From Penn State Health and Penn State Children's Hospital, welcome to Ask Us
Anything About... Safe Infant Sleep. I'm Scott Gilbert. Each year in the United
States, there are 3,500 infant deaths due to sleep related injuries. And we're here
to talk with Amy Bollinger, the Pediatric Trauma and Injury Prevention Program
here at Penn State Children's Hospital. About how you can keep your infant safe
while sleeping. Amy, thanks so much for being here today. Sure.
Let's start with the ABCs of safe sleeping. There's an acronym that's
very simple, very important, tell us what A, B and C stand for. Sure! So ABC stands
for Alone, Back and Crib. Alone meaning, that your infant should be alone in his
or her own sleep space. Back, means that you place your baby on his or her back
to go to sleep. And Crib, meaning that your baby should sleep in a crib with
nothing else in that crib but your baby. So let's go through each of those real
briefly. The first one is alone and that means they are sleeping alone in their
crib and not in mom and dad's bed. Correct, we know that in over half
of all sudden, unexpected deaths due to suffocation involved co-sleeping with a
parent. So co-sleeping under any circumstance is acceptable or not the
American Academy of Pediatrics does not recommend bed sharing. For the risk of
suffocation. Now, we did have a comment on our Facebook page from someone who said
that they are very scared of having their child in their bed for that very
reason. You know but she mentioned the only time my son is in my bed is in the
morning when we're both awake. That's probably okay. That's okay.
If the parent or caregiver is awake and able to watch the baby, that's fine.
That's safe. But also leaving a child on the bed, even if a child is awake is a
bad idea. They could roll off. They absolutely can and they do. We see that
very often in our pediatric trauma program. Parents, well-meaning, lay their
baby on the bed in the middle of the bed step out of the room and come back to
find our baby on the floor. You're watching, Ask Us Anything About...
Safe Infant Sleep from Penn State Health, I'm Scott Gilbert along with Amy
Bollinger. We welcome your questions. Just add of comment here to this Facebook
post and whether you're watching this video live or on playback, we will
get some answers for you. We're talking about the ABCs of safe sleep.
Putting your child down alone is the A. B is on their back in the crib so why is
that so important? Because I got to be honest, I think way back when I was in a
crib, I slept on my stomach. And not that I remember!
So did I. In fact, when I had my own children, my mom reminded me of that
every time she babysat. We all survived it so what's the big deal? We did survive
it but as time has evolved, so have studies and we know differently now.
Babies, all of us have two tubes in the backs of our throats. One's a breathing
tube and one is a tube for food and drink. When a baby lies down on his or
her back, the food and drink tube is on the back and the breathing tube is up.
So if a baby spits up that spit up is going to come up and go back and wash
right down into the food and drink tube. Not the breathing tube. Whereas, if
they're on their stomach something different happens? It's reversed. So the breathing
tube is now at the lowest point on the crib and the food and drink tube
is on the upper portion. So when they spit up, anything that backwash is
is going right into that breathing tube. And we have a diagram in fact I'm going
to hold this up so Mike can get a shot of it. We will also put a copy of
this diagram on the Facebook post for this particular video so you can kind of
get it a diagram. Because it does sound unusual. Everyone's afraid that their
baby is going to choke on their own vomit. When in fact,
that's not really a risk if they're on their back it is if they're on their
stomach. So that runs kind of counterintuitive to what a lot of people think.
It really is. So we talked about alone, on their back. And then the third one of course is
in a Crib. Tell me about what that crib should be like and look like. Right, so we
talked about a sleep space in injury prevention because a crib could mean a
few different things. Many families cannot afford a three and
$400 crib so a portable crib, such as a pack-and-play is perfectly safe for your
baby to sleep in. As long as you are using a fitted sheet designed for that
portable crib. In the crib there should be nothing. No bumper pads, no loose
fluffy blankets, no stuffed animals, nothing. They are all
very high risk for suffocation. And what we call entrapment. Sometimes what we
hear is when it comes to the crib bumper so that goes along the outer edge there
because you see these slats in a crib someone may say, well, what if my child's
arm could easily slip through or a light could slip through and get stuck they're
young they might not be able to get it out that crib bumper could prevent that.
Well, that's not necessarily true. Bumper pads were first designed when
slats of cribs were much wider and they were designed twenty, thirty, forty, years
ago so that babies heads would not get stuck between the slats.
Now, that the slats are closer together, the risk of having a head and
strangulation is mitigated. We don't see that anymore. It is not likely that a
baby will get his or her arm or leg stuck in between those slats and not be
able to move them out himself or herself. Sure. We welcome your questions for Amy
Bollinger of the Pediatric Trauma and Injury Prevention Program here at Penn
State Children's Hospital. We're in the Safety Center of the Children's Hospital.
