Crib Safety: What The Experts Say
In the first few years of life, your baby will probably spend more time in his or her crib than any other single place. Naturally, you want it to be welcoming, comfortable, and most of all, safe.
There are a number of steps you can take to safety-proof your baby's crib, including these, as recommended by the American Academy of Pediatrics (AAP), the National Safety Council, and other authorities on child safety.
First and foremost, ALWAYS place your baby to sleep on his or her back. SIDS (Sudden Infant Death Syndrome) rates have dropped by more than 50% since the America's "Back to Sleep" Campaign was introduced in 1994.
In addition, make sure your crib meets these safety standards, as recommended by the AAP:
- Make sure that the spaces between the slats are no wider than 2 ⅜" apart
- Choose a firm mattress, not a soft one. Never place baby on a water bed, sofa, or other soft surface.
- Avoid gaps between the mattress and crib walls. Try the "two fingers" test: if you can fit two fingers between the mattress and crib, it's not safe to use.
- Ensure the corner posts are level with the height of the end panels (or much higher, as on canopy-style beds). Otherwise clothing can get caught on the post.
- Don't choose a crib with decorative cutouts—a trapping hazard—on its end panels.
- Check the distance between the height of the crib sides and the mattress. When lowered, the crib sides should be at least 9" above the mattress. When raised, they should be at least 26" above the mattress in its lowest position.
- Make sure the drop sides can't be released by a child. The sides should feature a locking, hand-operated latch.
- Examine your crib frequently for hazards: loose parts, off-kilter joints, splinters, chipped paint. If you spot a problem, fix it immediately.
- When buying a new crib, look for Juvenile Product Manufacturers Association (JPMA) certification.
In addition, the National Safety Council offers these suggestions
- As charming as they are, don't be tempted to use an antique crib that doesn't meet current safety standards
- Avoid wrapping the mattress in plastic materials to protect it.
- Never place baby's crib next to a window. Blind cords, drapery cords, and window screens all pose hazards to kids
Finally, be ready to modify baby's crib as he matures. The AAP recommends removing mobiles and hanging toys when baby begins to push up on his hands and knees or at five months, whichever occurs first. In addition, as soon as baby stands up, set the mattress at its lowest position and remove any bumper pads, which can be used as stepping stones.
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What Every Parent Should Know About SIDS
Every new parent needs to learn about SIDS, or Sudden Infant Death Syndrome. And while the numbers are decreasing, about 2,500 infants in the United States still die from SIDS each year. Scientists don't yet know how to prevent it, but there are specific precautions you can take to reduce its risk.
What Is SIDS?
Experts define SIDS as the sudden, unexplained death of an otherwise healthy infant under the age of one. It occurs when babies are sleeping, which is why it is also referred to as "crib death." It is the leading cause of death in infants under age 12 months, and occurs most often in infants between the ages of 2-4 months, according to the American Academy of Pediatrics.
What Causes SIDS?
Although it's been the subject of many studies, researchers still don't know what causes SIDS. One thing we do know: back-sleeping babies are at less risk of SIDS than babies who sleep on their tummies or sides.
There are several theories regarding the possible causes of SIDS. One is that bedding around babies' faces can limit air supply, forcing them to re-breathe exhaled air, which is low in oxygen and high in carbon dioxide, a toxin. Another is that SIDS babies may not have the ability to wake themselves when their air is limited, due to a deficit in a part of the brain called the arcuate nucleus.
While the research continues, most experts agree that it may be a combination of factors—rather than a single cause—that contributes to SIDS. That's why it's important to take every precaution when laying your baby down to sleep.
Steps You Can Take Against SIDS
There are a number of precautions you can take to make baby's sleep environment safer, including these recommendations offered by the American Academy of Pediatrics (AAP), National Institute of Child Health and Human Development, and the American SIDS Institute:
- ALWAYS place your infant on his or her back to sleep, even for a short nap. Make sure baby's caregivers also follow this practice. A baby who sleeps on its back at home, but on its stomach elsewhere (a practice known as "unaccustomed tummy sleeping") is at a much greater risk of SIDS, according to the AAP.
- Make sure baby is sleeping on a firm crib mattress, not in an adult bed or on cushioned furniture.
- Remove all soft and loose items from the crib, including blankets, pillows, and stuffed animals.
- Do not allow baby to become overheated. Keep the room at a temperature that's comfortable for a lightly-clothed adult. Do not over-bundle baby.
- Place the crib in an area that's always smoke-free. Better yet, make baby's world smoke-free. According to the American SIDS Institute, the greater an infant's exposure to tobacco smoke, the greater the risk of SIDS.
- Have baby sleep in your room, secure in his cradle, bassinet, or co–sleeper. Sleeping in the same room as a parent reduces an infant's risk of SIDS. However, babies should not sleep unprotected in adult beds.
- Offer baby a pacifier at bedtime. Some studies show a lower rate of SIDS among babies who suck on pacifiers.
- Don't rely on products that claim to prevent SIDS. Products like monitors will alert you to baby's noises and movements, but don't eliminate the risk of SIDS. It's important for parents to remain vigilant.
