Transcription:
Safe Sleep for Babies

Michael Carrese: Every year in the United States, more than 3000 babies die as a result of sleep related problems. And in many cases, the cause is the baby sleeping in the wrong position. Today, we're going to find out more about this problem and what can be done about it from Taylor Owens and Caroline Stebbins, who both work as Nurses in the Neonatal Intensive Care Unit at the University of Arkansas for Medical Sciences. This is UAMS Health Talk. I'm Michael Carrese. And I thought, I'd start by having you each tell us a bit about your backgrounds, Taylor Owens. Why don't you go first? How did you end up in medicine and in neonatal intensive care?

Taylor Owens: I always knew from a young age that nursing was what I wanted to do as my career. I was born at 27 weeks myself. So NICU has always held a special place in my heart. I got my bachelor's degree from UCA in 2015 and started my career in labor and delivery for about two years. And then I applied to the NICU and that's where I've been since.

Host: No, that's great. And Caroline, what about you?

Caroline Stebbins: I have always loved and adored babies. And so I went to nursing school at Texas Christian University and I graduated in 2017. And my first job was in the NICU at UAMS, two and a half years ago. And I can't imagine leaving, it is absolutely my passion. And I'm so grateful that I get to work with all babies, especially premature ones every day.

Host: Yeah. I actually worked at an academic medical center for a long time and the people who work in the NICU just are so, so passionate about what they do. So first let's define the problem a little bit more overall infant mortality in Arkansas is above the national average. As I understand it. What's your sense of what is driving that problem? Taylor, you want to go first?

Taylor Owens: I just think we need more education on how to properly sleep your baby in. And it has to be like sleeping and during naps and just no co-sleeping. And that just starts with when you're in the hospital, really having your nurses educate your parents on how to keep the baby safe.

Host: And Caroline, would you agree? Education is a key to this?

Caroline Stebbins: Yeah, I definitely agree. I think also access and you know, when our parents were raising us, none of the research about safe sleep was prevalent. They had bumpers in our cribs and let us sleep on our belly and slept in the bed with us. And so I think as more research and education becomes available, we have to be prepared to talk about it with our families, so they go home and implement it with their kids and continue to utilize it for the generations to come.

Host: Yeah. So it has been well established for some time by American Academy of Pediatrics and other authorities, that baby should sleep on their backs. Why is that thought to be the best choice, Taylor?

Taylor Owens: Yeah. Have a less hazard risk of suffocation. If you lay a baby on their tummy to go to sleep, they can end up having their face down in the mattress, which has less oxygen available to them. So that they have a higher risk of suffocating. If you put them on their belly.

Host: Which makes sense. There anything else about that position? That's well, face down that's dangerous or face up that's better?

Taylor Owens: I know when I was a baby, my mom was told to put me on my stomach because they thought if you refluxed, it'd be a better position, but research shows that you really have no more chance of choking. If you're on your stomach versus on your back.

Host: You can see though why they thought that would be the case though, right?

Taylor Owens: Absolutely.

Host: What are some of the other key components of safe sleeping for babies? You mentioned crib bumpers, something I did with my kids. And you would see why people do that, you know, protect their head from getting knocked against the side of the crib. Why isn't that a good idea, Taylor?

Taylor Owens: Any extra items you have in a baby's crib just increases their chance of suffocation. So even though you would think you need to have padding on the side rails babies, usually aren't going to roll hard enough that they're going to cause damage to themselves if they bump into their side of their crib. So you're just causing more harm by adding extra things into it.

Host: So that means as I take it, you don't want anything in that crib? No stuffed animals? No, anything else is that right?

Taylor Owens: No blankets, no pillows, no stuffed animals. You just want your baby's mattress and your baby.

Host: What about blankets though? I mean, how do you make sure they're going to be warm enough?

Taylor Owens: That is where like any type of brand of sleep sacks would come in. It's like a wearable blanket, there's armholes and it usually zips up and then you've got some type of wing that crosses over the baby's body. So that keeps them in good position on their back. It keeps them warm, keeps a blanket from like coming over their face. So they're not going to suffocate.

Host: Well, that all makes sense, Caroline, what do you want to add to this?

