The latest AAP safe sleep guidelines!
On June 21 2022 the American Academy of Pediatrics (AAP) had revised its recommendations for safe sleep. OK, let’s be honest, you're too busy raising babies to have noticed, unless you work in a child-related field. You also might wonder why a Canadian would be blogging about this. Honestly, these recommendations will make their way across the border, it’s just a matter of time. As a Certified Sleep Consultant, I follow the AAP safe sleep guidelines as well as Health Canada’s/Canadian Pediatric Society’s.
Here are the 4 biggest changes that will affect how you practice safe sleep for your baby:
1) Weighted Sleep Sacks
These are sleep sacks which have a lightly weighted pocket that is located on the baby’s chest to simulate the loving touch of a parent’s hand or where weight is distributed throughout the sleep sack. I personally never used these with my two boys, but friends and colleagues said they can perform miracles. The previous AAP guidelines allowed a maximum weight of 10% of a baby’s weight to be allowed in one of these wearable blankets. Now the recommendation is to not use them at all.
What’s the potential risk?
The added weight could make it difficult for a baby who can roll onto their stomach to roll back over onto their back if they need to and this can increase the risk of suffocation. Also, if a baby had a cold, the weight could potentially prevent the deep breaths necessary to prevent that from developing into pneumonia.
2) Sleep Tents
These are tents that you place over your playpen to promote a dark sleep environment. These are perfect for travelling to ensure a nice dark sleep area for your baby.
What’s the potential risk?
There is a connection between Sudden Infant Death Syndrome (SIDS) and a baby overheating during sleep. These tents are used on summer vacations in hot climates, and even though you can place a fan near the tent, it could be challenging to monitor the inside temperature. They do have some airflow depending on the brand but the more breathable the fabric, the more light gets in. Some have a pocket inside for a baby monitor but not all monitors work inside that pocket. My baby monitor has a temperature gauge, but it is notorious for being off by a couple degrees.
3) Maximum 10-degree Incline
Any safe sleep surface can have a maximum of a 10-degree incline. Therefore, unsafe sleep surfaces would include any inclined rockers, swings, bouncers designed and marketed for sleep.
What’s the potential risk?
Babies have died from rolling over in these and not being able to roll themselves back to a safe breathing position. Also, babies’ heads are huge compared to their bodies and there is a concern of suffocation when a baby’s head falls forward. Now I did use an inclined rocker with my first boy, and it was amazing. Thankfully he was never injured when we used it, but I remember being quite upset when a recall came out in 2019 and I had to dispose of it. So, if your baby suffers from reflux and you need to elevate their bassinet or crib mattress, 10-degrees is the maximum for safe sleep. This should be adequate to help relieve symptoms and still promote a safe sleep surface.
4) Families should not rely on Home Cardiorespiratory Monitoring Devices
These devices are either blankets, socks, or diaper clips. They monitor your baby, and alarm if their heartrate or oxygen level falls below a specific level.
What the potential risk?
These products fall under a “wellness” category for infant product safety and therefore do not have the same quality assurance that actual medical devices must adhere to. The AAP worries that this will give parents false reassurance that their baby is safe and not monitor them in the same way they would without the device. Some parents actually expressed increased anxiety when using these devices as opposed to decreased anxiety. It is normal for newborns to have occasional, short periods of apnea (they stop breathing) and there is no evidence that these episodes are related to SIDS according to the AAP.
Bottom line is that 3400 babies still die of SIDS a year in the USA and 150 in Canada every year. The “Back to Sleep” campaign from 1994 reduced SIDS deaths by 50% in the USA. That is a potential 3400 lives saved from making small adjustments to how we put our babies to bed. You may recall a recent study that claimed they have found the cause of SIDS. Babies who died of SIDS had low levels of an enzyme called BChE that is important in the brain’s arousal pathway. This made it difficult for these babies to wake up when they were in a vulnerable state. SIDS, just like many other health concerns, is probably caused by multiple different factors. If a baby has low levels of this enzyme, is overheated in a sleep tent, at a 25-degree incline, under a weighted blanket, and their home heart monitor isn’t going off because it isn’t calibrated to a medical device, this leaves them at great risk of breathing difficulties! This is an extreme example, but you see where I am going with this.
I want to make clear that I commend the inventors of these products for their ingenuity. All these companies saw an infant sleep issue and used creativity to fix a problem. I hope these companies can pivot, work within the AAP guidelines as well as the Consumer Product Safety Committee (CPSC) to make small changes to their products and everyone wins. Until then, as a Sleep Consultant and a mom, I must follow the new AAP recommendations and suggest my clients not use them!
References:
https://www.cdc.gov/sids/data.htm
https://www.babysbreathcanada.ca/what-is-sids-sudc-stillbirth/what-every-sids-parent-should-know/
For more tips on drifting off to sleep visit my website at www.driftsleep.ca Kyla Lucas is a Certified Sleep Consultant, a Registered Nurse and a mom who resides in Tsawwassen, BC. Making sleep a Breeze. Drift Sleep Consulting. Everything you need to know about Infant and Toddler Sleep.