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At Nightingale Night Nurses, ensuring a safe sleep environment for babies is our top priority. The American Academy of Pediatrics (AAP) has established clear guidelines to help parents and caregivers create a safe sleep setup for little ones. In this blog post, we’ll share how our team implements safe sleep practices while providing professional overnight support.
What are the AAP Guidelines for Safe Sleep?
Before we dive into safe sleep and overnight newborn care, let’s review the current AAP Safe Sleep Guidelines [policy updated June 21, 2022].
Alone
Babies should always sleep alone, without any other people, pets, or soft bedding in their sleep area. Bed-sharing and co-sleeping with parents or siblings increases the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths. Babies should sleep in their own crib, bassinet, or portable play yard, positioned next to a caregiver’s bed for the first 6 months.
Back
Infants should be placed to sleep on their backs, not on their stomachs or sides. A baby sleeping on their back has been shown to significantly reduce the risk of SIDS compared to other sleep positions. It’s important that the sleep surface is flat and level, without any inclines or angles that could cause the baby to roll into an unsafe position.
Crib
Babies should sleep in a safety-approved crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet. The sleep area should be free of any soft bedding, pillows, blankets, toys, or other objects that could pose a suffocation or entrapment hazard. The crib should meet current safety standards set by the Consumer Product Safety Commission.
By following the AAP’s ABCs of safe sleep – Alone, on the Back, in a safe Crib – caregivers can help create the safest possible sleep environment for their newborns and infants. Adhering to these guidelines is one of the most effective ways to reduce the risk of SIDS and other sleep-related deaths.
Other Safe Sleep Factors
The ABC’s of Safe Sleep are essential, but there are additional factors that go into safe sleep and reducing the risk of SIDS:
- Room temperature: The recommended room temperature for safe sleep is 68-72° F. Overheating can increase the risk of SIDS.
- Air circulation: Researchers believe that air ventilation can reduce the risk of SIDS by reducing the amount of trapped carbon dioxide near an infant’s nose and mouth. Running a fan in an infant’s room has been shown to reduce the risk of SIDS by 72%.
- Breastfeeding: Studies have demonstrated that infants who are breastfed or fed human milk are at a reduced risk of SIDS. [However please note that Nightinales support however you choose to feed your baby!]
How We Follow AAP Safe Sleep with Overnight Newborn Care
Our team of Newborn Care Specialists and Postpartum Doulas are trained to implement AAP safe sleep. On overnights and 24/7 live-in care, we ask that families support us in the following so we can best ensure a safe sleep environment:
- Room sharing: Nightingales are expected to room share with babies 6 months and younger. We ask for a flat resting surface for the team member [bed, couch, cot, aerobed] in the same room as the baby’s safe sleep surface [crib, bassinet, pack ‘n play].
- Safe sleep environment: Nightingales are trained to ensure that the baby’s sleep environment meets safe sleep guidelines [i.e. adequately ventilated, recommended temperature range]. Please advise your team member on how to adjust any fans or thermostats as needed.
- Milestones: Nightingales can help parents prepare for important milestones such as learning to roll. They can help ease your baby out of an arms-in swaddle so that the transition is as smooth as possible, ensuring safety while minimizing disruptions to your baby’s sleep routine.
- Products: We can help you understand if a product is currently considered safe for infant sleep. If you’re unsure, always ask! Product recommendations and safe safe guidelines are not set in stone. What worked for your first baby may now not be considered safe for your next baby.
- Breastfeeding: We support ALL feeding choices! However if breastfeeding and/or feeding expressed milk is a goal for your family, Nightingales are trained and equipped to help support you. Newborn Care Specialists and Postpartum Doulas offer comprehensive breastfeeding and pumping guidance, and they are also trained to notice signs that a higher level of support [such as from an IBCLC] is warranted.
Frequently Asked Questions about Safe Sleep and Overnight Care
If you’re unsure how overnight newborn care will look, or how we can best support your family, please always ask! We’re here to help. The following safe sleep questions come up often with new families in the early stages of researching professional overnight newborn care options:
Q. Can I breastfeed with overnight newborn care?
A. Absolutely! If you’re breastfeeding, we’ll bring your baby to you to nurse. Your Nightingale can sit with you to offered continued support, such as helping ensure a good latch, tucking pillows under your arms to prevent neck and shoulder strain, or making sure your water bottle is full and within reach.
Alternatively, if you’d prefer privacy, your Nightingale can head back out to the nursery to tidy up and take notes, and you can send her a text when your baby is finished nursing.
Q. Can I room share with overnight newborn care?
A. AAP safe sleep guidelines ask that babies room share with a sober adult caregiver, not only a parent. We cannot best support your family without being in the same room as your baby. We ask to be in a private area with your baby, to best be able to do our job in ensuring your baby’s safety and wellbeing.
Many parents room share with their babies on their nights “off”, while the Nightingale room shares with the baby on the nights they are with you. Parents sometimes wonder if this will confuse the baby or affect sleep routines, but we don’t see this to be the case.
Q. My baby has reflux. Can I use an inclined crib?
A. Reflux is challenging, and we’re here to support your baby’s needs safely. Inclining the crib is no longer recommended per AAP guidelines. We can support your baby by offering paced bottle feeding [if applicable], offering regular opportunities to burp, holding them upright after feeds, and keeping a close eye while your baby is resting in an approved, flat sleep surface.
If your pediatrician has advised an inclined sleep surface, we can do so only if the team member is comfortable AND the parents sign a waiver releasing the team member of liability.
Q. The recommended temperature range of 68-72° F does not match my cultural beliefs. Can I keep my baby’s room warmer than this range?
A. It’s very important to us to offer culturally sensitive care. We do have to balance liability and family’s needs, and we understand that this is a challenging decision. We cannot ask team members to go against their training and AAP guidelines. However, if they are comfortable with keeping the room warmer than 72° F, we can do so if parents sign a waiver releasing the team member of liability.
Q. Can I use a weighted swaddle, Owlet smart sock, or dock-a-tot?
A. These products are not currently recommended for safe sleep. They have either been shown to increase the risk of SIDS, or in the case of vital sign monitors for healthy babies, they have not been shown to decrease the risk of SIDS. As such, we cannot recommend them or ask our team members to use them. However, as always, if team members are comfortable, we can move forward with care if parents sign a waiver releasing the team member of liability.
**It’s extremely important that we know about these details before we match you with a caregiver**[on your discovery call and/or on your intake form]. We cannot ask team members to use products that are not considered safe for sleep, and we cannot re-match your family last minute due to an unsafe product preference.
Safe Sleep = Good Sleep
When babies are put to sleep safely, everyone can rest easy. Safe sleep guidelines are being updated often, and we understand how confusing that can be. Rest assured that we are here to help you make informed choices and learn how to put your baby to sleep safely. Our team members are always happy to share evidence-based guidance to help parents understand how to follow AAP safe sleep guidelines or which products to use. Your baby’s safety and your whole family’s wellbeing are our top priority!