Ensuring Safe Sleep for Newborns and Infants
Sherri Hannan, a Registered Nurse and the Safe Kids Fayette County Coordinator, joins us to discuss the risks that newborns can face during sleep and how to reduce them.
Featured Speaker:
Sherri Hannan, RN
Sherri Hannan, RN is the Safe Kids Fayette County Coordinator. Transcription:
Ensuring Safe Sleep for Newborns and Infants
Joey Wahler (Host): When a new baby arrives, the thing it'll do most is sleep. So we're discussing ensuring safe sleep for newborns.
This is UK HealthCast, a podcast from UK HealthCare. Thanks for listening. I'm Joey Wahler. Our guest, Sherri Hannan, a registered nurse and the Safe Kids Fayette County Coordinator for Kentucky Children's Hospital. Sherri, thanks for joining us.
Sherri Hannan: Thanks for having me, Joey.
Joey Wahler (Host): So first, when a newborn comes home, in a nutshell, and then we'll get into some more specifics, what should parents know about, say, the bassinet and how the baby should be properly positioned for sleep right out of the box?
Sherri Hannan: Well, you want to first make sure that you are using a safe crib, something that meets all the current safety standards and not has any recalls. And then, you want to make sure that you have an empty crib with a firm mattress. That's the one place we put babies typically unsupervised when they're down for the night or for naps, so we want to make sure that that is a safe crib.
Joey Wahler (Host): And so let's talk first about a crib or a bassinet. What are a couple of the dos and don'ts, as far as safety goes?
Sherri Hannan: Well, lots of times, maybe the grandparent has saved the crib of mom or dad, and wants to do that as a hand-me-down. But typically, those don't meet the same safety standards of today, so making sure that you have a safe crib, one that meets all the consumer product safety standards, one that you will use properly each and every time. It needs to have a firm type-fitting mattress inside that crib, so making sure that baby has a safe place to sleep.
Joey Wahler (Host): How about anything inside the crib in terms of a blanket or a swaddle? Some people may not be familiar with what a swaddle is. Maybe you can explain that and tell us where those come into play.
Sherri Hannan: Well, you want to make sure that the crib is essentially empty. There should be nothing in the crib, no blankets, no pillows, stuff toys, bumper pads, completely empty. So you want to just put baby there on their back. And because we're saying no blankets, we have now what we call wearable blankets or sleep sacks that can be purchased, and baby can just be fitted into that when it's time for bed.
And we do know that sometimes babies, especially newborns to maybe up to four months or so, like to be swaddled. And that's a technique that you wrap the blanket kind of tightly around the baby. And that's okay if that's what your baby likes, but you want to make sure that their arms are kind of down to their side. Their hips and legs have room to move. But once baby starts to act like they're going to roll over, you want to stop swaddling baby, because they need their arms and their hands in order to actually roll and then roll back.
Joey Wahler (Host): Gotcha. Now, we backtrack for a moment. No pun intended when I say backtrack, because you mentioned the baby should be on its back. We always hear that in those early stages. Why is that so important?
Sherri Hannan: Well, it's different from what maybe grandparents used to do for their children, but it's evidence-based. Baby needs to be face up. Face down, the baby can rebreathe that exhaled carbon dioxide, which might be one of those reasons that babies go into a sound sleep, and they can run the risk of a SIDS death, which is that sudden infant death syndrome.
Joey Wahler (Host): Well, I was going to ask you about that next, so you led me in perfectly, Sherri. When we say SIDS, sudden infant death syndrome, it's something we've heard a lot about over the years. Do we know any more about what causes it today than we did when it first became more talked about years ago?
Sherri Hannan: Well, unfortunately, it is still that unexpected unexplained death of an apparently healthy infant. What we do know is that there's certain safety steps that we can take to try to reduce those risk. There's things that mom can do. Not smoke during pregnancy. Once baby arrives, not exposing it to that passive secondhand smoke. Even using pacifiers, which makes the tongue lie in a particular position so that it doesn't obstruct that oropharyngeal airway.
Joey Wahler (Host): You're talking about using a pacifier during sleep?
Sherri Hannan: Right. That is one of the things that have kind of helped with the positioning of the tongue. And like I said, it decreases obstruction so that baby's airway is nice and open. But baby doesn't take a pacifier, you don't have to make it take a pacifier, but it has been associated with helping to reduce the risk of a SIDS death.
Joey Wahler (Host): Aha. How about even for short periods, is it safe to let a baby sleep in your bed with you?
Sherri Hannan: Absolutely not. Baby should always be put to sleep in their crib alone, on their back. You know, feed baby, cuddle baby. But if you're tired and you want to sleep, just go ahead and put the baby in the crib, making sure that there's no risk of lying on the couch or even in a chair, even those things, still are kind of like a co-sleeping environment. It's just when you sleep, you need to be able to sleep soundly, because parents are fatigued. And when you sleep, you're really not aware of when you move and baby can be repositioned and there is a high risk of suffocation with rollovers and things like that when you leave baby in the bed with you.
