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Healthy
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Safe Sleeping for Infants
The babies are sleeping, is it time to relax? Maybe not yet, at least not until you have considered just how safe the sleeping area is. Safety must always be a top priority for parents and childcare staff when working with infants. Recent studies reveal that many items commonly used with babies, which have never before been thought of as being hazardous, can actually be quite dangerous.
Crib Hazzards
The crib can have several hazards, including crib design, bedding, toys, and positioning of the infant. There have been deaths that were caused by infants being strangled by fitted crib sheets. Some fitted sheets will shrink after washing and this shrinkage causes the sheet to be too small for the mattress. The sheet can then become loose enough that infants can pull it up and strangle themselves. Children as young as seven months may have the ability to pull up a sheet and get tangled in it, but may not be able to untangle themselves, resulting in suffocation.
Approximately 50 babies a year suffocate or strangle when they become trapped between broken crib parts or when using older cribs with unsafe designs. The Consumer Product Safety Commission (CPSC) has established regulations and guidelines for the safety of both full size and non-full-sized cribs, including requirements for spacing of the slats. Cribs, including portable cribs, may have defects which can cause injury or death.
When checking your crib for safety, the following guidelines set forth by CPSC should be considered:
- The crib should have a certification seal showing that it meets the national safety standards.
- There should be no loose, broken, or protruding brackets, screws, or other hardware. If you must repair a crib, be sure to use hardware (screws, bolts, etc.) that matches the original hardware. Do not place extra hardware on a crib.
- There should be no more than 2 3/8 inches between crib slats so that a baby's body cannot fit through.
- Corner posts should not protrude more than 1/16 inch above the end panels. If posts protrude higher than this, an infant's clothing can catch on the post and cause strangulation.
- Beds should not have cutout areas or carved wood or plastic on the headboard or footboard. An infant can stand in the crib, place their head or neck over these carvings or in the cutout, and become strangled by the entrapment.
- Choose a firm, snug-fitting mattress so that a baby cannot get trapped between the slats and the mattress.
- Check for cracked or peeling paint.
- Check wood for splinters or rough edges.
Sleep Positions
Positioning sleeping infants also is a very important consideration when planning babies' safety. Through the years, many people were taught to place babies on their stomachs. However, the American Academy of Pediatrics began a Back to Sleep campaign in 1992 which advocates placing healthy infants on their backs while sleeping in order to reduce the number of cases of Sudden Infant Death Syndrome (SIDS).
The sleeping position is crucial because babies are weak and have very weak lungs. When a baby is placed on his stomach for sleeping, he may get his face mashed into the mattress or bedding. If this happens the breathing passage can become blocked. Sleeping on their backs allows the nose and mouth to be uncovered. Since this campaign began in 1992, the number of SIDS deaths decreased by 50 percent.
There are some special exceptions to this rule of placing infants on their backs. The exceptions to this sleeping "rule" are for infants with certain medical conditions or malformations which can mean they should be placed on their side or stomach.
Bedding and Toys
Not only is the positioning important, the type of bedding used in the crib is also crucial. Mattresses need to be firm and flat. All fluffy pillows, quilts, comforters, and stuffed animals need to be removed.
Another consideration for infants' safety are the crib gyms or mobiles that are stretched across the crib. The CPSC has reports of strangulation when babies have been entangled in the cords used to attach these mobiles or crib gyms. If these items are used on a crib, they should be installed securely over the crib so they can not be pulled down. These items should be out of reach of children and should not have points that could catch clothing. When the child is old enough to push up on his hands and knees (about five months old), these toys should be removed from the crib.
Other Dangers
The strangulation danger also exists if cribs are placed close to windows with mini-blinds cords or drapery cords dangling. Such cords should be fastened securely out of the child's reach, even those cords which are not near the crib.
Other dangers may exist involving items used to help quiet and soothe infants. Pacifiers should never be tied to cords or hung around an infant's neck. Propping bottles can lead to choking. Research also indicates sleeping with bottles containing milk, juice, or other sugary fluids can cause tooth decay as the sugar stays in the child's mouth.
Be aware that the sleeping area is not always the cozy spot caregivers hope it is. Having appropriate information allows childcare programs to investigate the various items chosen for sleeping area, and helps promote children's safety.
Amy S. Hood, EdD, Infant and Toddler Specialist, Training and Technical Assistance Services, Western Kentucky University
Resources
The Consumer Product Safety Commission (CPSC) has available a complete list of recalls on products as well as general safety information. 800-638-2772; www.cpsc.gov.
Internet Resources
American Academy of Pediatrics, www.aap.org/family/inffurn.htm
Back to Sleep Campaign, www.nichd.nih.gov/sids
Kids in Danger, www.kidsindanger.com
National Safety Council, www.nsc.org/library/facts/cribtips.htm
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