1. Safe Sleep for Newborns
Rocky Mountain Children’s Health Foundation
Mary Kohn, MD
May 13, 2019

2. Goal of this lecture is to empower new parents with tools to avoid unexpected infant death

3. S.I.D.S. V. S.U.I.D.S.

4. Two Types of Infant Death during Sleep in babies under 1 year of age
S.I.D.S
“Sudden Infant Death Syndrome”
Also known as “Crib Death”
SIDS is the unexplained and quiet death of an otherwise health newborn, usually during sleep
S.U.I.D.
“Sudden Unexpected Infant Death”
This refers to accidental, sleep-related deaths in otherwise healthy newborns.
Most commonly, smothering or entrapment

5. Both SIDS & SUIDS are parents’ worst nightmares
But, there are things that you can do to prevent them

6. What is SIDS? Baby is put to bed and dies quietly in her sleep.
Otherwise healthy infant
Peaks between 1 and 4 months of age
90% occur in first 6 months of life
More common in infants exposed to cigarette smoke before and after birth
More common in premature babies and babies who are very small at birth
No evidence of illness or smothering on post-mortem exam

7. What causes SIDS? Unknown Many hypotheses over the years:
Not the cat’s fault!
Not smothering
Not caused by reflux or aspiration
Does not seem to be caused by infection
Does not seem related to heart disease

8. Current thinking is that it is associated with immaturity of arousal function of baby’s brain

9. What is SUIDS?
These are deaths that are caused by accidents related to sleep.
Smothering
Entrapment
Choking

10. Data Nearly 4 million babies born in U.S. in 2018
3500 babies under one year of age died of SIDS or SUIDS
Chances of any baby dying of either is 8 per 10,000
Not common but tragic
Often preventable

12. Prevention STRATEGIES
SIDS & SUIDS
Different causes but same prevention strategies

13. Prevention Strategies
Breast feeding
Sleep position
Sleep surface
Sleep location
Bedding
Pacifier
Smoking & alcohol
Overheating
Fans, ventilation
Immunizations
Commercial devices
Home monitors
Swaddling

14. Breast Feeding
Breast-fed babies are more easily awakened

15. Position Back-To-Sleep Campaign by NIH in 1992
“Safe to Sleep” is current program

16. Note that decline in SIDS deaths corresponds to change in recommendation for Back to Sleep

17. Sleep surface should be a firm mattress

18. Location
Same room
Separate surface
6-12 months

19. Various options

20. Baby Box
Inexpensive alternative

21. Bedding Use fitted crib sheet of appropriate size
Avoid “soft stuff in crib”
Pillows
Stuffed toys
Bumper pads
No loose blankets
Beware of cords, curtains that are close by

22. Decorating ideas from Pinterest

23. Khloe Kardashian’s Baby Nursery

24. Pacifiers Have been shown to decrease the likelihood of SIDS
May be due to increased arousal- baby is not as deeply asleep
If it falls out of baby’s mouth, don’t replace it, still protective
Don’t start until breast feeding is well-established

25. Cigarette smoking Major risk factor before and after birth
Exposure to tobacco smoke decreases arousal
Causes babies to be smaller, also a risk factor for SIDA
Second-hand smoke is also a risk
It is estimated that one-third of SIDS deaths could be prevented if all maternal smoking during pregnancy was eliminated.

26. Overheating Rule of thumb:
Baby only needs one more layer of clothing than an adult in the room needs

27. Won’t baby get cold?
Swaddle
Sleep Sack
Footie pajamas

28. Please keep these guidelines in mind when evaluating products
Not all products marketed for newborns are truly safe or necessary

29. Baby monitors are not advised- not effective and lots of “false alarms”

30. Rock and Play Sleeper Made by Fischer Price
Soft-sided sling that rocks baby to sleep
Recalled on April 11, 2019 by Consumer Products Safely Division
32 deaths have been associated with the product
Babies rolled over while unrestrained and were unable to breathe due to their position

31. Snoo Sleeper- based upon AAP recommendations but check the price!

32. Following the AAP guidelines is the best way to protect your newborn from both SIDS and accidental sleep- related death.