This is purely out of curiosity because I’ve seen it pop up: do you think that most people know that letting an infant sleep in a rock n play, swing, or other baby seat puts them at increased risk for SIDS? I’m asking partly because after weeks of awful sleep I put my kids on their bellies and got a lot of flack for it, but in my personal parenting circle and on here I’ve seen a lot of folks putting their kids to sleep in non-crib devices and no one says anything about it. I knew that sleeping on their backs was the safest and that there was an increased risk with stomach sleep so was nervous because of that but checked off my other boxes (alone, in the crib, in a swaddle or sleep sack—except for DD2 as we would use a receiving blanket on her bum on down during the few nights it was cool enough during a very hot summer—and obviously a non-smoking household). Do you think pediatricians communicate that babies should be in their cribs, or have you had a doctor recommend an RNP (our ped did for my SIL), or generally communicate that as long as they’re on their back in a device made for babies they are safe? I guess my real question is, do you think a discussion about the crib being the safest place, and non-crib (or made for sleep, so PNP, Moses basket, bassinet etc would be ok) devices being “unsafe” even though babies are on their backs is missing from our pediatric discussions? Also not trying to freak anyone out, and also it was a hard decision to put my kids on their stomach and I know I might get some more flack for that.
cantaloupe / 6085 posts
My take is that “back is best” has just done the best job with publicity (or whatever you’d call that). There are a ton of factors for sids that don’t get demonized in the same way. I think nearly everyone breaks the safe sleep rules / SIDS contributors in some way ... my first we pretty much followed them because she was an easy sleeper so why not? My second was not a good sleeper and we co slept a fair amount and I let him do tummy sleeping some in his crib too. I feel like I made the best choices I could for the larger situation.
My pedi did push us to get them in the crib (vs bassinet), but she meant in their own room which breaks another rule doesn’t it? I do think it’s very inconsistent.
persimmon / 1023 posts
I think everyone tries to do their best following the rules that are safest, but the desperation you feel when sleep deprived makes people make choices that probably aren’t safest. I knew full well that in our room, on his back, etc was safest but we moved him to his room at 6 weeks old, let him sleep in his swing or bouncy chair because I felt I was losing my mind and was desperate for rest. I had to weigh those options. Of course I was nervous and didn’t sleep well so it discouraged me but I think everyone has to make those hard choices. While I totally agree the recommendations have reduced deaths and are extremely helpful, in a practical world they just aren’t always able to be followed to the letter I don’t think.
persimmon / 1310 posts
I agree that some of the safe sleep recommendations are a lot more well-known than others. It’s also not clear which ones might have the biggest impact, and that is information that would be useful to parents if they feel they need to change something but aren’t sure what to try.
persimmon / 1390 posts
That’s definitely how I felt (just figure something out so we can all get sleep). I wish there was more information about what aspects of safe sleep are the most significant/have the most impact, and more on different types of sleep environments.
nectarine / 2433 posts
My friend's ped suggested the RNP.....so that's something?!!
eggplant / 11716 posts
My oldest had reflux and our ped ended up recommending a lot of "unsafe" sleeping ideas, even though she'd sent me home with a safe-sleep "back is best" flyer when I had a newborn. But I think her point was---sleeping alone in a crib on their back with no swaddling or anything else is *best*, but if you have a kid that isn't sleeping, is screaming all night--you have to try other stuff?
She recommended the Rock in Play or a crib wedge for sleep, and also recommended that I stop using a stroller bassinet and only use a reclined seat or car seat in the stroller.
persimmon / 1390 posts
@pachamama: Apparently, yes. I wish there was a guide or something that rated all the various sleep options like “Back, in crib, alone, in parent’s room: Safest,” “Rock n Play: Less safe,” “In your arms on the couch while you are also asleep: Least safe.” But also to include things like swaddles, dock a tots, pacifiers, etc.
persimmon / 1390 posts
@Anagram: Our first ped was like that. She said she couldn’t recommend putting the baby on her belly, but that I might make a judgement call as a parent. Our second ped took one look at DD2s perfectly round head, gave me the side eye, and said “She’s on her back, right?” Oops.
kiwi / 556 posts
So during our well-check questionnaire, it always says “do you always put baby to sleep on back” and “do you always put baby in a car seat” and (what I consider) super basic parenting stuff. I figure they ask because people just do what their parents did and don’t know or realize there is more/new info out there.
I have a friend who is decently educated about babies because she’s like the 10th friend to have a kid. But she regularly asks me things like sleep safety questions and car seat install guidelines. So I think even people who feel confident caring for babies don’t know the recommended guidelines for all things.
