Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by Heather Davis, Director of Women and Children's Services at Riverside, to talk about safe sleep for baby, right after this message.

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Host: And we are back with Heather Davis. Thank you for joining us today.

Heather Davis: Thank you for having me, Helen.

Host: Of course. Could we just get started by having you tell us a little bit about yourself?

Heather Davis: Yes, I have worked in healthcare for 30 years. I have been with Riverside for 21 years. Most of my years in Nursing have been in Pediatrics. And currently, I work with families in our birthing center. I am also certified as a Pediatric nurse for almost 7 years now.

Host: That's awesome. That's a long time. That's great to be helping the community for that long. our topic today is safe sleep for baby. And to get us kind of started, can you explain like the ABCs, as they say, of safe sleep and why they're so important?

Heather Davis: The ABCs of safe sleep are an easy way to remember that a baby is safe as sleeping alone on their backs and in a crib. This will reduce sleep-related infant deaths. After a substantial decline in sleep-related deaths in the '90s, the rates have stayed pretty consistent year over year. Approximately 3,500 infants die from sleep-related deaths annually in the United States, and rates for non-Hispanic Black and American Indian, Alaskan Native have decreased more slowly than rates of other infants.

Host: Got it. What are some of the most common mistakes then that parents seem to make when it comes to safe sleep for their baby?

Heather Davis: Common mistakes include having a soft object in a sleep space, such as pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like material, things that attach to pacifiers and loose bedding such as blankets and non-fitted sheets. These items can increase the risk of suffocation and getting entrapped or wedged with soft items. Infants are also at risk of overheating with extra layers of clothing and hats. So, it's important to dress the infants appropriate for the environment with no greater than one layer more than adult would wear. Parents and caregivers are also at risk of falling asleep with baby on a bed, couch, or chair.

Host: Got it. That all makes sense. I recently saw like a picture on, I don't know if it was Facebook or something online, and it was like, "Me sleeping in the '90s as a baby," and it had like 50 teddy bears in there and like the bunting around and all that. And then, it said like, "My baby sleeping," and it was just a baby on a surface. And while that can look cute and cozy, it's definitely good to know that that's not safe sleep. How does Riverside typically go about educating new parents about safe sleep before they leave the hospital?

Heather Davis: Parents are educated on safe sleep practices. After delivery, they also sign a safe sleep commitment while they're with us in the hospital. Safe sleep practices are modeled throughout their stay in the hospital, and they are educated on safe sleep again at discharge, and given a wearable sleep sack at discharge. We also provide education to families on safe sleep in our Best Beginnings class.

Host: That's great. That's awesome that you're able to give out sleep sacks as well from the hospital. That's something that is, you know, a good resource for folks that might-- I mean, not only not able to have it, but that's just great to have an extra one. That's a great thing.

Heather Davis: Yeah, absolutely.

Host: What role would you say that cribs, bassinets, and other sleep environments play in ensuring a baby's safety during sleep?

Heather Davis: So, these environments provide a firm flat surface and reduce the risk of suffocation or wedging or entrapment for the baby. The sleep surface can be covered with a fitted sheet and should not include soft blankets or objects like I had mentioned before. A firm mattress will maintain its shape, and it does not indent or conform to the shape of the infant's head when the infant is placed on the surface. It's not going to change shape when you put a fitted sheet, when you use a sheet that's for that model of crib. If you use an ill-fitting sheet, it can create gaps between the mattress and the wall of the crib or the bassinet or portable play yard or crib.

Host: Got it. Are there any specific sleep products that parents should avoid that might pose risk to infant safety?

Heather Davis: Parents should avoid sleep areas that are not designed for sleep such as car seats, infant carriers, bouncers, strollers, swings, and slings, particularly if that infant is under four months of age. It's important to know that there's been many recalls on products also. So, parents and caregivers can check the Consumer Product Safety Commission website to look for any recalls.

Host: Got it. So, if your child is in one of those other carriers or things like that, and they do fall asleep, is that something that you should try to minimize as much as possible or try to wake them up?

Heather Davis: Generally, when you get back to an area where you have a safe sleep place, the infant shouldn't stay there to sleep, they should be transported to a safe sleep space. I know that when you're taking a walk and you're awake and you're observing baby, you may have somebody in a stroller that falls asleep. But again, once you get back to a safe sleep space, you should remove the infant or at least be monitoring them when they're in an upright position.

Host: Got it. Cool. We're going to take a quick break to talk about finding a primary care provider.

Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

Okay. We are back. And can you talk about how safe sleep practices have evolved in recent years, especially with like updated guidelines?

Heather Davis: Yes. The newest recommendations include information on non-inclined sleep services. So really, laying your baby flat. Less than 10 degrees of incline is what's recommended. Anything higher than that is unsafe for infant sleep. For short-term emergency sleep locations, you can use a box, a basket, a dresser drawer to put the baby to sleep. But it needs to have firm padding. This can temporarily be used. However, this should be replaced as soon as a Consumer Product Safety Commission-approved surface is available.

Another recommendation is the AAP is unable to recommend bed-sharing under any circumstances at all. And for people who use substances, that could be sedating medications such as pain medications, certain antidepressants, alcohol, illicit drug use, and smoking can increase baseline risk more than 10 times when bed-sharing. For home cardiorespiratory monitors that people are purchasing over-the-counter, they're not intended for prevention and should not be considered a substitute for following American Academy of Pediatric Safe Sleep Guidelines. And tummy time is encouraged while awake and supervised for short periods of time, beginning soon after discharge from the hospital, increasing incrementally to at least 15 to 30 minutes daily by seven weeks old.

Host: Got it. That all makes sense. So, this is a lot of information and can be new information for relatives or folks like grandparents, other caregivers. How can they be educated about these safe sleep practices, especially if they may have raised children in a whole different era?

Heather Davis: So, we've been educating grandparents and other caregivers at our community events with safe sleep demos. We will continue to provide public education to include strategies for overcoming barriers to making changes. We do this through modeling behaviors while they're here and when they return up to the age of one in the hospital. We want to work with families and caregivers to understand cultural differences in a respectful way using non-judgmental communication. Safe sleep education is also provided to all of our employees, not just the employees that care for small children. By providing this education to all employees, we are reaching many more people that are equipped to share the importance of safe sleep practices.

Host: That's great. How does Riverside partner with the community organizations or what initiatives do they have to promote safe sleep in the broader community?

Heather Davis: We have many ways that we promote safe sleep in the broader community. We have provided information through the local paper, social media, including Facebook, Instagram, and Twitter. At community events such as our Baby and Beyond Fair in April, and an upcoming booth at the Farmer's Market, we have safe sleep simulation activity that we bring with us to provide an interactive discussion on what are hazards in the safe sleep environment. And we are also focused on keeping our photos consistent with safe sleep recommendations when we are displaying photos of sleeping infants.

Host: Awesome. So, what advice would you have to give to parents who may feel anxious or overwhelmed when trying to follow the safe sleep guidelines?

Heather Davis: I'd say keep it simple by remembering the ABCs of safe sleep. Make sure that your infant is alone on their backs and in a crib.

Host: Awesome. Well, thank you for joining me today.

Heather Davis: Thank you for having me, Helen.

Host: Of course. Well, thanks for being here. And thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.