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You are probably surprised by some of the advice that you get when you walk into your Pediatrician's office, but how are you going to react if your Pediatrician actually tells you that you should be giving your baby a pacifier at bedtime during your baby's next visit?
With the latest American Academy of Pediatric's recommendations about reducing the risk of SIDS reporting a protective role for pacifiers, you may find that your Pediatrician actually encourages you to give your baby a pacifier when you put him to sleep.
This may sound a little controversial to those who feel that a pacifier may interfere with breastfeeding, but not introducing the pacifier until your baby is at least a month old, when breastfeeding is often well established and before babies are really at risk for SIDS, should minimize any problems. You shouldn't force the pacifier on your baby though and don't put it back in his mouth once he falls asleep.
Cosleeping and SIDS
Another new recommendation, this one against cosleeping or bedsharing is also likely to be controversial. The AAP now makes a strong statement that infants should sleep in a 'separate but proximate sleeping environment,' such as a crib, cradle, or bassinet near your own bed.
Although a side-sleeper type crib might seem like a nice middle ground to having your baby sleep with alone in a crib or sleeping with you in your own bed, the AAP points out that 'safety standards have not yet been established by the Consumer Product Safety Commission' for these types of baby beds. That makes it hard to find a safe one.
Side Sleeping
The last 'new' recommendation in the AAP SIDS policy statement shouldn't be as controversial as the other ones. While experts have recommended that babies sleep on their back to reduce their risk of SIDS, side sleeping was also thought to be okay.
The AAP now advises that side sleeping is not as safe as back sleeping, especially since babies often roll over onto their stomachs, and that babies should always be put to sleep on their backs.
Reducing the Risk of SIDS
Other recommendations concerning reducing a baby's risk of SIDS from the AAP's new policy statement and a related press release include:
- Back to sleep: Infants should be placed for sleep in a supine (wholly on back position) for every sleep.
- Use a firm sleep surface: A firm crib mattress, covered by a sheet, is the recommended sleeping surface.
- Keep soft objects and loose bedding out of the crib: Pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects should be kept out of an infant's sleeping environment.
- Do not smoke during pregnancy: Also avoiding an infant's exposure to second-hand smoke is advisable for numerous reasons in addition to SIDS risk.
- A separate but proximate sleeping environment is recommended such as a separate crib in the parent's bedroom. Bed sharing during sleep is not recommended.
- Consider offering a pacifier at nap time and bedtime: The pacifier should be used when placing infant down for sleep and not be reinserted once the infant falls asleep.
- Avoid overheating: The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult.
- Avoid commercial devices marketed to reduce the risk of SIDS: Although various devices have been developed to maintain sleep position or reduce the risk of rebreathing, none have been tested sufficiently to show efficacy or safety.
- Do not use home monitors as a strategy to reduce the risk of SIDS: There is no evidence that use of such home monitors decreases the risk of SIDS.
- Avoid development of positional plagiocephaly (flat back of head): Encourage "tummy time." Avoid having the infant spend excessive time in car-seat carriers and "bouncers." Place the infant to sleep with the head to one side for a week and then changing to the other.
- Assure that others caring for the infant (child care provider, relative, friend, babysitter) are aware of these recommendations.
That last recommendation is very important, as many of these recommendations have changed in recent years, so an older caregiver may be unaware of how important they are.
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