LEAH HENRY-TANNER: Another way to lower SIDS risk is
sleep position. I think we spend a lot of time in the Bedtime Basics for Babies
program talking about always put baby to sleep
on the back. And so, the most thing– effective thing that
parents or other caregivers can do to keep baby safe during sleep
is to place baby on his or her back, and not just for
sleep, but– or for night time sleep, but for every time the baby sleeps.
So, at nap time. Like it says,
every sleep time counts. So...
GERADINE SIMKINS: The whole issue around back sleeping does not cause vomiting and choking.
We'd like to demonstrate why that is. First of all, when a baby
is in the back sleeping position, the trachea lies on top of the esophagus.
And, I'm going to demonstrate that. Anything regurgitated or refluxed
from the esophagus must work against gravity
to be aspirated into the trachea. Alright... so, let's pretend that
these two items are the trachea–
clear, air, wind, white... And the esophagus–
Um... yellow... bile... vomit...
OK? So, you can see the difference in these two.
The esophagus connects the throat to
the stomach. So the esophagus goes right from the throat right to the stomach.
It's an 8 inch tube, and it lies behind
the windpipe, and goes all the way down to the stomach.
OK? So, in a baby, the esophagus
goes from the mouth down to the stomach. The trachea,
where the air comes through, is about a 4 inch tube,
and, it lies on top. OK?
And, the trachea connects to what we call the bronchi.
So, it starts here, it's about a 4 inch tube, and it goes into the bronchi,
and then goes to each lung. So... bronchi, trachea...
Esophagus behind it into the stomach.
When this baby vomits, that vomit
has to work against gravity to jump up and get into the trachea.
Right? So, if the baby's lying on it's back,
and we have esophagus there, trachea there.
When the baby throws up, it will naturally
go on the side, because gravity will pull
the– the material down to the side. Right?
However, if you have this baby lying on its belly,
now... We still have the trachea behind
and... the trachea in front and the esophagus behind,
but when the baby is lying there, the vomit can pool
right here, and the baby can suck it in. Right?
Much more easily. So, there's vomit laying around the baby– and babies– little,
tiny babies, sometimes their heads aren't turned completely aside.
Sometimes, they're like that, Right? And so... so...
when they go to throw up, it just– it just
pools there and they [sucking noise] Whereas, if they're lying on their back...
[inaudible murmur] Yeah... and you have the
esophagus behind and the trachea in front, it's gotta go up hill
to get into that wind pipe. So you can see– maybe I should
put this up here. You can just see anatomically
how it– that– that this is not necessarily a logical argument.
So, when a baby is stomach sleeping position
anything regurgitated or refluxed will pool at the opening of the trachea
making it easier for the baby to aspirate or choke. Yeah, makes a lot of sense.
And, until you see this actually demonstrated,
I think we don't necessarily get it. This way is safe.
This way's not as safe. [inaudible murmurs]
Side lying is not as safe either. So, we're
we're– the whole message of the safe sleep campaign is "back to sleep."
All of the stories that you might have heard about
side lying, or those kinds of pillows that support the baby
from the behind– Not safe. On the baby's back is what is safe.
LEAH HENRY-TANNER: The risk period for SIDS is really the 2 to 4 month period,
and then after that it drops. It's still
possible, but the risk drops. So, by that time
baby is rolling over on their stomach...
and so, you don't– If they're at that point where they're rolling over,
you don't need to force them back on their back to sleep.
So, we talked a lot about the... safe sleep, baby on the back,
on a firm surface, with no objects,
toys, or loose bedding, and no crib bumpers...
And, I think that's sometimes kind of hard, because
usually when you buy a nice thing for your baby
it includes the bumpers, the nice fluffy blankets,
and the nice pretty comforters, but really baby just needs–
a sleep sack, would be ideal.
On a mattress that has
a tight fitting sheet. So this really demonstrates
what a safe sleep environment is. See? No bumpers...
Baby is on back, all by himself,
and no loose blankets or toys in the crib.
One of the things we saw a lot of in the–
when I participated in child death review
was the cribs often had a lot of blankets or clothes
or other stuff [murmurs] Yeah, or pillows...
in this environment, so...
Obviously, baby was in an unsafe sleep environment.
If parents are using a blanket, make sure that
the baby's feet are toward the end of the crib,
and that the blanket is tucked under the mattress, and the blanket only comes up to baby's chest.
Like that, so the arms are... are loose.
And then, also to make sure that baby's not overheated.
That the sleep clothing is appropriate
for the temperature of the room. Because overheating, again, is one of the
SIDS risk factors. So, we want to be able to counter that.
Like I mentioned, there are often
parents or caregivers that can't afford a crib.
And so, one of the things that we thought was really important to
include as part of the Healthy Native Babies project is identifying
other alternative places where babies can
sleep that they'll still be safe. And so...
in a basket... Just a laundry basket.
[laughter]
And this is a cardboard box...
or just a little piece of cardboard that has
a receiving blanket clipped down
so that it's nice, and it's firm
and you can put it at the bottom of the laundry basket.
Also, a box or carton– but make sure it's clean,
And hopefully not used with pest–
food or anything that had pesticides on it. A drawer....
Is a great alternative. Or a washtub.
GERADINE SIMKINS: You know, if... If the idea is to have the baby in a
separate location, it's safe, on it's back, then the next step would be
where it's not too cold, you know... Or where there isn't a draft
Just helping them try to think through the most logical thing. If they
are a member of a family that
can't afford a crib, or doesn't have a crib, but can get a $3 laundry basket...
LEAH HENRY-TANNER: But if you do use– or families use
an alternative sleep surface, just make sure
that baby's in it all by itself... that there's no
kids jumping on it, or animals crawling into it–
GERADINE SIMKINS: Cats with'em... LEAH HENRY-TANNER: Cats or dogs... yeah...
And then, the SIDS risk is significantly
higher when a baby shares a bed with other children,
or is placed on a sofa, because a sofa is really soft
um... sleeps in a bed with a mom who smokes cigarettes,
or sleeps in a bed with an adult who's been drinking alcohol.
And then also, be aware that the risk factors
increases if baby sleeps in a bed with more than one
bed sharer. Especially if the baby's sharing a bed with
two adults. And, it's also riskier if the baby is
younger than 14 weeks of age.
But there have been studies
that show room sharing– having a separate sleep area
for baby in the same room where a parent sleeps
reduces the risk for SIDS and other sleep related infant deaths
And so, because of this evidence, the American Academy of Pediatrics– the AAP
recommends room sharing as the best option. Studies suggest that
bed sharing is always riskier than not bed sharing in terms of
SIDS and other sleep related causes of infant death, such as accidental
suffocation or smothering and other accidental or unknown
causes of injury and death. So, room sharing instead of bed sharing.
I really like this whole approach of risk reduction,
because we know that telling people "Don't do this"
is just not the way to– to teach anything.
To anybody. And so that's why we're always so
happy to come to communities to be able to share these materials,
because they're really important.