Why Are Babies Not Supposed to Sleep in Car Seats
Some Babies Slumber Better in Car Seats and Swings, but Are They Safe?
Recent product recalls, and a new study, reaffirm the old advice: Infants should sleep flat on their backs in a crib.
This story was originally published on May 24, 2019 in NYT Parenting.
A new study published May 20 in the periodical Pediatrics highlights the risks of allowing babies to sleep for extended periods in rocking devices or car seats. If the thought of giving upward your babe swing or vibrating chair is daunting, I get it. My first child is now eleven. Although day-to-day memories of his first few months are fading, ane that remains fresh is his screaming. As an baby, he was often difficult to soothe. My wife or I would put him in his car seat: Cue the screams. Rocking chair? Screams. Crib? Tum time? Stroller? Guess. The one thing that worked was his baby swing. We would strap him in, turn on the motor that swung the cushioned seat dorsum and forth, and count on about xxx minutes of blissful silence while he snoozed.
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Safe sleep advocates, and pediatricians like me, have long been concerned almost the array of rocking or bouncing devices on the market that promise to calm crying infants. Only if y'all had told me, as the new father of a fussy three-month-old, that I needed to give up the swing, I'one thousand not sure what I would take done.
Yet, the real dangers associated with these devices cannot be ignored. Early final month, Fisher-Price recalled its pop Rock 'due north Play sleeper after multiple infant deaths in the device were reported. Just two weeks later, Kids Two recalled its similar rocking sleepers after 5 infants died.
Information technology is a heartbreaking situation. I of the earliest reports to the Consumer Product Safety Commission, from January 2018, reads as follows:
My 6-month-old son was put down for a nap in the Fisher Toll Rock n Play. During the time of his nap, he rolled over in the Rock Due north Play and silently died. The Rock N Play is sold as a sleeper and is marketed for "corking overnight slumber" . . . My son was a beautiful, healthy babe and only died because of the Rock N Play and the false sense of security they provide with their false and UNSAFE claims of the Stone N Play beingness used for safe slumber. The only place for safe slumber for an baby is a flat surface. This expiry trap needs to exist recalled and labeled equally a SUPERVISED PLAY Product then no other family has to lose their child like I have.
The authors of the Pediatrics study, led by Dr. Jeffrey Colvin, reviewed a registry of more than 10,000 infant deaths that occurred during sleep. Approximately iii pct of these deaths took identify in what the authors called "sitting devices": auto seats, swings, bouncers and strollers. The majority of the infants who died in "sitting devices" were between 1 and 4 months old, and the majority of the deaths were due to suffocation. Of the deaths that occurred in "sitting devices," over 60 percent occurred in car seats, 35 percent in swings and under v percent in strollers. While wrong harness use was the biggest risk cistron, other risk factors resembled those for SIDS: infants built-in prematurely or at a depression birth weight (less than 5.5 pounds) and secondhand smoke exposure. Deaths in "sitting devices" were also found to exist more likely when a caregiver was sleeping or distracted, and when someone other than a parent was watching the baby.
Nonetheless, for some parents, the baby in motility is the only infant who sleeps: either dorsum and forth in a swing or a parent's arms, or back and forth in a auto or stroller on an bumming cruise around town (God forbid y'all hit any traffic). That is why devices which promise (and sometimes deliver) a calm and sleepy baby with less parental exertion are so attracting. It's not a coincidence that nigh of the deaths occurred in the showtime few months of life, when babies are still waking up frequently and many parents are going back to work. What is an exhausted parent to do?
What does safe sleep look like?
The safest sleep environment for an babe is the most dull setting you can imagine: a apartment, empty crib, devoid of blankets, bumpers, cushions or even blimp animals. In a perfect world, you lot put your baby downwards on his back drowsy but awake, and he sleeps, nevertheless and sound, for long stretches at night, every bit well equally extended daytime naps.
When is information technology safety to have your kid sleep elsewhere?
Sometimes slumber on the move is inevitable, and most babies volition demand to fall sleep in a car seat or stroller from time to fourth dimension; the authors of the Pediatrics study took pains to reiterate the fact that car seats remain the safest way for babies to travel, and to note that most all of the car seat-related deaths occurred outside a motor vehicle. It's also of import to call up that deaths in these devices were relatively rare. Nevertheless there are a few rules of thumb to keep in heed.
First, babies in car seats, strollers and bouncers should be observed. Obviously, this is impractical if you are, say, driving a car, but you should never go out your child alone in a car seat. For devices like swings and rockers, y'all must be nearby and keeping an middle on your infant.
