Safe Sleep, SIDS, and the Ongoing Debate

I have had this question posed to me several times in my career. "What is safe infant sleep?" 

That is a loaded questions, and the answer really depends upon whom you ask. In America healthcare professionals have take a hard line. The Ohio Department of Health provides a safe sleep pamphlet to new parents. The ABCs of safe sleep stand for Alone, Back, Crib. They recommend that babies always sleep alone, on their backs, in a crib. In the UK and other European nations, health professionals address co-sleeping as an option but discuss steps to make it safer. The Mother Baby Sleep Laboratory at the University of Notre Dame are much more moderate in their recommendations and acknowledge co-sleeping as a safe option within certain guidelines. 

Everyone seems to agree on a few issues. The first is babies should always sleep on their backs. It helps to prevent choking, slow asphyxiation from their own gases, and overheating. Additionally the sleep area (and home) should be free of smoke (and cigarette smokers). The sleep area should be firm (not a  bean bag or waterbed or pillow) and free of any extraneous items (bumpers, blankets, pillows, stuffed animals). Breastfeeding leads to more natural sleep patterns and immune support. To facilitate breastfeeding babies should be near their mother. All of these recommendations have been linked to a reduction in the rate of SIDS (Sudden Infant death Syndrome). Experts also agree babies should NEVER sleep on couches, chairs, or bean bags, alone or with others. Also, an adult bed is not a safe place for babies to sleep alone. 

Combined with the fear of SIDS, many detractors claim that co-sleeping will create co-dependent spoiled children. James McKenna, Director of the Mother-Baby Behavioral Sleep Laboratory, says that fear is unfounded. He claims over 80% of breastfeeding mothers co-sleep at some point and that studies have shown children who co-sleep actually become more secure and independent. 

So what are your options for "safe sleep?" I would recommend you read the research and decide for yourself. There are a few options. In a crib in a nursery. In a crib or cot in the parents' room. In a co-sleeper or cot "sidecar" alongside the parent's bed. In a co-sleeping "box" in the parents' bed, or alongside the mother in a bed. Statistically, the "safest" place seems to be in a cot or co-sleeper alongside the parents' bed, in a sleep sack, free from smoke, blankets, pillows, and toys. 

Whatever you decide, educate yourself. Look at the evidence, and do what is right for you and your baby.