When It Comes To Baby's Crib, Experts Say Go Bare Bones

Oct 18, 2011
Originally published on October 18, 2011 4:23 pm

No more blankets in the baby's bed. Not even when it's cold outside. No bumpers, pillows, or toys. All these accoutrements are hazards for newborns and infants, according to the American Academy of Pediatrics, which has released new expanded guidelines for reducing deaths from Sudden Infant Death Syndrome, or SIDS, and other causes including suffocation, entrapment and asphyxia.

"Babies can roll into [anything] soft and suffocate against it, and babies can crawl under it and suffocate," says Rachel Moon, a pediatrician at Children's National Medical Center in Washington, DC and chairwoman of the AAP Task Force on SIDS. "Even the hard bumper pads are a problem because babies can scoot in and get their head wedged in between the mattress and the bumper pad and can't get out."

Over the past 20 years since the academy's initial recommendations to put infants to sleep on their backs instead of their stomachs, the incidence of SIDS has declined dramatically. Even so, some 2,300 babies still die every year in the U.S. from SIDS.

Moon says the safest environment is a bare one. The only thing that should be in the crib is the mattress with a tightly fitting sheet and the baby, she says. Some products claim they can help prevent SIDS, but there's absolutely no evidence for that, says Moon.

The new recommendations also suggest the baby should be in the parents room, so parents can hear, see and touch them if needed. But not in the parents' bed, with potentially risky pillows and heavy blankets.

Accidental suffocation may account for some of these deaths. There are also some babies who are particularly vulnerable because their brain hasn't fully matured yet and they don't wake up easily when faced with an obstacle. Exposure to tobacco, alcohol or illicit drugs during pregnancy can increase that risk.

This is the first year the academy also recommends breast feeding and immunization to prevent infant death. Moon says they both help prevent infection and its known that many babies who die from SIDS often suffered from an infection before they died. The infection may have weakened their immune system and their ability to breathe normally.

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ROBERT SIEGEL, HOST:

Today, the American Academy of Pediatrics offered some new advice for parents to help create safer sleeping environments for their infants. Over the past 20 years, the incidence of sudden-infant death syndrome, SIDS, has decreased dramatically. Even so, every year in the U.S., 2,300 babies die from SIDS. NPR's Patti Neighmond reports on the new guidelines.

PATTI NEIGHMOND, BYLINE: Pediatrician Rachel Moon chaired the taskforce that came up with the new advice for parents. She says parents often mistakenly believe all the new baby accessories they see in stores are safe.

DR. RACHEL MOON: So things like blankets and pillows and bumper pads and all of these nice fluffy, pretty things, parents think that that's what they're supposed to do to make everything pretty for their baby.

NEIGHMOND: But for sleeping babies, Moon says, soft and fluffy can be dangerous.

MOON: Babies can roll into soft and suffocate against it. Babies can crawl under it and suffocate. Even the hard bumper pads are a problem, the firm ones, because babies can scoot in and get their head wedged in between the mattress and the bumper pad, and they can't get out.

NEIGHMOND: Some products actually claim to help prevent SIDS. Absolutely not true, says Moon. There's just no evidence. The new guidelines are specific: no bumpers, no blankets, no pillows, no toys.

MOON: We want the baby to be on their back, in a crib that is bare. The only thing that should be in the crib is the mattress with a tightly fitting sheet and the baby.

NEIGHMOND: That's right, no blankets. The academy recommends layered clothing in cold weather. And the baby should be in the parents' room, so parents can hear them, see them and touch them, if needed, but not in the parents' bed with all its high-risk pillows and blankets. Accidental suffocation may account for some infant deaths, there are also some infants who are particularly vulnerable because their brain hasn't fully matured and they don't wake up easily when faced with an obstacle. Exposure to tobacco, alcohol or illicit drugs during pregnancy can increase that risk. This is the first year the academy also recommends breast feeding and immunization to prevent infant death.

MOON: It may be that they both help to prevent infection, and we know that a lot of babies who die from SIDS have had minor infections before they died.

NEIGHMOND: An infection may weaken a baby's immune system and their ability to breathe. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.