Dr. Harvey Karp, author of “The Happiest Baby on the Block,” will be taking your baby and parenthood questions on the CNN Parenting Facebook page live at 11 a.m. ET Monday, October 30.
Baby sleep is best if you play loud, rumbly white noise during all naps and nights
An unswaddled baby can roll to an unsafe position more easily than a swaddled one
We need more training to get a driver’s license than to become a parent, in our culture. Even though we would benefit from parental education, some of us have never even held a newborn before having one of our own. And we often rely on advice from friends and family, much of it outdated or just plain wrong.
When it comes to baby sleep, bad advice can be dangerous. October is Safe Sleep Awareness month, an opportunity to learn more about sudden unexpected infant death and debunk the myths about what is sabotaging your sleep and highlight habits that potentially risk your baby’s safety.
Myth 1: Your baby sleeps best in a silent room.
Not true. In fact, total silence can make it hard for your baby to doze off. Remember, the womb is noisy: louder than a vacuum cleaner and running 24 hours a day. For nine months, your little one’s been lulled to sleep by the rhythmic whooshing of the blood flowing through the placenta. To her, the quiet of the average home is jarring. Plus, in a silent room, she’s more likely to wake up when a loud truck on the street or any other bump in the night breaks that silence. The truth is, your baby will sleep best if you play loud, rumbly white noise during all naps and nights.
Myth 2: You should never wake a sleeping baby.
Nope. You should always wake your sleeping baby using a little technique called “wake and sleep.” It gently teaches your child the important skill of self-soothing. Here’s briefly how it works: Starting as early as the first day of life, wake him up the tiniest bit after sliding him into bed. Just tickle his neck or feet until his eyes drowsily open. Very soon after, he’ll drift right back into slumberland. In those few semi-awake seconds, he’s just soothed himself back to sleep – the first step toward sleeping through the night.
Myth 3: Some babies sleep worse when swaddled because they want to be free.
Not really. Your baby may fuss and resist swaddling at first, so it may look like she hates it. But babies don’t need freedom, they need the feeling of security they had in the womb. Without wrapping, your infant will flail her arms, whack herself in the face and startle easily throughout the night. That’s a recipe for poor sleep.
Swaddling is the first step to calming, and it’s important you don’t stop there, especially if your infant’s been fighting it. To help her settle, you’ll want to layer in other womb-mimicking steps: “shushing,” side/stomach position, swinging and sucking, which, along with swaddling, make up the 5 S’s of setting up a baby for sleep success. And once the S’s become part of your sleep routine, she’ll give up her battle! (Note: Side/stomach position is for calming only, never for sleep.)
Myth 4: We should teach babies to sleep in their own rooms.
Having our babies grow up to be independent takes a long time. There’s no need to rush it. In fact, having your new child sleep in another room is inconvenient (for feedings and diaper changes) and possibly dangerous. The American Academy of Pediatrics recommends that babies sleep in the parent’s room for at least six months (always on their back, in their own bed). The simple practice has shown to significantly reduce the rate of sudden infant death syndrome.
Myth 5: Swaddling should be stopped after two months.
Swaddling reduces crying and increases sleep. But new research shows that swaddled babies who roll to the stomach have double the risk of SIDS compared with an unswaddled baby rolling over. As a result, the pediatrics academy is now recommending that parents stop baby-wrapping at 2 months. On the face of it, the group’s new advice seems to make sense, but it completely ignores the risks of not swaddling.
In an eight-year review of data collected by the Consumer Product Safety Commission, only 22 sudden unexplained infant deaths related to swaddling were reported; almost 50% were in sleep sacks (a wearable blanket), and 90% were found on the stomach and/or with bulky bedding. (Note: Fatalities categorized as sudden unexplained infant death include sleep deaths from accidental suffocation, strangulation and SIDS.)
During those eight years, hundreds of thousands – if not millions – of babies were swaddled. Since sudden unexplained infant death strikes one in 1,200 babies, one would have expected hundreds or perhaps thousands of swaddle-related deaths over this period if wrapping caused these deaths. Of note, during the same eight years, 1,026 deaths related to sofa sleeping were reported to the safety commission.
