Safe Sleep for Newborns in Summer: Reducing SIDS Risk

So it’s summer, it’s hot, and you have a newborn. With the risk of Sudden Infant Death Syndrome (SIDS) being higher in young babies and overheating being a contributing factor, how do parents create a safe sleep environment with temperatures soaring?

Lynette of Baby On Board Spain interviewed Sleep Consultant Rachael Wilson on this very important subject:

Can you explain more about the link between high room temperatures and SIDS - why exactly can high temps increase the risk of SIDS?

There is a particularly higher risk to preterm babies and statistics show that boys are more at risk of SIDS than girls.

In preterm babies , there may be parts of their brains that haven’t fully developed yet which help to control their body temperatures. And if external temperatures are going up and down this is a particular risk factor for premies if they can’t self-regulate their body temperature. These babies have often have spent time in the NICU where temperature and breathing have all been carefully controlled, so when they go home it’s important to continue being cautious with sleeping temperatures. That said, studies are still being done on higher temps and the SIDS risk, and since we don’t know exactly why even some at-term babies (born between 37-42 weeks) can also be affected it is important to be cautious with sleeping temperatures for all babies, and reduce all general SIDS risk factors as much as possible (like exposure to passive smoke, babies sleeping in separate room to mum, babies sleeping on uneven surfaces etc.. ) A great resource on SIDS risk factors and reducing them can be found at The Lullaby Trust.

Until what age are babies most at risk from SIDS for any contributing factor (including heat)? 4 months? 6 months? In other words, when can we, as parents, exhale a little?

Rachael explained that, while we probably never stop worrying about our little ones while they sleep, most cases occur between birth and 6 months. But she said it’s important to be aware that even in older babies we should still be cautious.

What temperature should the room be at?

The recommendation is between 16-20 degrees Celsius. However, 16 can feel pretty cold, so the families that I work with I recommend between 18-20 degrees throughout the year.

Incase the room doesn’t have air conditioning, how can parents bring the temperature down?

There are a number of things we can do:

1. Keep the blinds down during the day, and windows open. Otherwise the sun comes in and heats up the room! If possible, keep the windows open behind the blinds to let a bit of air in and out. This can be good to do overnight and early morning but if you find (especially during the afternoon) that you are just letting hot air in then at the hottest times consider having the windows closed and using a fan. Contrary to popular belief, a fan won’t reduce the temperature of the room but it will circulate the air and cool the skin down.

2. Let the heat out. Heat rises! So if you have an attic, then open the window up and let the hot air out.

3. Create a DIY aircon unit. Freeze some bottles of water and place them infront of fans to disperse a cooler vapour around the room.

4. No aircon or fans directly on baby. Since little babies can’t move away, pull a sheet over themselves if cold, or tell us, make sure nothing is directly blowing on baby, it should instead be circulating around the room. If the cot is below the aircon then move the cot.

And can we cool the baby down before they go to bed?

Yes! You can do the following:

• Give baby a cool bath (either in the bathroom or in a small paddling pool)

• Place toys in the fridge and let baby play with cooled toys!

• If not having bathing, wipe down with a cooled flannel

• Don’t be tempted to wrap baby up in a big, warm towel after the bath. Instead, use a lighter towel and dab them dry.

What about dressing baby and using bedding? How should parents dress baby for sleep in summer and what types of blankets or TOG* ratings should they use? *TOG- Thermal Overall Grade - rating which refers to thermal insulation of sack. Dressing: For baby sleep sacks- check the guide for which TOG rating of sack to use with which amount of clothes (this depends on the temperature of the room), but if it’s getting very hot (over 26 degrees) then maybe just put them to sleep in a nappy.

Bedding other than sleep sacks: Use pure cotton or organic bamboo sheets only. No fleece or man made materials. Cellular blankets are not recommended in high summer temps. But if it’s so hot that you don’t want to sleep under a blanket then your baby probably doesn’t either!

You can also cool bedding in the fridge and use this to cool the cot down before putting baby in (remembering to remove before baby goes in if still very cold or damp). And do the same with hot water bottles (filling with cold water instead) in the cot or to lay baby on during tummy time.

And swaddling in summer - good idea or bad idea? Any favourite summer sleep swaddles?

If the temperatures are going over 20 degrees then it’s a bad idea as it can risk overheating the baby and be very uncomfortable and sweaty for them.

If temperatures are optimum (18-20 degrees) then some good summer swaddles are Merino Kids - which do a lovely wool swaddle which helps to regulates temperature. The MiracleBlanket Baby Sleep Wearable Swaddle is also good as legs can be in or out.

Finally, co-sleeping in summer- what is the recommendation? There is a new study by the American Academy of Paediatrics that recommends that co-sleeping is not to be practised at all. More on this study here.

And on the subject of co-sleeping in summer, bed sharing can increase heat within the bed so during summer months this can create an even higher risk (than co-sleeping in general) in all babies, but especially if babies are premature or exposed to other contributing SIDS risk factors. As a sleep consultant I have a duty of care to guide parents to the latest studies on any SIDS risk factors and encourage them to make informed decisions.

If parents decide to co-sleep in summer then I would recommend (as well as the usual co-sleeping guidelines which can be found here) they try to transfer baby to their own safe sleep space (i.e. a cot) once they are asleep.

In the Baby On Board group antenatal course we cover safe sleep and reducing SIDS risk in Session 3 (Newborn Care & Feeding).

Further info on Rachael and how she supports parents so the whole family can get a good (and safe) night’s sleep.

Watch the full interview: