Experts urge parents to learn about safe sleep practices for infants

Sudden infant death syndrome is the unexplained death of a healthy baby who is less than a year old, according to SIDS usually happens during sleep.

“Practicing safe sleep habits for children is extremely important in decreasing their chance of SIDS,” said Emily Woodley, manager of the Jamestown Regional Medical Center Family BirthPlace. “I think we are finding out in life that prevention is key for a lot of things.”

The Jamestown Regional Medical Center in Jamestown, North Dakota, has been teaching tactics and practices to new parents for putting their newborns to sleep. Woodley has been educating parents of newborns about proper practices for more than a decade.

Woodley said medical center staff educates parents of newborns throughout their hospital stay about safe sleep practices and gives them a booklet about postpartum “baby blues” after childbirth and caring for an infant.

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In 2018, the North Dakota Department of Health named the medical center the first hospital to receive the gold-level distinction from the Cribs for Kids Safe Sleep program that encourages hospitals to educate and model the safest practices for putting an infant to sleep.

Emily Woodley, Jamestown Regional Medical Center Family BirthPlace manager, talks about the proper way to place a baby in a crib for sleeping. Woodley also talked about the safety issues with cribs.
John M. Steiner / The Jamestown Sun

Emily Woodley, Jamestown Regional Medical Center Family BirthPlace manager, talks about the proper way to place a baby in a crib for sleeping. Woodley also talked about the safety issues with cribs.
John M. Steiner / The Jamestown Sun

The center also offers anytime, anywhere education through YoMingo, a pregnancy app designed to give access to valuable information, according to the Jamestown Regional Medical Center’s website. New YoMingo users can register on the site and get access to evidence-based education for new and expecting parents, information specific to an expecting mother’s arrival and stay, community health resources and a list of available classes and support groups and other tools.

Woodley said any caretaker — babysitters, grandparents, aunts and uncles or older siblings — should know the best practices for putting an infant to sleep.

“The hardest probably is for parents to stay strong with caretakers … because they grew up in a different time,” she said. “Times have changed, things have changed. We want you to be able to do the things to keep our children safe.”

New parents can get overwhelmed with a lot of information at one time, and it is nice to have nurses and the Family BirthPlace give information on how to correctly get an infant to sleep, said Shannon Klatt. Klatt is director of health promotions and certified car seat technician at Jamestown’s Central Valley Health District, and the mother of an infant.

“I learned a lot from the nurses and providers at Jamestown Regional Medical Center,” she said. “Back is best and not have anything in the cribs, not have any blankets or any other objects. Just the baby on their back in their crib.”

Woodley recommended that infants up to age 1 should sleep on their backs

“That is when the risk of SIDS decreases,” she said. “And actually from zero to 4 months is the highest risk of SIDS.”

She said infants will typically start rolling consistently when they are about 4 to 5 months old, which is when they are in a sleeper or a sleep sack without the wrap.

“If they always put them on their back to start, if they flip then it’s OK,” she said. “They have more head control. They will be able to get themselves out of the unsafe situation.”

Even when a child is a year old, parents should still set infants on their back when putting them to sleep, Woodley said.

“But by then kids are moving around so much that a lot of them are either walking or standing up in their cribs,” she said.

What to do and not do

Woodley said cribs should not have bumper pads because infants can get caught up in them and strangle or suffocate themselves. She said cribs with spindles should not be used.

“The spindles are too far apart and they can get their head stuck in there,” she said. “All those cribs have been recalled, but of course some people might have them.”

The medical center has pack ’n play cribs that it gives to parents who don’t have a safe crib for an infant to sleep in.

“We offer that in conjunction with Central Valley Health District,” Woodley said. “We partner with them and I can get cribs from them when needed.”

Fuzzy blankets should not be used because they can get up over an infant’s mouth and suffocate the baby, she said. Nothing should be on an infant’s head while sleeping because that can also get over their mouth and cause suffocation.

Jamestown Regional Medical Center gives every new parent a sleep sack, which is a wearable blanket and an alternative for keeping a child warm without using loose blankets in a crib. Woodley recommended sleep sacks from HALO, whose founder lost his first newborn to SIDS. HALO’s SleepSack wearable blanket replaces loose blankets in the crib that could cover an infant’s face and interfere with breathing, according to its website.

A baby doll is wrapped in a sleep sack and placed safely in a crib for sleeping.
John M. Steiner / The Jamestown Sun

A baby doll is wrapped in a sleep sack and placed safely in a crib for sleeping.
John M. Steiner / The Jamestown Sun

If an infant is in a sleep sack and starts rolling, a caretaker should take the baby out of it, Woodley said.

She said no other objects such as toys should be in the crib because infants should be on their back and have their own sleep space with a sleep sack and nothing else. It is not recommended for infants to be on their side or stomach when they are being put to sleep, she said.

“Babies do need tummy time while they are awake during the day,” Woodley said. “That’s how they get some of their motor strength, but you want to make sure that baby is always on their back to sleep.”

She said infants should always be set on their backs when a caretaker puts them down to sleep.

“If the baby flips themself, it’s OK to leave them,” she said. “Once a baby starts rolling over that is when I would only put them in a sleeper and not put them in a sleep sack. Otherwise the sleep sack will keep them plenty warm and that is safe for them to sleep in.”

Woodley said breastfeeding is known to help decrease the risk of SIDS. She also said offering a pacifier at sleep time can help.

“You do not have to force it in, but if a baby will take that and then if that falls out, it’s OK to leave that one item in (the crib),” she said.

She also said no co-sleeping — when caretakers have an infant in the same bed as them. She said it is recommended that infants are in the same room as parents but in a different sleep space with a firm mattress.

“You think you are not going to roll over on them but people do,” she said. “We have soft fluffy pillows and blankets and all those things, and that is just not safe for babies.”

It is fine to be holding infants when they are sleeping because they are wrapped up and in the presence of a caretaker, Woodley said.

“It’s when they go to sleep by themselves, they should be in their own space again and on their back,” she said.

Having a fan blowing in the room not directly on the infant will also help circulate the air and has been known to decrease the risk of SIDS.

Smoking around a child increases the risk of SIDS because of the secondhand smoke exposure, she said.

She said keeping infants healthy by taking them to appointments and getting immunizations will also help decrease the risk of SIDS.

Car-seat safety

Klatt said children in car seats should be rear facing because that is the safest they will be in a vehicle and that will protect their spinal cord that is still very fragile.

“There is not necessarily a law that states they have to stay rear facing for a certain amount of time, but each manufacturer typically sets a guideline for that,” she said. “So generally if you look in a car seat manual it is two years, but we also recommend that a parent keeps their child rear facing until they reach the maximum height or weight limit of the seat itself that is set by the manufacturer.”

Klatt said it is safe for an infant to sleep in the car seat in a vehicle but it is not safe for the infant to sleep in the car seat when it is not in the vehicle.

“The reason for this is because when a car seat is installed properly in the car it’s at a recline that ensures that the baby is able to breathe whereas when it is taken out of the car there is potential for the recline to not be correct and asphyxiation can happen,” she said. “So it is very important to not have a baby sleeping in the car seat when it is out of the vehicle.”

Woodley said infants should be in their regular clothes when they get strapped into a car seat.

“You should never put an infant in a big snowsuit or a big puffy coat and put them in that because then you can’t get the harness tight enough and there is slack in it so they can pop out,” she said. “Another thing that is missed a lot is the chest clip doesn’t get pulled up high enough. It should be at armpit level and often it is left on at their tummy, and if they get in a car accident, they are just going to come right out.”

Klatt said all car seats that are available to purchase in any store are safe because they have gone through very extensive testing for crash safety.

Central Valley Health has three car-seat technicians and offers car-seat safety checks and car seats to anyone in need.

“Anybody who has a question in regards to car seat safety, we are always here to answer any questions,” Klatt said. “We take phone calls. We do appointments. We are pretty flexible for anybody.”

Woodley said Jamestown Regional Medical Center has five to six car-seat technicians who can answer questions about car-seat safety. The Stutsman County Sheriff’s Office also has a car-seat technician who can do a safety inspection.