Choosing safe sleep products for newborns

When you are pregnant it can be overwhelming to see the range of sleeping products available, many of which claim to be essential in helping your baby sleep and say they are safety tested. It also may seem galling to bring your tiny baby home and diligently follow the guidelines to place them in a cot away from you on a firm, flat mattress with no toys or things to cuddle and think, “But they look so small in there, don’t they need anything to snuggle to reassure them after being curled up in my warm, fluid filled womb for the last 9 months?” It can also be difficult to tune out the pressure from well meaning friends and relatives who gift beautiful thick knitted blankets, gorgeous hammocks, and cute comforters for them to cuddle while asleep. But the Safer Sleep advice from the Lullaby Trust (a UK charity dedicated to reducing the instance of Sudden Infant Death Syndrome) remains: ‘The safest place for a baby to sleep is a separate cot, crib or Moses basket. We recommend a firm, flat, waterproof mattress.’ So what sleep products are safe to use and what aren’t? How can we ensure our new babies stand the best chance of getting a good sleep (and us as well!) if we have to place them, alone and tiny, into a bare cot with nothing to cuddle?

Ok, take a breath mamas and consider one thing before you start Googling sleep aids on Amazon, these are the only sleep products your newborn truly needs (to start with): • cot or Moses basket • portable sleep space (such as Moses basket , carry cot or travel cot) • mattress • mattress protector, sheets, and blanket or sleeping bag • room thermometer • car seat*

The items that are not recommended for newborns are:

• pods or nests

• pillows, duvets or thick heavy bedding

• cot bumpers**

• hammocks and swings

• sleep positioners

• comforter/lovey ***

Why are these items not recommended?

• Pods or nests - because even when placed on a firm flat surface they are not firm and flat themselves, they reduce airspace around the baby, and the raised sides can present a suffocation or strangulation hazard.

• Pillows, duvets and thick bedding are either suffocation hazards or increase the chance of overheating ( a SIDS risk factor).

• Cot bumpers are also a suffocation and strangulation hazard (and are not recommended at any age).

• Hammocks, swings and sleep positioners may put baby into a position that obstructs the airway.

• Comforters and lovies (even when breathable) can be a suffocation hazard.

So if you don’t intend to co-sleep, first it would be wise to see how your baby fares alone in their cot, following the safe sleep recommendations of a firm, flat, waterproof mattress and a cot clear from pillows, toys, heavy blankets, cot bumpers etc.. They may surprise you, and sleep like a dream (pardon the pun)! And what if they don’t? Well, then there are many things we can do to help them without introducing unsafe sleep products into the equation. These include:

• Skin to skin contact: new babies love skin to skin as it calms them down, regulates their temperature and breathing and makes them feel safe. It is fine for your new baby to fall asleep on you (as long as you remain awake) if that works for your family. It also doesn’t mean they will only ever be able to get to sleep in your arms, but sometimes you gotta do what you gotta do to survive the newborn stage in one piece! Baby to carer contact to aid sleep can also be effectively achieved in a sling or baby-carrier (for naps, not overnight) but care must be taken that they are used safely and the airway is never obstructed.
  

• Rocking and feeding to sleep: Newborns need human comfort to feel safe and the motion of gentle rocking is reminiscent of the months they spent inside the uterus. Also, breastmilk contains melatonin which is the sleep hormone. It may be advisable to try rocking or feeding to drowsiness and placing them down drowsy but not fully asleep to reduce the chance of baby developing a reliance on rocking or feeding to fall fully asleep. But again, sometimes needs must. Do what works for your family dynamic.
  

• White noise: White noise can help babies feel calm as it emulates the sound of blood rushing through uterus and placenta that they have been used to inside the womb. It is actually recommended for all babies, whether they seem to sleep well or not, to help them sleep better and longer. The best type of white noise to use is the ‘shushing’ sound (rather than heartbeat, nature or wave sounds). You may buy a machine or use a phone App. For a machine this one comes well recommended amongst sleep consultants. If you prefer to use an app then recommended ones are: For the iPhone- 'SleepHero', and for android- ‘babyshusher- The sleep miracle’. The white noise should be around 50-65 Dcb loud to aid sleep without being damaging to tiny ear drums.
  

• Swaddling: Swaddling is a great way for baby to feel snug and secure, like they did in the womb. And also reduce the Moro reflex present in newborns, which can startle them awake. You should follow safe swaddling guidelines, and stop using swaddling as soon as your baby starts rolling (or trying to). Some top rated swaddles are the ‘Miracle Blanket’ (good all-rounder, and great for babies with colic), and the ‘Love to Dream’ (good for an ‘arms up’ sleep position so baby can still suck hands and self-soothe).
  

• A dummy/pacifier: Sucking releases relaxing hormones which lulls baby to sleep. There is also some research suggesting that using a dummy for sleep could reduce the risk of sudden infant death. The guidelines are to chose an orthodontic dummy to best adapt to the shape of baby’s mouth, to wait until breastfeeding is well established (at up to about 4 weeks old) before introducing, and to stop using for sleep between 6 and 12 months (to reduce long-term reliance, as well as possible dental and speech issues).
  

• A pre-bed warm bath: This depends on how your baby feels about bathtime! But this can be a great way to soothe, relax and wind down even tiny babies, remind them of the sensation of water in the womb, and release some sleep-inducing melatonin. After a bath, the body temperature drops a few degrees and this temperature drop signals the body that it’s time for sleep. A bath gives another opportunity for some skin- to -skin and maybe a gentle and relaxing baby massage. That said, newborns don’t need (and shouldn’t be) bathed every day but this may help them sleep on ‘bath days’.

*Car seats only to be used for sleeping for up to 2 hour maximum stints. After 2 hours the car should be stopped and baby should be taken out, checked, and allowed to stretch and move. As soon as you reach your destination, baby should be moved to a firm flat surface to sleep. **Cot bumpers are not recommended at age. *** Comforter/lovies which are pieces of washable cloth usually with a little fabric animal like teddy or rabbit attached are not recommended before the age of 12 months.

Giving birth in Spain and wondering about safe sleep for your baby? This is one of the topics we cover in Session 4 (Caring for your newborn baby) of our group antenatal course . Sweet dreams!