New recommendations for the safe sleep of babies: flat beds and goodbye to co-sleeping

WASHINGTON (The Washington Post).— The new recommendations of the Academy of Pediatrics of the United States emphasize a handful of simple rules that parents can follow so that your kids sleep safe.

“If there is one thing we have learned, it is that the simpler the bettersays Rachel Moon, director of the group that wrote the guideline and a professor of pediatrics at the University of Virginia School of Medicine. “Babies should always sleep in a crib or bassinet, on their back, without stuffed animals, pillows, blankets, or any other bedding.”

Although those tips were already in the previous guide, published in 2016, now new guidelines recommend babies sleep on a flat surfaceno tilt, and also point out that preventive devices, such as SIDS (sudden infant death syndrome) monitors, are not helpful and should not be used to prevent death in sleep.

Perhaps the most alarming statistic that appears in the new guidance has to do with putting babies to sleep on armchairs and sofas, since it increases the chances of the child dying between 22 and 67 times, compared to putting them to sleep in their crib or bassinet

“And when feeding or lying with a baby on these types of surfaces, parents and caregivers need to be especially vigilant about falling asleep and staying wide awake,” says the new guidance.

All soft objects — including pillows, blankets, comforters, stuffed toys and even sheets — pose a risk of SIDS, suffocation and strangulation, the guide warns.

The new recommendations come as part of a series of measures by the United States Government to regulate products designed for baby sleep. Last week, the Consumer Product Safety Commission issued an alert on certain rocking chairs, after confirming 13 deaths since 2009. The agency’s commissioner highlighted the risk of babies sleeping on inclined surfaces. Although the rate of infant sleep deaths fell sharply in the 1990s—when pediatricians began recommending that babies always sleep on their backs—they’ve remained fairly stable ever since. About 3,500 sleep-related infant deaths are recorded each year in the United States.

In its report with the recommendations, the Pediatric Association acknowledges that its historical opposition to co-sleeping with infants has met with resistance from parents who practice it due to cultural preference, ease of breastfeeding, and other reasons. The Association “understands and respects these choices,” the report states.

“However, based on the evidence,” the report continues, “we cannot recommend co-sleeping under any circumstances”, and then recommends as an alternative that they sleep in the same room with their parents for the first six months of life.

For parents who still choose to share sleep with their baby, the guide points out three practices in particular that increase the risk to the child’s life by more than 10 times: co-sleeping when the parents’ speed of response is affected by extreme fatigue or medication, that the adult is a smoker, or sleeping with the baby on a soft surface, such as a sofa or air mattress. And hardly less risky is co-sleeping with a baby less than four months old, with a premature or low birth weight baby, or with any adult other than their parents.

While broadly in agreement with these recommendations, one SIDS expert says that such simple advice is difficult to convey the complexity and interaction of risk factors.

“The Pediatric Association has a virtually impossible task: sift through all the literature and studies on infant death in sleep and come up with a guideline of recommendations that parents can follow,” says Richard Goldstein, associate professor of pediatrics at Harvard Medical School and director of the Robert Sudden Death Program at Boston Children’s Hospital. “If one wants to convey a clear and direct message, he ends up saying that co-sleeping is absolutely dangerous in any circumstance.”

Goldstein cites studies published by British researchers at the University of Bristol showing that co-sleeping is primarily unsafe with babies born preterm, or if the father is a smoker, uses drugs, or has had more than two drinks of alcohol.

Among other recommendations, the guide suggests:

(Translation by Jaime Arrambide)

By Dan Hurley

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