• Adrienne Fenton

How to set up a safe sleep environment for your Newborn

There is so much to learn about life with a new baby and The Night Shift understands that sleeping is one of the areas that you want to get right. Having a safe, cosy sleeping environment for your Newborn also allows the rest of the family to rest easy. Part of being a parent is worrying that your baby is safe…. 24/7. So, with this in mind, lets unpack the top 5 ways to keep your baby safe when they’re sleeping.

Safe Sleep tips to keep your baby safe while they sleep[1]

Sleep your baby on their back

· Avoid sleep wedges and other positioning devices as they may cause baby to roll to their tummy.

· Once Baby can roll, remove their arms from their swaddle and practice rolling in both directions with Baby during the day.

Keep your baby’s face uncovered from blankets, toys and objects

· Remove any loose blankets from the cot and use a sleeping bag wherever possible.

· Ensure any bedding is tucked in firmly at the bottom and sides.

· It is recommended that babies are not offered a cuddly until over 6 months old. Ensure it is made from breathable fabric and no bigger than a handkerchief.

Keep the bedroom and preferably the whole house smoke free

· Babies exposed to smoke during pregnancy and after birth have a significantly higher risk of SUDI. This risk remains even if people smoke outside.

· Ensure baby does not sleep in a smoker’s bed.

Place the cot, bassinet or Pepi Pod in a safe environment

· Provide baby with their own cot/bassinet/pepi pod.

· Ensure the mattress is clean and firm.

· Avoid cot bumpers, toys or other accessories in the cot.

· Ensure baby doesn’t have too many layers on to reduce overheating. WHO recommends a bedroom is between 16-20 degrees.

Breastfeed baby if you can

· Breastfeeding lowers their arousal threshold meaning they wake easier and more frequently

In New Zealand we use the acronym PEPE to remember the 4 key principles of Safe Sleep.

P - Place baby in their own baby bed

For the first 6-12 months it is recommended that baby shares a room with their caregiver. The baby’s bed should be close to the caregiver’s bed but on a separate surface designed for infants eg cot/bassinet/Pepi Pod. Room sharing decreases the risk of SUDI by 50%[2].

Baby’s mattress should be clean and firm so that it maintains its shape while baby is sleeping. Softer mattresses could create an indentation and this increases the chance of suffocation especially if baby rolls to their tummy.

The mattress can be covered with a sheet to allow it to be cleaned regularly. Keep other soft materials such as sheepskins, pillows, cuddlies out of the bed until baby is at least 6 months old. Any blankets used should be tucked in snugly at the sides and feet so baby can’t grab at them. Sleeping bags are even better!

E - Eliminate smoking

Protect baby during pregnancy and at home by making your home and car smokefree. If anyone at your family home is smoking, ask them to smoke outside and wash their hands and face before returning inside. Air the house completely whenever possible, even in the middle of winter.

Smokefree NZ offer quit services to support you on your journey to quitting smoking. They can work with you to create a Quit Plan and provide information on the benefits for you and your family.

P - Position baby flat on their back to sleep

Babies who sleep on their tummies have six times the risk of SUDI[3]. For this reason alone we want to ensure that baby is placed on their back anytime they sleep. This ensures their face is clear and their airways are unobstructed.

Once baby can roll “back to tummy” remove their arms from inside their swaddle/sleeping bag so they can use them to roll themselves to their back and/or lift their head/face off the mattress. Help baby learn how to roll in both directions by practicing with them during the day.

Generally, if baby can roll confidently in both directions they are strong enough that you don’t need to worry if they position themselves on their tummy for sleep. To ensure their sleep space remains safe, keep all toys, bumpers, blankets etc out of the cot/bassinet/Pepi Pod so baby can’t get tangled up while sleeping.

Wedges and other positioning devices can increase the likelihood of baby rolling to their tummy. Unless advised by a medical professional I recommend you keep the cot clear of these items.

It is unclear why, but studies have shown that sucking on a dummy/pacifier can decrease the chance of SUDI. This is true even if the dummy/pacifier falls out during sleeping. The same protective effect has not been demonstrated with finger/thumb sucking[4].

E - Encourage breastfeeding

Breastfed babies have a heightened arousal system and will generally wake more frequently. Breastfeeding for at least the first 2 months helps to reduce SUDI risk[5].

That said, it is so important to feed your baby the way you are comfortable feeding your baby! “Breast is best” is true. But “Fed is best” is just as true! Do your best to follow as many safe sleep guidelines as you can but do not beat yourself up about your choice or your circumstances surrounding how and what you feed your baby.

What is a Pepi Pod?

A Pepi Pod is a safe sleep space for babies when they are on an adult’s bed, on a couch or away from home. Pepi Pods are available on Trade Me or through your GP, Midwife, Plunket Nurse or Work & Income NZ.

Pepi Pods are designed to align with baby’s need for closeness. Ventilation slits allow for breathability and windows allow baby to see familiar faces and places.

What is Sudden Unexpected Death in Infancy (SUDI)?

In New Zealand, 40-60 babies die of Sudden Unexpected Death in Infancy every year[6]. SUDI is when no cause of death can be found. It also includes accidents during sleep such as suffocation.

SUDI is a mysterious process and there is a lot of research being studied to better understand the causes, and the ways to prevent it. What we do know is that there are 2 main risk groups

· Babies under 6 months old

· Babies who have external stressors eg tummy sleeping, loose blankets, smoking etc

The third component is infant vulnerability. Research shows that some babies are more vulnerable than others. Babies have an in-built arousal or “wake up” response that alerts them when their airway is blocked. In vulnerable babies, the response system is somehow compromised and they are not alerted when something is wrong. This means they do not arouse from sleep or otherwise respond to protect themselves. This explains why some babies die when placed in an unsafe sleep environment, and others, when placed in the same environment, do not[7]. There is no way to diagnose which baby is vulnerable and which isn’t. This means we have to assume that all babies are vulnerable and reduce their exposure to the risk factors within our control.

At The Night Shift, we take the safety of babies seriously and follow the practices of Plunket, Hapai Te Hauora and the American Academy of Paediatrics (AAP) safe sleep guidelines to ensure we are up to date on current research.

Now that you are armed with more information, you will be able to assess your baby’s sleeping environment to ensure that it is safe. If you would like further information, or a second set of eyes on your baby’s bedroom, all consultations with The Night Shift include a nursery assessment. Book a consultation with me here.

At The Night Shift we want to do everything we can to ensure your baby’s sleep environment is a safe place. It goes without saying that the first priority of any parent is ensuring their baby is safe and sound. The responsibility is on each and every one of us to keep our babies safe. And together with a little understanding, we can do just that.

#safesleep #sidssafe #safesleephabits #safesleeping #sidsandkids #rednoseday #sidstips #babysleepconsultant #babysleepnz #nzmumlife #nzmum #mumlifenz #dadlife #sleepcoaching #sleeptraining #babysleepenvironment #nursery #babysleepcoach #sleepsolutions #thenightshiftnz

[1] https://pediatrics.aappublications.org/content/138/5/e20162938 [2] https://pediatrics.aappublications.org/content/138/5/e20162938 [3] https://www.plunket.org.nz/caring-for-your-child/safe-sleep/sudi-sudden-infant-dealth/ [4] https://www.pediatrics.org/cgi/content/full/116/5/e716 [5] https://www.aappublications.org/news/2017/10/30/BreastfeedingSIDS103017 [6] https://www.plunket.org.nz/caring-for-your-child/safe-sleep/sudi-sudden-infant-dealth/ [7] https://pediatrics.aappublications.org/content/137/1/e20153665

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