on car seats in the car, toys, your hair and clothes, etc.

What you can do Do not let your baby get too hot Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bed time Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Don’t let your baby overheat Do not overdress your baby Avoid over bundling and covering of the face and head Dress baby in no more than 1 layer more than an adult would wear to be comfortable Always check on your baby for signs of overheating

Use a “wearable” Blanket Sleep Sacks or wearable blankets should be used rather than blankets Be sure to check on the baby to avoid over-heating Keep the room where your baby sleeps at a comfortable temperature. NEVER put a fan or heater in the baby’s bed!

What you can do Use a pacifier at nap time and bed time Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bed time Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Consider a Pacifier Studies have reported a protective effect of pacifiers on the incidence of SIDS Never coat the pacifier with anything sweet. Don’t use a string or anything else to attach a pacifier around your baby’s neck or clothing If breastfed, wait 3-4 weeks of age until breastfeeding is fully established

What you can do Schedule and go to all well child visits Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let you baby get too hot Use a pacifier at nap time and bed time Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Schedule and Go to all well-child visits There is NO evidence of any causal link between immunizations and infant death Recent studies suggest that immunizations may have a protective effect against infant deaths Talk to your health care provider Visit healthychildren.org to get more information on immunizations as well as an immunization schedule

What you can do Place your baby to sleep on his/her back for every sleep Place your baby to sleep on a flat, firm sleep surface Keep soft objects, loose bedding, blankets and other objects that could increase the risk of entrapment, suffocation or strangulation out of the crib Place your baby to sleep in the same room where you sleep, but not the same bed Keep your baby away from smokers and places where people smoke Do not let your baby get too hot Use a pacifier at nap time and bed time Schedule and go to all well child visits Do not use products that claim to reduce the risk of SIDS/SUID

Do not use products that claim to reduce the risk of infant death These include wedges, positioners, special mattresses and special sleep surfaces Manufacturers should not claim a product protects against SIDS unless there is scientific evidence to prove it

Electronic Monitors Do not rely on equipment that claims to reduce the risk of SIDS Encourage your clients to always check on their baby.

BUYER BEWARE! Dockatot Babocush Snuggle Me Organic

Remember your ABC’s Baby should sleep… Alone, on his/her Back, in a Crib with the Dangers Eliminated No pillows No blankets No bumper pads No stuffed animals No toys No clutter No cords No smoking

The Central Oklahoma Fetal and Infant Mortality Review (FIMR) Project is funded through the Oklahoma State Health Department, Maternal and Child Health Service, Title V.