Joey Wahler (Host): So speaking of risk, going back to when a baby is sleeping on its own, what are a few of the biggest health risks that parents need to avoid?
Sherri Hannan: Well, one is overheating baby. Lots of times we think that baby really needs to be bundled and warm. Just maybe one extra layer than what you have, those wearable blankets again, will suffice. And even American Academy of Pediatrics are even encouraging that once baby comes home from the hospital, when they sleep in just around the house that you remove the little cute hats that are on baby's heads, just to help reduce that overheating risk. But again, making sure that baby is in a crib that has nothing else in it, so that if they do move around, that they're not at risk for suffocating. A firm-fitting sheet on the mattress that fits well into the crib. Any of those things will help reduce the risk of suffocation with baby left alone in the crib.
Joey Wahler (Host): Caps that parents put right on the infant as soon as they're born, that's I guess you're saying for photo op purposes only, and then you should get rid of them.
Sherri Hannan: Right. I mean, they may use those in the hospital just as a newborn. But when you start bringing baby home, especially at night sleeping, that is one of the things, that it's purpose is to make the heat stay on the body and you want to make sure that we don't overheat those babies. Again, that is one of those risk factors for SIDS, is overheating. So removing those sleeping hats right before baby goes down, and it's also even encouraged sometimes to have a fan going, because it circulates that air and that helps reduce the carbon dioxide intake rebreathing, those types of things.
Joey Wahler (Host): So it sounds like you're saying when it comes to regulating the temperature around the baby, that it's better to err if need be on the side of it being a little cooler rather than warmer.
Sherri Hannan: Well, we don't want baby to be cold for sure. You can touch a baby and see if their skin is cool to the touch. We're not advocating for that. We just don't want baby to be sweaty and really warm to the touch when they're bundled up, just because overheating is one of those risk. You know, a wearable blanket, one more layer than what you would have is probably all that is really necessary for a baby. If you keep your home extra cool, because that's how you like to sleep, just making sure that baby may have a onesie and a sleeper and then their sleep sack on, and that should be adequate. And of course, a newborn baby is probably waking up every few hours and the parent can reassess if they need more or less.
Joey Wahler (Host): Understood. So a few other things, one being at what age, at what point do the needs of a sleeping baby change in terms of when is it safe to start putting some things in the crib and what would those things be?
Sherri Hannan: Well, I would say probably the SIDS risk is typically for an infant under 12 months. Once they start rolling to their bellies and back to their back, they're going to reposition themselves. So again, during sleep, making sure that the crib is empty, not until probably they are well over maybe a year and a half that you would have a special blanket or a toy. But kids just don't need pillows and a lot of like big, heavy weighted blankets and things like that in the crib with them. So, when they're just in the crib playing, maybe offer some toys. But when it's actual time for sleep, remove all those extra things. You know, baby sleeping, they don't need it. So, there's tummy time when a parent is supervising and interacting with their baby. But when it's time for sleep, just to keep that crib empty, you know, always putting the child down on their back and just always remembering as well that the crib is the designated sleep environment. Leaving kids sleeping in car seats and swings, and strollers is not advisable. As soon as you can, you need to move baby to the crib, and out of those things, because those aren't approved sleeping devices.
Joey Wahler (Host): Very important point there. How about if your baby awakes and starts crying? And I shouldn't even say if, I should say when, right? Once you check on them, Sherri, is it okay to ever let them "cry themselves back to sleep" if you're reasonably sure that everything else is okay?
Sherri Hannan: When you've checked on baby and they don't need to be fed, they don't need a diaper change, maybe just soothing them, patting them, that type of thing is okay. Crying doesn't hurt baby. One of the things that parents need to establish is some of those sleeping patterns and there's some studies about sleep training, if you will. But you want baby to be able to get themselves to sleep. They're not necessarily having to be rocked every time or having that sensation of being asleep, laying on mom's chest or something, they need to be able to wake up, get themselves back to sleep.
But of course, infants typically they always need to be checked and they're just frequent eaters. So, they're not going to sleep for very long periods of time. So, if it's been two, three hours and baby has slept well, check on them, especially if it's been, greater than that because that's usually a pattern of a newborn or a very young baby, is to awaken at least every three or four hours to eat. Their bellies are so small. They can't hold very much. So it's a quick turnaround for feedings.
Joey Wahler (Host): Well, very helpful information indeed. Folks, we trust you're now more familiar with ensuring safe sleep for newborns. Sherri Hannan, thanks so much.
Sherri Hannan: Thank you.