Plus, people may know and still use stuff. My baby has slept with a small crocheted blanket her whole life. At first I’d just put it over her legs while swaddled and didn’t worry because she couldn’t move the blanket. Then when she wasn’t swaddled I didn’t worry about it because she only had it while I was in her presence and she wasn’t much of a mover in the crib. By the time she was more mobile she had grown attached to it and it was a lovey so I let her keep it (though I would let her fall asleep with it, then remove it from the crib). I also propped my infants to the side slightly with a rolled blanket while newborns because they’d sleep better. I think there’s a lot of things with baby sleep you do to survive. Especially if you have a colicky/reflux baby.
grapefruit / 4361 posts
I've been wondering about this too. A couple of times LO has fallen asleep in my arms (10 wks old) and I've slid her off me and onto the couch or bed, and she ends up on her stomach because I tried not to jostle her much. I stay close by and keep watch on her, but she sleeps SOOO long that way.
I feel like on HB, having LO sleep in a RnP or swing, or co-sleeping in bed; is much more accepted then tummy-sleeping in a flat crib.
pomelo / 5220 posts
I think we all know that in an ideal world, our babies would be swaddled and sleeping peacefully on their backs in their quiet, dark, cold, smoke-free rooms. In reality, most people I know have fallen asleep holding their baby, used a rock n play or mamaroo, co-slept, used a blanket, etc. I would like to think we all do as much as we possibly can to be safe but my LO would NOT sleep flat for a few weeks of his life, so into the RNP he went. The only person who gave me a little "that's so unsafe" lecture about it was my mother. I offered for her to hold him all night and that ended the conversation. Our pediatrician said to keep trying to put him in his bassinet but was understanding about the RNP because he was spitting up a lot. So yes, did I know he shouldn't be in the RNP? sure. Did I do it anyway cause I was losing my mind? yes.
cantaloupe / 6131 posts
There are things that are hypothetically ideal and then there is the reality of your child and your life. Everyone freaks out about SIDS, for example, because it’s so mysterious and tragic, but infant safety in all aspects is the goal here, not just SIDS prevention.
Like it’s just as dangerous to have a baby around a mom who is losing it because of sleep deprivation or PPD or exhaustion. A baby with terrible reflux could choke and die if they are swaddled and laying flat on a crib when they spit up. A baby can dehydrate or fail to thrive if a mom insists on exclusively breastfeeding, has bad supply, and won’t supplement. A baby can die without vaccines.
People just arbitrarily choose something to be superior about because that’s the thing they can manage to do successfully with their kids, not realizing everyone just has a different experience.
TLDR version: you do you boo boo.
kiwi / 544 posts
@gingerbebe: A baby cannot die from spitting up while lying on his back! Babies have an anatomical mechanism to prevent this from happening. Babies constantly spit up while lying on their backs-if what you say is true, they’d be dying left and right. Sorry but just couldn’t let this misinformation get out there and terrify people.
Otherwise, I agree-parents have to make choices that work for them. The questionnaire at our peds office asks about how the baby sleeps but that’s it. All I really knew going in to this was no blankets and sleep on back in crib so that is what we mostly do. But she sleeps in the RNP for naps and sometimes I’ll nap on couch too when she’s in there. Our ped has never asked!
cantaloupe / 6131 posts
@JJ2626: actually your baby can aspirate on their vomit like anyone else and get incredibly sick and yes, die. I know people who’s children have been readmitted to NICU for this reason. I have two boys who had severe reflux and even if the vast majority of babies will not have an aspiration related injury or death from laying flat on their back and choking on copious amounts of vomit, tell that to a mom who feels she cannot sleep all night while watching her baby sleep “safely” flat on their back in a crib like they are “supposed” to.
persimmon / 1390 posts
@gingerbebe: I think the part about choosing something to be good at rings true, and I find it frustrating that some parents flaunt something they do so well (my original parent friend ring was all first time moms when I was struggling to survive with DD2, and now they’re starting to have seconds and switching their stance on a few things!). I have found that some people I’ve talked to take it that I am doing that when I’m really just trying to respond to a question or talk about something going on in our kids’ lives which makes me sad because I love talking about kids! It makes me feel like I should put a disclaimer on stuff sometimes like “My kids eat great! But they still wake up multiple times a night, I yelled at my kids way too much this week, and was late to work today because I was vacuuming ants off the living room carpet.”
Also @desertdreams88 I feel like that too: like outing myself on HB as a mom of a stomach sleeper would label me a “bad” mom.
So I guess from the feedback we’re not really getting anything standardized from our doctors! I was surprised that stomach sleeping was taboo but various back sleeping methods weren’t as much so the feedback satiated my search for the “Why!”
persimmon / 1390 posts
@gingerbebe: Yes, this is so true. My mom was horrified that babies are put on their backs now. She has seen so many people die from aspiration pneumonia as an ICU nurse, and also saw babies who aspirated when she was an OB nurse.
wonderful pea / 17279 posts
I won’t speak for other parents, but every “safest” rule I broke I fully knew it. We didn’t use a RNP, but, we took turns holding our baby at night the first 5 weeks of his life while we camped out on the couch since he preferred our arms vs the bassinet.
cantaloupe / 6131 posts
@Becky: doctors have to worry about liability. I’ve literally had my pediatrician flat say to me “I am really only allowed to tell you that sleeping on their backs is the safest thing for the vast majority of children in the largest number of settings” and then just give me a look like “help me out man, what am I supposed to do?”
Meanwhile the NICU nurses put my newborn ON HIS BELLY in the incubator bc he slept better that way, seemingly bc he was on monitors and what not.
As another example, for my first son who had insane reflux and colic, I was given the following advice all from the same medical system during the first 6 weeks of life:
- exclusively breastfeed. Breast is best, don’t give bottles or pacis
- pacis help reflux babies
- pacis reduce SIDS risk
- eliminate soy and dairy and acidic food and nuts and everything else (I ate rice and chicken and bananas for months)
- skin to skin as much as possible it will help them fuss less
- hold upright after feedings for 30 minutes
- only let them sleep on their backs swaddled
- don’t let him cry too much in case he spits up
- supplementing is okay if you have low supply but most moms don’t have that problem you should just feed on demand
- for a reflux baby feed half as much twice as often - so instead of feeding 3oz every 3 hours, feed 1.5oz every 90 minutes.
- for a reflux baby, feed as slowly as possible so either a paced slow feeding or pump before you nurse to get the initial letdown and then feed on a slower flow using fattier hindmilk
-make sure you eat enough to keep up your supply
-make sure you get enough rest bc it affects your supply
-your baby is losing weight you should feed more milk more often
- your baby is losing even more weight maybe you should supplement
- your baby should room share with your baby bc it reduces SIDS risk
- back on a flat crib is best
- you should incline your crib
At some point I snapped at my medical office. I said it is literally impossible to breastfeed my child (who takes 45 minutes to eat) and then hold him upright for 30 minutes and then hold him in my arms to sleep for 15 minutes just to feed him again bc it’s been 90 minutes since the last feeding for 24 hours a day. This while being able to eat 3 things myself and having a baby who screams most of the time in our bedroom in a crib that should or shouldn’t be inclined.
It’s all BS. Do you girl.
clementine / 935 posts
@gingerbebe: This is what I was coming here to say. I think you have to weigh risks. DD slept in a rock n play for several months because she did. not. sleep. otherwise. We decided the risk of being in the rnp was less the risk of us crashing a car or something because we were so exhausted. But we definitely knew the rules.
wonderful cherry / 21504 posts
Eh. I had a different primary pediatrician for each of my two kids when they were newborns, plus one attending. All three doctors asked where baby was sleeping at every check up. For the first few months I told them truthfully, swaddled in the rock and play. They always nodded and wrote and it down, the asked the next question, or made sure to remind me to ditch the swaddle if they started rolling or whatever. No problem with the rnp itself.
But yeah, I think everyone does what they have to do. I’ve easily kept both my kids rear facing well past 2, because neither got car sick or complained about it. My friend whose kid screamed and threw up rear facing turned him around before he turned two, so we wouldn’t get in an accident listening to the screaming and puking. I don’t judge that one bit.
honeydew / 7463 posts
@bhbee: yes, everything you said. There are so many sleep safety rules and everyone picks and chooses what is convenient or works best for them. I admittedly act all “omg I’d never do that” (in my head) about some sleep safety things and absolutely turn around and do others.
grapefruit / 4466 posts
I think there are different categories of things:
--stuff that is clearly dangerous and should never be done, like having an infant sleep on a couch or with loose blankets/pillows, etc
--stuff that in an ideal world would be safer, but might not in practice, i.e. if the baby won't sleep that way and this raises the risk of falling asleep with the baby in the arm chair, or whatever, which we know is substantially more dangerous than an alternative way that the baby would actually sleep
--stuff where the evidence that it is safer is actually really thin. Like security theatre for babies - recommendations will change in the future as we learn more and sometimes there's a tendency to overstate benefits given the available evidence (not just wrt sleep, breastfeeding would be a prime example...)
nectarine / 2821 posts
It has always bothered me how a lot of the recommendations are just said to prevent sids, but they are actually preventing specific things, like suffocation, or entrapment, not a sudden unexplained event.