Caroline Stebbins: I think that a lot of parents worry about everything under the sun for their babies. And so that's why we put things like bumpers and extra blankets and whatever else in the crib, but having as few things and as possible with them, just that fitted sheet and then really babies only need one extra layer. Like if you or I were to go to sleep in a tee shirt and shorts, they would just need one more layer than that to keep them warm. So they're not going to get that much significantly colder than we would. So that swaddle blanket or the sleep sack will keep them warm. And it is designed intentionally to prevent them from getting entangled in loose clothing or bedding that blanket just laid over the top of them or excessive bundling might cause. And so that's why it encourages safe sleep when you swaddle a baby in an item, like a sleep sack

Host: And Caroline, what about the mattress? Is there anything parents should about that? Or they just kind of comes standard with cribs.

Caroline Stebbins: Most of them are standard. It needs to just be flat. You don't need to elevate it. And then just a fitted sheet. It doesn't need any other blankets or fluffy bundling on top of it. There are all kinds of different brands of mattresses that claim higher breathability or whatever. But the most important thing is just that they're flat and don't have anything extra on top of them.

Host: Taylor, I think was you, or one of the two, you mentioned co-sleeping at the top of the show and you hear a lot about, you know, whether that makes sense. Some families do that as a tradition. But as I understand it, the medical authorities are really down on that idea. Can you talk about that a little?

Taylor Owens: Yes. We really discourage co-Sleeping, I mean, all the research and evidence shows that you're very likely to have SIDS related death with co-sleeping, especially with exhausted parents. You could just easily roll over just a little bit and not know, you have suffocated your baby. Your baby could roll, roll just a little bit and roll off the bed. It's just safest to put your baby in your crib and then you can have the crib right beside the bed.

Host: Yeah. That was another question, I mean, that's, that's totally fine to have them in the room with you. It's just that they should be in the crib.

Taylor Owens: Absolutely. Share your room. Don't share your bed.

Host: One thing I was going to ask too, Carolina's pacifiers, are they, are those safe one? When a baby's sleeping?

Caroline Stebbins: Yes. Babies can have pacifiers with them. When they're asleep, you can put one in the bed. If they're old enough to pick it up and put it in their mouth on their own, or they can have it in their mouth as they go to sleep. There's no problem currently indicated with having pacifiers while they go to sleep.

Host: So, what am I missing here? What else should parents know about safe sleeping practices?

Taylor Owens: A good, easy way to remember is a, B, C, D. So you want your baby to be alone. You want your baby to be on their back. You want them to be in their crib. And you do not want to smoke in your home or around your baby.

Host: And would you add something to that, Caroline?

Caroline Stebbins: Most SIDS deaths happen between one month and four months of age. So that really first six months of their life is the most important time to ensure that they're sleeping safely. So if you can keep them in your room with you until they're about six months old, and if they're old enough to roll over onto their stomach, then you don't have to roll them back onto their back, but always put them down to sleep on their back. Don't put them on the sofa, don't put them anywhere where they might fall off or leave them unintended just in their crib or their bassinet, flat on their back with nothing else with them is the most important thing to do.

Host: Yeah. So a lot of this is common sense, but some things, as you were saying, you know, been passed down from to generation and folks just need to be aware of what the new rules are. And A, B, C, D, I was taking notes so alone, on the back, in the crib and don't smoke, is that right?

Taylor Owens: Yes.

Host: All right. Great. Well, listen, we're out of time but I want to thank you both very much for being with us today. We've been talking to Taylor Owens and Caroline Stebbins who both work as nurses in the neonatal intensive care unit at the University of Arkansas for Medical Sciences. Thanks to you both very much. For more information you can visit UAMShealth.com. If you found this podcast helpful, please share it on your social channels. Or you can check out the full podcast library for additional topics that may be of interest to you. This has been UAMS Health Talk. Thanks for listening.

Conclusion: The unit-based council for the neonatal intensive care unit at UAMS is hosting a sleep set drive for the NICU from September 1st, all the way through October 20th of this year. Our goal is to collect 150 premium sleep sacks and a hundred newborns sleep sacks, to be utilized on the unit for our babies. We will accept any new or gently used sleep sacks of any brand. Our hope is that by collecting more sleep sacks for the unit, we will always be able to model safe sleep, to correspond with our safe sleep education. Please contact, NICU reunion at UAMS.edu if you would like to donate. Always remember your ABCDs, that your baby should be alone, on their back, in their crib and don't smoke because safe sleep saves lives.