Joey Wahler (Host): And for more information, please call Kentucky Children's Hospital at eight 859-323-5000. Again, 859-323-5000. If you found this podcast helpful, please do share it on your social media. And thanks for listening to UK HealthCast, a podcast from UK HealthCare. Hoping your health is good health, I'm Joey Wahler.
Ensuring Safe Sleep for Newborns and Infants
Joey Wahler (Host): When a new baby arrives, the thing it'll do most is sleep. So we're discussing ensuring safe sleep for newborns.
This is UK HealthCast, a podcast from UK HealthCare. Thanks for listening. I'm Joey Wahler. Our guest, Sherri Hannan, a registered nurse and the Safe Kids Fayette County Coordinator for Kentucky Children's Hospital. Sherri, thanks for joining us.
Sherri Hannan: Thanks for having me, Joey.
Joey Wahler (Host): So first, when a newborn comes home, in a nutshell, and then we'll get into some more specifics, what should parents know about, say, the bassinet and how the baby should be properly positioned for sleep right out of the box?
Sherri Hannan: Well, you want to first make sure that you are using a safe crib, something that meets all the current safety standards and not has any recalls. And then, you want to make sure that you have an empty crib with a firm mattress. That's the one place we put babies typically unsupervised when they're down for the night or for naps, so we want to make sure that that is a safe crib.
Joey Wahler (Host): And so let's talk first about a crib or a bassinet. What are a couple of the dos and don'ts, as far as safety goes?
Sherri Hannan: Well, lots of times, maybe the grandparent has saved the crib of mom or dad, and wants to do that as a hand-me-down. But typically, those don't meet the same safety standards of today, so making sure that you have a safe crib, one that meets all the consumer product safety standards, one that you will use properly each and every time. It needs to have a firm type-fitting mattress inside that crib, so making sure that baby has a safe place to sleep.
Joey Wahler (Host): How about anything inside the crib in terms of a blanket or a swaddle? Some people may not be familiar with what a swaddle is. Maybe you can explain that and tell us where those come into play.
Sherri Hannan: Well, you want to make sure that the crib is essentially empty. There should be nothing in the crib, no blankets, no pillows, stuff toys, bumper pads, completely empty. So you want to just put baby there on their back. And because we're saying no blankets, we have now what we call wearable blankets or sleep sacks that can be purchased, and baby can just be fitted into that when it's time for bed.
And we do know that sometimes babies, especially newborns to maybe up to four months or so, like to be swaddled. And that's a technique that you wrap the blanket kind of tightly around the baby. And that's okay if that's what your baby likes, but you want to make sure that their arms are kind of down to their side. Their hips and legs have room to move. But once baby starts to act like they're going to roll over, you want to stop swaddling baby, because they need their arms and their hands in order to actually roll and then roll back.
Joey Wahler (Host): Gotcha. Now, we backtrack for a moment. No pun intended when I say backtrack, because you mentioned the baby should be on its back. We always hear that in those early stages. Why is that so important?
Sherri Hannan: Well, it's different from what maybe grandparents used to do for their children, but it's evidence-based. Baby needs to be face up. Face down, the baby can rebreathe that exhaled carbon dioxide, which might be one of those reasons that babies go into a sound sleep, and they can run the risk of a SIDS death, which is that sudden infant death syndrome.
Joey Wahler (Host): Well, I was going to ask you about that next, so you led me in perfectly, Sherri. When we say SIDS, sudden infant death syndrome, it's something we've heard a lot about over the years. Do we know any more about what causes it today than we did when it first became more talked about years ago?
Sherri Hannan: Well, unfortunately, it is still that unexpected unexplained death of an apparently healthy infant. What we do know is that there's certain safety steps that we can take to try to reduce those risk. There's things that mom can do. Not smoke during pregnancy. Once baby arrives, not exposing it to that passive secondhand smoke. Even using pacifiers, which makes the tongue lie in a particular position so that it doesn't obstruct that oropharyngeal airway.
Joey Wahler (Host): You're talking about using a pacifier during sleep?
Sherri Hannan: Right. That is one of the things that have kind of helped with the positioning of the tongue. And like I said, it decreases obstruction so that baby's airway is nice and open. But baby doesn't take a pacifier, you don't have to make it take a pacifier, but it has been associated with helping to reduce the risk of a SIDS death.
Joey Wahler (Host): Aha. How about even for short periods, is it safe to let a baby sleep in your bed with you?
Sherri Hannan: Absolutely not. Baby should always be put to sleep in their crib alone, on their back. You know, feed baby, cuddle baby. But if you're tired and you want to sleep, just go ahead and put the baby in the crib, making sure that there's no risk of lying on the couch or even in a chair, even those things, still are kind of like a co-sleeping environment. It's just when you sleep, you need to be able to sleep soundly, because parents are fatigued. And when you sleep, you're really not aware of when you move and baby can be repositioned and there is a high risk of suffocation with rollovers and things like that when you leave baby in the bed with you.
