Safe Sleep Practices

safe_sleep_babyI was recently interviewed by channel 8 KGW( ) due to a ban in Minnesota that prohibits swaddling in day cares.  The real issue is this:

1.  If your baby spends most of the 24 hours swaddled very tightly with the legs forced straight – this can be bad for hip development.

2.  If your swaddled baby ends up face down on a soft mattress, there may be an increased risk of SIDS (Sudden Infant Death Syndrome). 

We have known since the 1990’s that putting babies to sleep on their backs reduces the SIDS risk by at least 30%.  Just imagine putting you newborn face-down on a bean bag (parents please don’t try this at home). Clearly, suffocation is a real danger.  This is the reason for the recommendation that infant mattresses be firm and that babies be put down on their backs.

A study published in the BMJ (British Medical Journal) in 2009 had important findings related to SIDS:

  – Twice as many died while co-sleeping (note however that most of the co-sleeping deaths were also associated with parents who had used drugs or alcohol or were co-sleeping on a couch).

   – 20% who died used a pillow (compared to 3% who didn’t use a pillow).

   – 60% of SIDS mom’s smoked (compared to 14% who did not).

   – 26% of SIDS was in premature infants (compared to 5% who were not).

   – 28% were in poor health at the time of SIDS (compared to 6% who were healthy at the time).

   – 29% of the SIDS infants were found prone (sleeping on their tummy face down) compared to 10% who were on their backs.


The message should be this:  
Place your newborn and infant on a firm surface (mattress) on their back.  If you co-sleep, don’t do so on a couch, don’t drink or use drugs. Provide a firm surface and a mechanism so you, the parent, cannot roll onto your baby in their sleep.  Do not smoke in the home. Babies and infants should not use a pillow.  And be especially careful with premature infants and those that are ill.

Full details of this study can be read at:

For guidelines on Safe Sleep Practices and SIDS / Suffocation Risk Reduction, refer to the detailed report sponsored by the Academy of Pediatrics and The American Public Health Association in conjunction with National Resource Center for Health and Safety in Child Care and Early Education University of Colorado, College of Nursing


Dr. Paul


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