It may look familiar to some patients and families here and we do welcome your
questions on Safe Infant Sleep. Just add them to the comment field below this
post. We're talking about putting baby to sleep in a nice safe crib and as you
mentioned that means free of a lot of items. But there are a lot of things you
can buy. A lot of accessories you can buy for a crib that would seem to enhance
the safety. One of them might be a wedge-shaped device that you can put the
baby up next to to keep them from rolling over onto their stomach. Sure and
again you know, the American Academy of Pediatrics says they are absolutely not
safe. They put your baby at an increased risk of suffocation. And that's
really what we're talking about. I mean, all of these risks seem to go back to
that one individual factor, suffocation. They do, sudden, unexpected, infant death
is not completely preventable. There are unfortunately babies and families who
have to go through a devastating loss such as an infant death. But there are
factors and things that we can do to prevent the suffocation and
strangulation piece of the umbrella term of sudden unexpected infant death.
To prevent at least some of them. To prevent at least some of them. Right, no parent
put something in his or her baby's crib with the intent of doing harm.
So we want to be sure that we're educating moms and dads and grandparents
and aunts and uncles about what the right thing is to do. The safest thing is
to do for your baby. And there are some factors that go beyond the crib. One of
those is smoking in the household. That's been shown to increase the risk of
sudden infant death. Correct? It really has. Pregnant women who smoke during
their pregnancy, their babies have a three times higher incidence of
sudden unexpected infant death as compared to moms who don't smoke during
pregnancy. This is very important information here on,
Ask Us Anything About... Safe Infant Sleep and for that reason, we ask you to share this
Facebook post on your feed so we can help to get the word out. And of course,
we do welcome your questions as well here for Amy Bollinger. We're talking
about some of the myths. Any other myths or anything we didn't touch on there
that that sometimes come up when, you know, kind of anything we want to set the
record straight on to make sure people have, like you said, the most current
information which admittedly is evolving. Sure one of the things that we recommend
also is that infants not sleep unsupervised in any kind of sitting
devices. A car seat, a highchair, anything that that puts the baby in a sitting or
reclining position. Because babies move around and they can get themselves stuck
in a position where they cannot protect their airway. And you know, that's an
interesting factor because we had a colicky baby in our house and the only
way she'd fall asleep in the middle of the night was if we drive her around. And
you know what happens if you take her out of the car seat after that drive
she's going to wake up. But bottom line, that's not safe. Now specifically, we
talked about the car seat, why is that not safe? Because babies can scooch down
and actually get their necks hung up on the straps themselves and if that
happens and the caregivers are asleep, they have no way of saving or protecting
their infant. I suddenly feel guilty but we lucked out.
But there are a lot of these things that, it's true, like you say, that these
factors may not be a problem, you might get away with them. The problem is, you
might not and that's why it's important to keep the ABCs in mind. Absolutely.
Absolutely. And you told me about something else,
interestingly, before the interview about some binky's that have; Is that binkies?
That have stuffed animals on their, Pacifiers! We call them pacifiers. Right! Oh that's right!
And so this one doesn't have a stuffed animal but they actually make
those now they have stuffed animals. So I don't know what the official term is for
the pacifiers that have the stuffed animals. I'm a little old at this point
but there are apparently stuffed animals that attach to a pacifier. Those stuffed
animals are actually large enough that they can completely cover an
infant's nose and mouth . Which can lead to airway compromise and eventually
suffocation. So we don't recommend those in the crib. And so, we think about
these things as something that would comfort the child when in fact they
could actually put them in harm. So how old should a child be then before you
can introduce things such as maybe an extra blanket or stuffed animals at what
age or size is it okay to do that? We say, not under one year. A minimum of one year.
And even longer in the sleep space. There are very rare instances where infants
are suffocated or strangled by blankets that get wrapped around the rails of the
crib and then around their heads and necks. Very, very rare but we see it.
And so, we recommend absolutely nothing in that crib under the age of one year.
No need to take chances right? Right? Well, we thank you for watching and we do
welcome your questions again even if you're watching this video on playback
if there's something we didn't touch on feel free to add it to the question and
comment field there and we'll make sure we get that question to Amy Bollinger.
She's manager of the Pediatric Trauma and Injury Prevention Program, here at
Penn State Children's Hospital. Amy, thank you for your time and thank you for
watching Ask Us Anything About... Safe Infant Sleep from Penn State Health.