Second, rockers, bouncers and other such devices must exist used as their manufacturers recommend. Use whatsoever seatbelts or restraints that are included (some of the Rock 'n Play-linked deaths occurred when unrestrained infants rolled sideways and suffocated). Make sure your child is not besides big or besides modest for the device. Avoid any device that has an active recall, specially if your baby may fall asleep in it. Make certain y'all send in the warranty card when yous purchase a device and then yous can receive safety notifications. If you are using a secondhand device, you can bank check to encounter if there is an agile recall in the United States on the Consumer Product Safety Commission website. And remember that you should avoid using a secondhand car seat. The materials used in automobile seats may weaken over time, and if they have been in an accident, they may not function correctly.
Hither's the most important part: Once your child falls asleep in a swing or a machine seat (exterior of the car), you should transfer him to a crib or bassinet. As Dr. Colvin noted, "Merely like you would never let your infant travel in a car unless they were in a automobile seat, y'all should never let your baby sleep when exterior of the machine unless they are in a crib or bassinet."
Other Concerns
In my pediatric sleep clinic, overuse of swings and car seats to help babies fall comatose tends to upshot in frequent nighttime awakenings. Why is this? Everyone has natural awakenings during the nighttime. If your baby gets used to falling comatose in a swing and you lot transfer her to her crib once she is sound asleep, she is likely to need that swing to autumn back comatose whenever she has one of her natural nighttime awakenings. This condition is chosen inappropriate sleep onset clan. In practical terms, this means that, to get your infant to return to sleep, you lot volition demand to provide the same circumstances she needed to fall asleep at bedtime. (The treatment for this is sleep training.)
Another concern is that overuse of these devices can lead to flattening of the skull in some infants. Although this is generally benign, a helmet or other device may be necessary to resolve the issue — and most parents would prefer to avoid information technology in the first place. The American University of Pediatrics has some information on this hither.
What should you do if you are really struggling?
Poor infant sleep is often very stressful for parents and is associated with postpartum depression. Compounding parental exhaustion is the fact that parents in the United States have significantly less parental leave than parents in other industrialized nations, often returning to work before their babies are sleeping through the night. I suspect this is why adherence to the "Back to Sleep" recommendation for safe sleep plateaued in 2001. Although sudden infant death syndrome rates proceed to decline, a concurrent increase in the rate of suffocation and strangulation deaths has led to a plateau in the charge per unit of baby slumber-associated deaths since the late 1990s. These may be associated with the kind of unsafe sleep practices that are used by exhausted parents, ofttimes accidentally (such every bit falling asleep with the babe on a couch). Although it is difficult to study, there is some bear witness that increasing parental go out is associated with fewer babe deaths.
I spoke with Dr. Harvey Karp (author of "The Happiest Baby on the Block," which I relied on when my starting time son was crying all the time) about the challenges facing new parents. He noted that the safe slumber guidelines can only go so far when no provision is made for the sleep of wearied parents.
Dr. Karp developed the SNOO, a bassinet that uses move, sound and swaddling to calm crying babies. Unlike the Rock 'n Play or like devices, the SNOO meets the same safety requirements every bit a bassinet or crib and, in a recent study, was shown to be almost every bit constructive as parental attention in soothing crying infants. The cost of the SNOO puts information technology out of reach of most young families, but it is heartening to see more innovation in this space. We need to notice novel and condom ways to help exhausted parents to both sleep and keep their babies asleep. More generous family get out policies are necessary too, Dr. Colvin noted. "Equally a community, we need to develop programs that support families with infants and fill in the gaps, especially when information technology comes to straight profitable those families and providing respite for parents," Dr. Colvin said.
If y'all are struggling, I strongly recommend discussing your concerns with your kid's pediatrician, both to rule out any medical cause for your infant'southward irritability (such as acid reflux or a milk protein allergy), and to come upwardly with strategies to help yous manage your exhaustion. These may include asking a grandparent or friend to provide some respite care or, if your kid is over 4 months quondam, sleep grooming.
The bottom line
The prospect of transferring an baby — peacefully asleep, at long last — from car seat to crib can feel agonizing in the moment. But it is crucial to avert unsafe sleep practices, considering they can have catastrophic consequences. Try to think that, in fourth dimension, your child volition sleep meliorate, and so will you. Enquire for help, be safe and hang in in that location.
Craig Canapari, M.D., is an banana professor of pediatrics at Yale Academy, director of the Pediatric Slumber Heart at Yale-New Haven Hospital and the author of It's Never Besides Belatedly to Sleep Railroad train. He blogs well-nigh childhood sleep bug on his website.
Source: https://www.nytimes.com/2020/04/17/parenting/baby-sleep-dangerous.html
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