But it’s where a mother breastfeeds that has doctors concerned.
“Couches and armchairs are extremely dangerous places for infants,” reads a policy statement from the American Academy of Pediatrics (AAP) released Monday.
The warning comes in AAP’s set of updated guidelines, meant to help reduce the risk of SIDS, which is the leading cause of death for healthy infants under the age of one. What exactly causes SIDS is still unknown, but a number of risk factors have been identified.
Case reports show babies have a “much greater” chance of dying from SIDS when breastfed on places like sofas and rocking chairs — “things that are commonly promoted as places to go to breastfeed at night,” according to Lori Feldman-Winter, a pediatrics professor and co-author of the report.
Winter says it’s “very natural” for mothers to doze off while breastfeeding because the hormones it produces make the brain sleepy.
Suffocation is a top hazard when it comes to couches, Winter says. Not only are they usually a soft surface (which is not recommended for infants), but they also tend to have plenty of crevices an infant can get stuck in.
So where should moms breastfeed?
The recommendation is for mothers to breastfeed in bed.
“No pillows, sheets, blankets, or any other items that could obstruct infant breathing or cause overheating should be in the bed,” the report states.
“A large percentage of infants who die of SIDS are found with their head covered by bedding.”
Winter suggests placing the bed “away from a wall where the baby might become trapped should the mom fall asleep, even for a short amount of time.”
This doesn’t mean pediatricians are now giving the green light for bed sharing, sometimes referred to as “co-sleeping.”
“We still cannot say that bed sharing, sleeping on the same bed surface is safe,” Winter cautions. “We still believe that’s a hazardous sleep arrangement.”
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Babies born premature or with a low birth weight are “particularly at risk” for SIDS in the bed-sharing environment, Winter says.
Where should a baby sleep?
Once a mother finishes feeding, the baby should be returned to the crib or bassinet close to the parent’s bed, according to the report.
Mothers who don’t breastfeed can still help reduce the risk of SIDS.
Researchers are pushing more strongly for a shared sleep environment, which is believed to decrease the SIDS hazard by as much as 50 per cent.
That means a separate, firm bed for baby in the parents’ bedroom. Doctors say they should ideally stay there for a year, or at the very least six months.
It’s believed this leads to a better sleep state for the baby, Winters says, and makes breastfeeding easier.
“The marketing of this concept of getting a nursery ready… does unfortunately inadvertently lead families to think that a separate sleep environment is OK and safe.”
Pacifiers appear to be the exception. The report cites studies that suggest soothers have a “protective effect” against SIDS, “even if the pacifier falls out of the infant’s mouth.”
Just don’t use pacifiers that hang around an infant’s neck. Those that attach to their clothing shouldn’t be used on sleeping infants either.
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A study from August found nine out of 10 parents put their children in sleep positions that could compromise their health.
Experts stress there should be nothing but a fitted sheet inside a baby’s bed. So lose the blankets, pillows, and teddy bears.
Infants should also be placed on their back, which is the safest sleeping position for them. When they can turn over on their own, you don’t need to flip them to the back position, Canadian pediatricians say.
When is a baby most at-risk for SIDS?
According to a 2006 study:
- 90% of SIDS cases in the U.S. occur before an infant reaches the age of 6 months.
- SIDS peaks between 1 and 4 months of age.
- SIDS is uncommon after 8 months of age.
Babies exposed to cigarette smoke prenatally or after birth are believed to have a higher risk of SIDS.