I also totally altered my belief in the sids recommendations by being a peds nurse. Most all the nurses I work with are so used to making the little nests and elevating the crib and putting tons of blankets and crap everywhere in the crib like toys and supplies. Granted, the babies are on monitors, but it has skewed my view so much!
nectarine / 2821 posts
Also none of my pediatricians ever asked me where my baby slept, so weird.
coffee bean / 43 posts
It honestly blows my mind that pediatricians would feel within their rights to ask AND TAKE NOTE OF how you put your child to sleep.
They're not a parenting authority, they can answer (some) medical questions and assess general developmental progress.
It drives me nuts how overinserted they can be in the entire parenting experience.
I did only put my son to sleep on his back, but I also moved him into his own room at 1 month (next door to mine) because he woke up every time my husband snored. Because sleep is important to THEIR development and a parent's ability to function, that was huge.
Then, he went through a 6 month long sleep regression and I'm not talking one or two times a night, but 4-8 times a night, night terrors, literally worked off of 3-4 super broken hours of sleep a night for a YEAR. You'd better believe I brought him back to my bed and nursed him while cosleeping all. night. long. because he wouldn't take a paci and I was on the verge of losing it.
Another guideline, the whole sleeping-through-the-night crap. At 9 months, my ped told me I needed to stop nursing at night and pick a weekend and let my son cry it out to figure it out. What he didn't take into account was that as a teething baby, he went almost completely off of solid foods so from a nutritional standpoint, really did need those late night feeds and from a sanity standpoint, I was more than willing to do that vs. fight him going back to sleep on his own (plus, felt wrong).
You do you - I'm convinced all of these ridiculously stringent guidelines were created by people who never actually had children. Obviously, we all want the best for our kids and would never intentionally place them in the way of harm. There are outliers to every statistic, and my son needed my presence to sleep - I needed sleep to care for him and to function at work, so we did what got us the most mileage.
wonderful pear / 26210 posts
My view is that there are really some people out there that have no clue, and these questions that are asked are intended for them, not necessarily me, the research I have done and my experience, so I just answer honestly and move on.
nectarine / 2243 posts
@looch: yes I agree with you completely.
The risk of sids is actually very low. But it is the number one killer of healthy infants older than a month. So I’d imagine the AAP thinks that there isn’t much downside in continuing the recommendation until it is proven otherwise. And there have been measurable decreases in the incidence of sids since the back to sleep campaign began.
With all of that being said, my kids have slept in “not sleep safe approved devices” and napped on their bellies.
I think pediatricians might have to ask the question. Maybe it’s like asking about pain scales as a physician. You have to document it to receive reimbursement from Medicare. Maybe there is an equivalent? I have no idea but I wouldn’t be surprised. Parents don’t have to answer the question but maybe the doctors do have to ask.
coconut / 8472 posts
I feel like as parents we take on the amount of risk we’re comfortable with. I co-slept with DS as a newborn, and DD slept in a swing for weeks at night. You do what you gotta do.
Also, most people, even medical staff, are not super educated in statistics. I once read the history of circumstances for reported SIDS deaths. And you know what? Most of them seemed to have smothered in unsafe conditions, like on a couch. It is INCREDIBLY rare for a baby alone in a crib with no blankets sleeping on their stomach to pass away from SIDS.
grapefruit / 4291 posts
@ShootingStar: yep, I’m in New Zealand and most of the deaths attributed to bed sharing here involve unsafe practices/ risk factors such as alcohol or drugs, unsafe bedding, formula feeding or low birth weight infants, they VERY rarely happen when safe bedsharing guidelines are being followed.
persimmon / 1270 posts
I was surprised by how secretive I felt I needed to be about sleeping my babies on their bellies in am empty crib compared to how many people I know put their babies in rnps or swings to sleep and were open about it.
nectarine / 2433 posts
How do we feel about the safety of the Dock a Tot?
apricot / 317 posts
@JJ2626: actually...babies CAN choke from spitting up on their backs, although death isnt likely from this in a normal baby. DS2 has CP with dysphagia (an inability to swallow and/or cough correctly -both in my son's case- potentially leading to aspiration and a build up of fluid in the lungs) and his dysphagia was undiagnosed until he was nearly 12 months old. If he had ever actually slept on his back, he could have aspirated and died silently before we ever knew that this was an issue. He was absolutely a stomach sleeper because of his CP and because he had terrible reflux as a baby- stomach sleeping really seemed to help his reflux. Interestingly enough, because of his abnormal muscle tone, he could put himself on his tummy from the age of 2 weeks old....so even placing him on his back never did any good. My husband and I were so unnecessarily terrified of the risk of SIDS from stomach sleeping that we literally took shifts watching him 24/7 for the first 3 months of his life.