Crib and sleeping safety

Because your newborn will spend at least half of the time sleeping, where and how you put the baby to sleep is no small matter. For the first weeks, many parents place their newborn's crib or bassinet in their own bedroom. Some families welcome the child into the "family bed," while others provide a separate room and crib for the baby. Your choice will depend on personal preference and needs.

Some breast-feeding mothers prefer to nurse while lying in their own bed. After feeding, they may place the infant in a nearby bassinet, cradle or crib, or the baby may remain in the parents' bed and nurse on demand throughout the night. Keep in mind that many adult beds may pose a serious risk of the baby falling to the floor or becoming trapped between the mattress and bed frame. Waterbeds are not safe for babies.

Crib and bassinet precautions

Falls are the most common injury associated with cribs. But it's easy to prevent falls if you follow a few safety rules. All safety guidelines for cribs also apply to bassinets. If you use a bassinet for the first few weeks, keep in mind that your baby will quickly outgrow it. A baby who's too large will make the bassinet unstable. Start using a crib by the end of the first month or when the baby weighs 10 pounds. Your child should be able to use a crib from birth until nearly age 3.

You may want to buy a portable crib or playpen for traveling, but it shouldn't take the place of a full-size, permanent crib. Portable cribs aren't subject to the same federal safety requirements as permanent cribs.

All new cribs are required to meet stringent safety requirements. Whether you opt for a new or used crib, be sure to follow these safety guidelines:

• Side slats should be less than 2 3/8 inches apart.

• End panels should be solid, without decorative cutouts.

• Drop sides should be operated with a locking, hand-operated latch, secure from accidental release.

• Corner posts should fit flush with end panels.

• The mattress should be snug fitting — you shouldn't be able to get more than two fingers between the mattress and the crib side.

• The top edge of the raised crib sides should be at least 20 inches above the mattress surface. The lowered crib side should be at least 4 inches above the mattress.

• Periodically check the crib to make sure it has no rough edges or sharp points on metal parts and no splinters or cracks in the wood. If you notice tooth marks on the railing, cover the wood with a plastic strip. Such strips are available at most children's furniture stores.

• Place bumper pads around the entire crib. Keep them in place until your baby is big enough to stand up. These prevent the baby from hurting his or her head. Be sure to tie all the strings on the pads, and make sure the strings are less than 6 inches long to prevent strangulation.

• Never use any type of thin plastic as a mattress cover. If you cover the mattress with heavy plastic, be sure the cover fits tightly. Zippered covers are best.

• Some older cribs — those made before 1974 — were painted with lead-based paint, which can cause lead poisoning in children. The simplest way to avoid that problem is to use a crib made later than 1974.

• Be sure that the hardware fits properly and that all joints are tight.

• Never place the crib near a hanging window blind or drapery cords. Avoid placing a crib next to a window.

• When choosing bedding for your baby's crib, don't use pillows or large quilts and comforters. Instead, use crib sheets and baby blankets.

Similarly, don't put stuffed animals in an infant's crib. Excessive bedding and stuffed animals might cause risk of suffocation or lead to overheating a baby.

• If you hang a mobile over your baby's crib, make sure it's securely attached to the side rails. Hang it high enough so that the baby can't reach it to pull it down, and remove it when the baby is able to get up on hands and knees.

• If you use a playpen or portable crib with mesh sides, make sure the mesh has a tight weave and keep all sides raised at all times.

Always place your baby on his or her back to sleep, even for naps. This is the safest sleep position for reducing the risk of sudden infant death syndrome (SIDS). SIDS, sometimes called crib death, is the sudden and unexplained death of a baby under 1 year of age. Typically with SIDS, a peacefully sleeping baby simply never wakes up. In most cases, no cause is ever found.

Research shows that babies who are put to sleep on their stomach are much more likely to die of SIDS than are babies placed on their back. Infants who sleep on their side are also at increased risk, probably because babies in this position can roll onto their stomach. Since 1992, when the American Academy of Pediatrics began recommending the back-sleeping position for infants, the incidence of SIDS has declined nearly 50 percent in the United States.

The only exceptions to the back-sleeping rule are babies who have health problems that require them to sleep on their stomach. If your baby was born with a birth defect, spits up often after eating or has a breathing, lung or heart problem, talk to your baby's health care provider about the best sleeping position for your baby.

Make sure everyone who takes care of your baby knows to place the infant on his or her back for sleeping. That may include grandparents, child-care providers, baby sitters, friends and others.

Some babies don't like sleeping on their back at first, but most get used to it quickly. Many parents worry that their baby will choke if he or she spits up or vomits while sleeping on his or her back, but doctors have found no increase in choking or similar problems.

Other tips that may help reduce the risk of SIDS include:

• Breast-feed your baby. Although it's not entirely clear why, breast-feeding may protect babies against SIDS.

• If you dress your baby in a kimono or sleep sack, you may not need to use a blanket. If you use a lightweight blanket, place your baby toward the foot of the crib, tuck the blanket around the mattress and pull the blanket up only to the baby's chest.

• Don't smoke or expose the baby to household smoke. Infants whose mothers smoke during and after pregnancy are three times more likely to die of SIDS than are infants of nonsmoking mothers.

• Keep the temperature in your baby's room at a level that's comfortable for you, not warmer than normal.

Some babies who sleep on their back may get a flat spot on the back of the head. For the most part, this flat spot will go away after the baby learns to sit up. You can help keep your baby's head shape normal by alternating the direction your baby lies in the crib — head toward one end of the crib for a few nights and then toward the other. This way, the baby won't always sleep on the same side of his or her head. You can also change the location of interesting objects, such as mobiles, so that your baby doesn't consistently look in one direction.

When your baby is awake and someone is watching, place the baby on his or her stomach for a little tummy time. This helps strengthen the baby's neck and shoulder muscles and reduces the likelihood of a flat spot on the head.

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