The ABC's of safe infant sleep

Many parents and caregivers are not up-to-date on what are considered safe sleep habits for their infants.

“We find that several misconceptions persist among families coming to Kootenai Health to deliver their babies,” said Heidi Trainor, an occupational therapist in developmental services and the Safe Sleep Program at Kootenai Health. “One of the most widespread and concerning misconceptions is that it is…appropriate to sleep with their babies.”

Those misconceptions can be deadly. In 2015, there were about 3,700 sudden unexpected infant deaths (SUIDs) in the United States, according to the Centers for Disease Control and Prevention. SUIDs are commonly reported as three types – Sudden infant death syndrome (SIDS), unknown causes and accidental suffocation and strangulation in bed (ASSB).

It’s that third category especially that Liz Montgomery and the Inland Northwest SIDS/SUID Foundation work to prevent by providing education to local families and caregivers.

“Bed sharing is dangerous, and research after research has proven this,” Montgomery said. “Our adult mattresses are so soft, we sleep with heavy blankets and heavy pillows… and it’s super easy to sleep with your baby. It’s so much easier to put your baby next to you after a feeding rather than taking that extra step of putting them in a safe sleep environment.”

Montgomery emphasizes the same recommendations of the CDC and the American Academy of Pediatrics – The ABC’s of Safe Sleep – Baby sleeps Alone, on the Back, in a Crib. Cribs should be clear of blankets, bumpers, toys or anything else that can restrict breathing.

Though these recommendations have been in place for some time, Montgomery said images and messages of unsafe practices are still too prevalent, especially on social media. She said photographers and families who show off cute pictures of their babies sleeping on a parent’s chest or in a posed shot with pillows and blankets can have a negative, if unintended, influence on those who don’t know safe sleep habits.

“Pictures say all the words. Photos have such an impact on what we do,” Montgomery said. “We don’t see pictures of people smoking anymore because we know as a culture it’s bad for us. I encourage more people to show pictures of their babies sleeping safely.”

Another common misconception is the safety of a baby sleeping in a car seat or baby swing. The American Academy of Pediatrics recommends that babies only sleep in a car seat while driving.

“There’s a potential of overheating, pinching off the airwaves or strangulation – any baby that falls

asleep at an incline needs to be taken out of those and put into a safe sleep environment,” Montgomery said.

Montgomery said it is still unsafe to let children sleep in car seats or swings at home even with a parent watching them.

“Supervised unsafe sleep is not recommended,” she said. “They’re not going to cry, they’re just going to stop breathing.”

Understanding SUIDs and solutions

As recently as a few years ago, Montgomery said every infant death was labeled as SIDS or a crib death. The CDC has since established a more detailed means of categorizing individual incidents.

“SIDS is… where there aren’t any red flags, nothing that could have caused overheating, strangulation, we just don’t know,” Montgomery said. “It is extremely rare.”

A SUID is identified if there are potential dangers, such as crib bumpers or blankets, but there is no sure cause.

“It’s very difficult to determine a suffocation or overheating death. They have to know 100 percent (to be established as an ASSB),” Montgomery said.

Examiners aren’t necessarily required to follow CDC guidelines in an investigation, Montgomery added, and many investigators still aren’t familiar with what to look for in established SIDS vs. more preventable losses.

What matters is there are still more than 3,000 SUIDs nationally, and that Montgomery believes education and awareness on safe sleep can be the change that reduces that number.

“SUID is the number one cause of death for children under a year old,” she said. “People need to know that, and I know they don’t because I talk to a lot of people across the state and in our area.”

The Inland Northwest SIDS Foundation, in addition to fundraising and awareness efforts like the Oct. 8 Run for the Angels event in downtown Coeur d’Alene (see sidebar), also provides support materials and training for families, as well as local agencies such as hospitals, churches, shelters and classrooms. The Foundation also hosts free monthly safe sleep classes in both Coeur d’Alene and Spokane Valley.

Kootenai Health has obtained the highest level of designation through the National Safe Sleep Hospital Certification Program (“Gold Safe Sleep Champion”). Kootenai’s Safe Sleep program encompasses hospital policy, staff training, parent education and modeling of safe sleep environments.

“We educate families using standardized teaching points that reflect best practice as identified by the American Academy of Pediatrics,” Trainor said. “The vast majority of families will choose to do what is best and safest for their infants. Staff will intervene on behalf of any infant who is being held or positioned in a way that is not safe.”

Through special grants, Kootenai Health is also able to provide a Halo Sleep sack to families whose babies have been delivered at the hospital.

“These are provided as both a teaching tool to assist us in educating families and a safer alternative to loose bedding or swaddling in a blanket, which may become loose,” Trainor said.

Thanks to donations, sleep sacks are also provided at the INW SIDS/SUID Foundation monthly classes. Additionally, both the Foundation and Kootenai Health can work with families who qualify for additional financial and educational support for safe sleep practices.

Support is out there

One of the major functions of the INW SIDS/SUID Foundation is to provide information and support for families who have lost a child – including those who have had a miscarriage.

“We’re trying to bring awareness to pregnancy, infant and child loss to our community, and it’s a subject that isn’t talked about a lot,” Montgomery said.

Montgomery started the foundation following the loss of her son, Mason. She participated in the SIDS Foundation of Washington until that group disbanded a few years ago from lack of funding. She then started the INW SIDS/SUID Foundation to fill that vacancy in Idaho, Eastern Washington and Western Montana.

The foundation sends out packets and resources to people who have suffered an infant loss or miscarriage, and there are loss support groups. The annual Night Under the Stars event serves as the foundation’s major fundraiser.

The 5th annual “Run for the Angels 5K Family Fun Day” will be held Sunday, Oct. 8 at McEuen Park in Coeur d’Alene. The event includes jump houses, music, an obstacle course and other family-friendly activities. The day includes a balloon release and remembrance ceremony for local families.

Montgomery said the event attracts people from across the foundation’s coverage area and has steadily grown, with more than 1,000 people attending the event last year.

To register for the 5K and for more information on all the services available through the Inland Northwest SIDS/SUID Foundation, visit www.INWSIDS.org or call (208) 557-4371 or email info@inwsids.org. You can also contact the foundation to volunteer for the event or for sponsorship/donation opportunities.