The point is, though swaddling may introduce a theoretical risk, there is not a lot of proof it is causing a true increase in sudden unexplained infant death. On the other hand, swaddling has been shown to reduce infant crying and boost sleep. That is of critical importance because the stress provoked by persistent fussing and parental exhaustion is a potent trigger for postpartum depression, child abuse, car accidents and even risky sleeping practices, which are associated with up to 70% of all infant sleep fatalities.
We don’t want babies rolling over swaddled, but we also don’t want them rolling over unswaddled during the 2- to 4-month-old peak period for SIDS. An unswaddled baby can roll to an unsafe position more easily than one whose movement is restricted by snug swaddling. And, since swaddling improves sleep, unwrapped babies wake more often and are more likely to tempt their tired parents to fall asleep with them in their beds.
To solve this tricky problem, I assembled a team of MIT-trained engineers and renowned industrial designer Yves Behar to invent a type of swaddle that keeps sleeping babies safely on the back. In October 2016, my company Happiest Baby debuted Snoo, the world’s first responsive bassinet that employs this special swaddle, which clips to the base of the bed to prevent rolling. This innovation allows parents to reap the substantial benefits of swaddling for a full six months without any of the risks.
Myth 6: Putting babies to sleep on the back has solved SIDS.
The National Institute of Health-led Back to Sleep campaign quickly reduced sleep deaths from 5,500 in 1994 to 3,500 in 1999. However, for the past 17 years, progress has completely stalled. The tragic truth is that 3,500 infants die during their sleep each and ever year. Although more babies are sleeping on the back, the rate of accidental suffocation and strangulation infant deaths has quadrupled since the mid-1990s. What’s behind this alarming trend? Unsafe sleeping practices. Seventy percent of all sudden unexplained infant death victims are found in adult beds, sofas and other risky locations.
A recent study revealed that while most parents fully plan to follow the ABCs of safe sleep (Alone, on the Back, in a Crib), less than half actually do it. And by the end of the night, about 60% of babies have migrated from their bassinet to their parents’ bed, according to a study in the Journal of Clinical Lactation.
The terrible, unintended consequence of the Back to Sleep campaign is that it has worsened infant sleep. Babies just don’t sleep well on their backs in still, quiet cribs. And as discussed in myth 5, when babies don’t sleep well, parents resort to bed-sharing, which leads to many more infant suffocation deaths.
It is very important that parents continue to place their babies to sleep on the back, but they also need to start using more tools to improve their child’s sleep. The good news is that there are three effective ways to boost slumber for back-sleeping babies: sound, swaddling and rocking.
Rumbly white noise is inexpensive and very effective for improving a baby’s sleep. Snug swaddling is too, but as explained above, pediatricians now recommend that parents stop wrapping at 2 months old. Motion, or swinging, is also great, but the American Academy of Pediatrics has found that sleeping in sitting devices, such as rockers and swings, may allow a baby’s head to roll forward and cause accidental suffocation and death.
These are issues we sought to address with the Snoo bed. It allows for safe swinging (it is totally flat), safe swaddling (the baby can’t roll over) and safe sound, as the sound increases when a baby cries but then immediately softens – after the baby calms – for all-night sleep promotion. We designed it to deliver the right level of womb-like stimulation that is right for any particular baby to calm his or her fussing and boost sleep.
For nearly 20 years, despite enormous public health educational programs, we have failed to reduce infant sleep death. But, by focusing on sleep efficacy (boosting a baby’s sleep), we now have a very exciting means to prevent many – if not most – of these deaths. And as a health bonus, improving sleep efficacy may also allow us to reduce other serious and unsolved health problems triggered by exhaustion and crying, such as postpartum depression (with about a half million cases diagnosed a year) and shaken-baby syndrome (1,300 incidents a year).
Join the conversation on CNN Parenting's Facebook page
Please join me in October – and all year long – by telling new parents about exhaustion’s role in sudden unexplained infant death and by sharing the sleep-boosting tips mentioned here. I am confident that we will dramatically improve the health of American parents and babies as we put more energy and emphasis on helping parents promote better infant sleep.
Dr. Harvey Karp is the author of “The Happiest Baby on the Block” and founder and CEO of HappiestBaby.com, the maker of innovative tools to help babies sleep.