Don't Forget Tummy Time
There is one drawback to back-sleeping: it can lead to positional plagiocephaly, or the development of a flat spot on the back of baby's head. To avoid this problem, experts recommend plenty of supervised tummy time, which also helps build neck and torso strength. They also suggest changing babies' position during waking hours, and varying the angle of baby's head while lying on his back.
The Risk is Real
As heartbreaking as it is, a parent can take every possible precaution and still lose a child to SIDS. Sometimes it is simply unpreventable. It is not in any way the parent's fault.
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Must-Read Guide to Babies and Ear Infections
Answers to parents' top questions about this common ailment
By William Sears, M.D., Babytalk
"Doctor, I think my baby has an ear infection!" I hear this every day in my practice, and because ear infections are such a common cause of sleepless nights and missed work (not to mention just downright painful!), I spend a lot of time explaining what can be done to prevent them. Now, if you came to see me in my office (and you're always welcome to), here's how I would answer your questions.
Why are ear infections so common in babies?
Let's venture inside the middle ear to see how germs and tiny ears make such frequent contact. A canal called the eustachian tube connects the middle ear to the back of the throat and helps to equalize pressure. But the throat, along with the nose, serves as a moist breeding ground for bacteria. Because a baby's eustachian tube is short, wide and horizontal, throat and nose secretions -- and any germs they may be harboring -- travel more easily through it. Any fluid trapped in a cavity (such as the middle ear) acts as a medium for germs to grow, hence the frequent ear infections we see in many young children.
Why is it important to treat ear infections properly?
Your child's hearing depends on the proper vibrating of the eardrum and the structures of the middle. Repeated infections can damage the eardrum, while repeated fluid accumulation dampens the vibrations, both of which interfere with hearing. That's why it's imperative to take ear infections seriously, especially when your baby is learning to talk. Periodic hearing loss can lead to speech delays or even language problems that can affect her school performance later.
How can I spot an ear infection?
The following signs are babies' way of saying, "There's some painful stuff going on in my ear. Please take me to the doctor!" Early treatment makes for a better outcome, so if your baby has had several ear infections, learn to read his unique "sore-ear language." One sign you likely won't see is a fever. High temps don't often accompany an ear infection unless there's a more severe respiratory infection.
The nose knows In babies, middle-ear infections usually follow a cold, so what's coming out of the nose often reflects what's going on in the ear. A common scenario is that baby is mildly stuffy and has clear, watery nasal drainage, but isn't that sick -- until a few days later when crankiness kicks in and the discharge becomes more yellow or green and snotty.
It's been a hard day's night If baby is waking more frequently at night and seems to be in pain, especially with a worsening cold, that's also a red flag. As the infected fluid places pressure on the eardrum, he may not want to lie flat when napping or sleeping. To alleviate the pressure, position him so that the sore ear faces up.
The eyes have it The rule in our practice is that when a parent tells us their baby has a cold and eye drainage, we see them that day. In the early months, eye drainage may simply signal a clogged tear duct, but when accompanied by a cold, especially in an older infant, it usually means an underlying sinus and/or ear infection.
If I suspect an ear infection, should I always take my baby to the doctor?
Usually. Ear infections are hard to treat blind -- sort of like drawing a map when you're not sure where you're going. Your doctor needs to examine both the eardrum and the whole respiratory tract to make what is called the right "drug and bug" match.
Most mild to moderate ear infections will completely heal without the use of antibiotics, which is why the American Academy of Pediatrics recommends the "watch and wait" approach. "Watch" means to observe your child for signs that she is becoming sicker. "Wait" means the doctor may not immediately prescribe antibiotics for her, even if there is fluid behind the middle ear, unless she fails to improve on her own within two or three days.
He's tugging at his ears a lot, so why does the doctor say he's fine?
Ear-tugging doesn't necessarily signal an ear infection. It can be referred pain from teething or that baby is simply discovering his ears and likes pulling on them. However, if a baby has a cold, especially with nasal or eye drainage, and is pulling at his ears, the problem is likely not teething. Tugging, rubbing or banging on the ears can also be a sign that your child has some ear pain from persistent or chronic middle-ear fluid, a condition known as otitis media with effusion. In my practice I find that a mother's intuition is useful in alerting me that her baby is feeling worse. If you feel there's something more to your baby's symptoms, talk to your pediatrician.
How can I prevent ear infections altogether?
Now that you know how germs make their way into those little ears, here are some guidelines to keep that germy fluid from collecting behind your baby's eardrums:
Bottle-feed upright Feed baby in an upright position (at least 30 degrees) and keep her upright at least 30 minutes afterward.
Keep allergens at bay Irritants can cause fluid to build in the nasal passages and middle ear. Keep stuffed and real animals and other fuzzy things away while baby sleeps. And absolutely no smoking around baby!
Pass on pacifiers Studies show a correlation between the frequency of pacifier use and ear infections. Limit pacifier use to when baby is falling asleep at night, especially once she is 6 months or older.
Boost immunity Fruits, veggies and seafood have been shown to improve babies' developing immune systems.
She'll outgrow it The good news is that as your child grows, the eustachian tube becomes longer and narrower, and slants more acutely, making it more difficult for germs and fluid to collect in the middle ear. At the same time, her immune system matures, minimizing those pesky ear infections.
