The Grapevine

Infants At Risk Due To Unsafe Sleep Practices By Babysitters, Relatives

A new study has reported that non-parental supervisors were more likely to place babies in unsafe sleep environments and positions, urging pediatricians to raise awareness among caregivers. The paper titled "Characteristics of Infant Deaths during Sleep While Under Nonparental Supervision" was published in the Journal Of Pediatrics on Monday. 

Unsafe sleep positions constitute practices such as placing infants on their stomachs or putting them to sleep in locations such as a couch instead of the crib. Crib death, commonly referred to as sudden infant death syndrome (SIDS), is the sudden unexplained death of a baby between 1 month and 12 months of age. The researchers of the new study examined more than 10,000 infant deaths from 2004 to 2014 and found that 1,375 cases occurred during the absence of a parent.

The American Academy of Pediatrics (AAP) recommends a bare crib as the best sleeping environment. This means avoiding the use of soft bedding, crib bumpers, blankets, pillows and soft toys. Such items could obstruct the infant's breathing or cause overheating.   

"If someone else — a babysitter, relative, or friend — is taking care of your baby, please make sure that they know to place your baby on the back in a crib and without any bedding," said Dr. Rachel Moon of the University of Virginia School of Medicine, the UVA Children’s Hospital and the UVA Child Health Research Center.

The AAP also recommends placing babies on their back, known as the supine position, when putting them to sleep. It has been suggested that sleeping face down may increase the risk of rebreathing expired gases and overheating. The new study revealed that babies were less likely to be put in this position when under non-parental care. Only 38.4 percent of relatives, 38.6 percent of friends and 37.8 percent of babysitters had placed infants in the recommended supine position.

"A lot of relatives and friends may not be aware that babies are safest on their backs," said researcher Dr. Jeffrey Colvin of Children's Mercy Kansas City. "They may have raised children before we knew that this was safest."

However, the study also noted that licensed childcare providers have increasingly adopted much safer practices than before. Compared to past studies when many providers would place infants on their stomach instead of their back, researchers found that the same group was now the most likely non-parent to follow recommended sleep practices. The study showed that 72.5 percent of licensed childcare providers placed the babies in a crib or bassinet. It was 49.1 percent among babysitters, 29.4 percent among relatives and 27.1 percent among friends. 

To reduce the rates of sleep-related infant deaths, the researchers emphasized the importance of safe sleep education particularly targeted at non-parental supervisors.

"It’s always best to discuss where and how your baby should sleep," Dr. Moon said. "You can’t make assumptions that the person with whom your baby is staying will know what is safest."