Friday, July 5, 2013

Crib safety

The phone call starts like this.
" Our baby can sometimes turn onto his/her tummy during the night and can't turn back over, what should we do?"

For generations, babies were put into their cribs on their tummies. Grandmothers are a wise bunch. They knew that babies do tend to sleep more deeply when they are on their bellies.
Ah, but now but the experts say that it is actually safer for babies to be having lighter sleep for the first couple of months.

The "Back to sleep" movement began in 1992.
The claim is that the incidence of SIDS has decreased 50% since babies have been going to sleep on their backs ( or sides as a second choice).
The statistics are compelling so even though we are seeing way more flat heads than we used to, we accept the recommendation that you should put your child to sleep on their back.

Because the sleep isn't quite a deep, if they have a need that needs to be met, they can more easily wake up and let you know about it.
Also, for very young babies who have poor head control, having them on their back is the safest position so that they don't get their little face planted into the mattress.

Okay, but now the baby is rolling over!
It is NOT reasonable for you to stay up all night and watch them, or even wake up every couple of hours to check on them or turn them.

My best suggestions are:
Make sure your crib is as safe as can be
( scroll down to see some consumer reports pointers on crib safety)

Do plenty of tummy time during the day. Make it fun and pleasant. Your baby will be able to work on their head control as well as other motor skills. Soon they will master rolling in both directions.

By the time they are in control of their bodies and able to roll at will, they will get themselves in whatever position they choose, regardless of how you put them in the crib.

Do try to switch the positions as much as you can to avoid having them lay on the same exact spot. It is okay to put them on their sides and switch up the direction.

Nurse Charity told me about a great idea. Make an inexpensive and safe positioner by filling a men's large tube sock full of rice. Seal it up and then put the other sock on there in the other direction.
Tuck this in front of your baby so that if they end up flopping over it will be onto their back, not their tummy. You can use more than one. Place these below the nipple line, not up near the face.

Below are some guidelines from consumer reports on how to make sure your crib is as safe as it can be.

A crib is one baby item you definitely want to buy new. That's the only way to be sure you'll get one that meets the latest safety standards. We recommend you purchase a JPMA-certified, full-sized crib with stationary sides. This guide will help you find the perfect one so the whole family can rest easy.
Basic is best

The safest cribs have simple lines and no scrollwork or finials. Infants can strangle if their clothing gets caught in such detail work. Following this advice will get you a safer crib and save you money. Consumer Product Safety Commission regulations for full-sized and portable cribs as of 2011 required the elimination of drop-side models, which have been connected to at least 32 deaths during a few years prior. (Drop-side cribs let parents raise and lower one side to get the baby out. They are no longer considered safe.) The standards also include rigorous new durability testing and require improved warnings and labeling. Consumer Reports' tests, which are based on the new mandatory safety standards, address such issues as mattress support, slat strength, and structural integrity.
Buy new

If possible, avoid buying or accepting a used crib. Older models might not meet current safety standards or might be in disrepair. By law, the production date of a crib must be displayed on it and on its shipping carton.
Still, be on the lookout for safety hazards. Even when you're buying a new one, bring a ruler with you when you shop to check the spaces between the slats and other places on the crib. If they're greater than 2 3/8 inches wide, they're too far apart. If you buy a crib online, measure any openings immediately when it arrives at your home.
Check for sharp edges and protruding screws, nuts, corner posts, decorative knobs, and other pieces that could catch your baby's clothing at the neck. Buying a new crib could protect your baby from such hidden dangers as drop sides, slats, or hardware that might have been weakened by rough use, as well as loose hardware or glue joints caused by changes in humidity during storage.
Check construction and workmanship

One or more stabilizer bars--metal rods fastened to both end boards beneath the crib--can help to make the frame more rigid. The simplest in-store test is to shake the crib slightly to see if the frame seems loose. But be aware that display models aren't always tightly assembled. Without applying excessive pressure, try rotating each slat to see if it's well secured to the railings. You shouldn't find loose slats or spindles on a new crib, or any cracking if they're made of wood.
Buy the mattress at the same time

Pair the mattress and crib you plan to buy to make sure they're a good fit. (Mattresses are typically sold separately.) By law, a mattress used in a full-sized crib must be at least 27 1/4 inches wide by 51 5/8 inches long and no more than 6 inches thick. Still, do a quick check. If you can place more than two fingers between the mattress and the crib frame, the fit isn't snug enough.
Make sure to check all the hardware carefully when your crib is assembled, and periodically tighten or replace anything that's missing or loose. Missing and loose parts are a leading cause of accidents and death, because they can create gaps where a baby can wedge his head and neck and suffocate or strangle. Tighten all nuts, bolts, and screws. Check mattress support attachments regularly to make sure none of them are bent or broken. If you move a crib, double-check that all support hangers (which hold the mattress up) are secure.
Use the proper sheets

When buying a mattress, make sure you also buy crib sheets designed to fit tightly. If a sheet isn't the correct fit, your baby might pull it up and become entangled. Hand-me-down sheets can be great, but make sure the elastic at the corners is still strong. Test the sheet, whether new or used, by pulling up on each corner to make sure it doesn't pop off the mattress corner. Blankets, quilts, and pillows also pose a suffocation hazard and should not be used in the crib. Instead keep your baby comfortably warm and safe in a swaddle wrap or blanket sleeper. Resist the urge to put those adorable stuffed animals in the crib for the same reason.
Arrange for assembly

Cribs are shipped unassembled, so if you're not sure you can put one together correctly (it's usually a two-person job that requires up to an hour from unpacking to complete assembly), ask a handy friend or relative for help or see if the retailer can send people to assemble it in your home. The latter can cost an extra $70 or more, but it can give you peace of mind. Besides saving tempers and fingers, having people sent by the store to set up your crib allows you to inspect it on the spot and reject it if you discover flaws.
Adjust the mattress to the right height

Most cribs let you adjust the mattress height; some have three levels, some have more. The higher levels make it easier to take your infant out of the crib, but they're dangerous when your child is able to pull herself to a standing position. Before your child reaches that stage--about 6 months--the mattress should be at its lowest setting. Bumper pads and large toys can help your little escape artist climb out, which is another reason they don't belong in the crib.
Place your baby's crib away from windows, window blinds, wall hangings, curtains, toys, and furniture so that he can't get to anything dangerous. Make sure any baby monitors (and cords) are also out of reach.

Crib bumpers are fairly controversial.
The question comes up at many of my safety classes. I have done a lot of searching on the topic and can't find a definitive answer.
I would try to do without them, but there are some babies who are constantly whapping their heads against the rails that might benefit from a set. On the other hand, if you have a climber that is going to use them to help climb out of the crib, they are more hazard that help.
If you do choose to get bumpers, make sure they are the breathable mesh kind.
Another option that wasn't around when my kids were little are the high tech motion sensors that have been coming onto the market lately. There are a number of them, reasonably priced from Amazon that sense a lack of motion after a certain amount of time and set off an alarm. I know of quite a few families who have one and say it gives them a little peace of mind.
With any monitor, expect some false alarms and growing pains until you get comfortable with it. Read all directions. A monitor that is not used properly is useless and can offer false reassurance.


  1. Surely there must be solutions that deliver the best benefits to babies and their parents. After so many years we still can't agree on the best positions for babies to sleep in and back it up with research?

  2. Actually it is opportunity for all new born child baby cribs for posting.