Joey Wahler (Host): So speaking of risk, going back to when a baby is sleeping on its own, what are a few of the biggest health risks that parents need to avoid?
Sherri Hannan: Well, one is overheating baby. Lots of times we think that baby really needs to be bundled and warm. Just maybe one extra layer than what you have, those wearable blankets again, will suffice. And even American Academy of Pediatrics are even encouraging that once baby comes home from the hospital, when they sleep in just around the house that you remove the little cute hats that are on baby's heads, just to help reduce that overheating risk. But again, making sure that baby is in a crib that has nothing else in it, so that if they do move around, that they're not at risk for suffocating. A firm-fitting sheet on the mattress that fits well into the crib. Any of those things will help reduce the risk of suffocation with baby left alone in the crib.
Joey Wahler (Host): Caps that parents put right on the infant as soon as they're born, that's I guess you're saying for photo op purposes only, and then you should get rid of them.
Sherri Hannan: Right. I mean, they may use those in the hospital just as a newborn. But when you start bringing baby home, especially at night sleeping, that is one of the things, that it's purpose is to make the heat stay on the body and you want to make sure that we don't overheat those babies. Again, that is one of those risk factors for SIDS, is overheating. So removing those sleeping hats right before baby goes down, and it's also even encouraged sometimes to have a fan going, because it circulates that air and that helps reduce the carbon dioxide intake rebreathing, those types of things.
Joey Wahler (Host): So it sounds like you're saying when it comes to regulating the temperature around the baby, that it's better to err if need be on the side of it being a little cooler rather than warmer.
Sherri Hannan: Well, we don't want baby to be cold for sure. You can touch a baby and see if their skin is cool to the touch. We're not advocating for that. We just don't want baby to be sweaty and really warm to the touch when they're bundled up, just because overheating is one of those risk. You know, a wearable blanket, one more layer than what you would have is probably all that is really necessary for a baby. If you keep your home extra cool, because that's how you like to sleep, just making sure that baby may have a onesie and a sleeper and then their sleep sack on, and that should be adequate. And of course, a newborn baby is probably waking up every few hours and the parent can reassess if they need more or less.
Joey Wahler (Host): Understood. So a few other things, one being at what age, at what point do the needs of a sleeping baby change in terms of when is it safe to start putting some things in the crib and what would those things be?
Sherri Hannan: Well, I would say probably the SIDS risk is typically for an infant under 12 months. Once they start rolling to their bellies and back to their back, they're going to reposition themselves. So again, during sleep, making sure that the crib is empty, not until probably they are well over maybe a year and a half that you would have a special blanket or a toy. But kids just don't need pillows and a lot of like big, heavy weighted blankets and things like that in the crib with them. So, when they're just in the crib playing, maybe offer some toys. But when it's actual time for sleep, remove all those extra things. You know, baby sleeping, they don't need it. So, there's tummy time when a parent is supervising and interacting with their baby. But when it's time for sleep, just to keep that crib empty, you know, always putting the child down on their back and just always remembering as well that the crib is the designated sleep environment. Leaving kids sleeping in car seats and swings, and strollers is not advisable. As soon as you can, you need to move baby to the crib, and out of those things, because those aren't approved sleeping devices.
Joey Wahler (Host): Very important point there. How about if your baby awakes and starts crying? And I shouldn't even say if, I should say when, right? Once you check on them, Sherri, is it okay to ever let them "cry themselves back to sleep" if you're reasonably sure that everything else is okay?
Sherri Hannan: When you've checked on baby and they don't need to be fed, they don't need a diaper change, maybe just soothing them, patting them, that type of thing is okay. Crying doesn't hurt baby. One of the things that parents need to establish is some of those sleeping patterns and there's some studies about sleep training, if you will. But you want baby to be able to get themselves to sleep. They're not necessarily having to be rocked every time or having that sensation of being asleep, laying on mom's chest or something, they need to be able to wake up, get themselves back to sleep.
But of course, infants typically they always need to be checked and they're just frequent eaters. So, they're not going to sleep for very long periods of time. So, if it's been two, three hours and baby has slept well, check on them, especially if it's been, greater than that because that's usually a pattern of a newborn or a very young baby, is to awaken at least every three or four hours to eat. Their bellies are so small. They can't hold very much. So it's a quick turnaround for feedings.
Joey Wahler (Host): Well, very helpful information indeed. Folks, we trust you're now more familiar with ensuring safe sleep for newborns. Sherri Hannan, thanks so much.
Sherri Hannan: Thank you.
Joey Wahler (Host): And for more information, please call Kentucky Children's Hospital at eight 859-323-5000. Again, 859-323-5000. If you found this podcast helpful, please do share it on your social media. And thanks for listening to UK HealthCast, a podcast from UK HealthCare. Hoping your health is good health, I'm Joey Wahler.