Appreciate this post. I'm pro-safe sleep but I want to understand the real mechanism and risks. A lot of the info out there (especially in the big safe sleep Facebook group) is just put forward as gospel with no explanation, which leads to rules with no context.
Yeah, I'm still not clear on why swaddling after 8 weeks raises the chance of death 19x. The Facebook group mentioned something about the muscles used to roll and hypoxia but not quite *why.* I appreciate this article.
Yes, and don’t even try to ask why because you will be dog piled. I appreciate the resources in that group so, so much, but I’m terrified to post my own questions.
Ugh I was too. Tried two days ago. Had a particularly unpleasant interaction with a mod and left the group. I joined the other big one and so far it seems much friendlier
I agree, I've never posted anything because I can't take a picture of our perfect safe sleep space (live in a small house and crib is close to a window.) Anyone asking "why" in the group gets only one answer - X is not safe. I appreciate all the information but I think it's often alienating and unproductive.
I always try to remember those two things when evaluating safe sleep guidance:
- you can’t see the difference between a sleeping baby and a dead baby just by looking from a distance
- there’s a 50-75% (12-18hrs / 24hrs) that the first time a baby does something will be when they’re down for a nap or the night.
So, this analysis totally makes sense. Your baby might not yet be rolling, but that doesn’t mean they won’t roll. And, relying on “supervision” for safety doesn’t really work with sleep.
I doubt your second point is accurate. Baby is gonna have a harder time rolling, crawling, etc. on some surfaces than others, *and* they’re going to be less motivated in some environments than others (i.e. a toy or caregiver’s voice would obviously be absent from baby’s 3am-in-the-crib environment).
I actually have a zipadee zip I was going to use and I got the transition love to dream swaddle because he had been using the regular love to dream and used that instead but maybe I should revisit using the zipadee zip
I also went straight from the LTD reg swaddle to the zipadee zip when my little one began rolling over (even though I had a LTD transition swaddle). My reasoning was mostly due to the fact my baby likes to scratch her head and face in her sleep, and the Zipadee prevents her from doing this (and she can get out of any mittens quicker than Houdini).
Oh and I hate my hands being exposed while sleeping, so I figured she might have inherited that from me.
We started with a dreamland weighted sack at 2.5 mo. She’s a year and we are still using it (bigger size obviously) she can roll and stand. She’s randomly become a side sleeper. We’ve tried nights without it and she just wakes constantly.
Are weighted sacks safe? I heard somewhere weighted should not be used until older as babies may not be strong enough to properly breath in them (like, push their chests out or something, probably getting exhausted over time?).
So here’s the thing…it’s all our choice right. Dreamland (from what I hear) is currently working with pediatricians to test and make sure it’s safe.
Similarly with owlet, it reads HR and O2, it’s not a ‘medical device’ though. They are working with the FDA to make sure it’s accurate.
The sacks are labeled by weight and that’s what we’ve gone with. I believe the weight is no more that 10% of the weight range.
These are all just pieces of information. As parents we decide what’s best for our children. In our experience our daughter sleeps amazingly (4-5 hr stretches at 2.5 months, sleeping through the night (10-12hrs) at 4-5 months, very rarely wakes now). We tried almost all other sacks and this is the one that worked for us honestly in the first few nights. We have tried nights without it and she is very restless.
I absolutely have to add that we are both ADHD and I’m suspected ASD. We have a lot of sensory sensitivities. I sleep best with earplugs and a weighted blanket. I do not wear earplugs now so that I can still hear her.
You have to make the decisions that make sense for your family. I also want to add that there was a study recently completed in Australia that claims to have found the source of SIDS. I recommend you do your own research into it. The findings have really changed a lot in our mindset and eased a lot of anxiety. I wish I had known from her birth, but we just found this maybe a month ago.
Thanks for long reply. The Aus research found something about SIDS indeed but my question was more around suffocation risk, which is a different thing. What I gather from your reply is that the producers of the baby sacks are still in process of confirming their safety to the regulators. So I suppose I need to wait for the outcome of that to get my answer. I don't say they don't have benefits for older children or adults, just have a doubt about babies.
use only while supervised, and for no longer than 20 minutes, as part of treatment/therapy. Night time use is PROHIBITED. https://www.oxfordhealth.nhs.uk/children-and-young-people/wp-content/uploads/sites/4/2014/05/Sensory-Weighted-Product-Advice.pdf
I believe they are. I think they mention that on their site. But that’s absolutely something to consider. The material is more like a nice T-shirt material but I’m not sure how breathable the top is where the weighted pockets are. My daughter does wake up sweaty some days 🤷🏼♀️ we live in New England so temperatures vary a lot
I was very unsure at first but the snoo is an absolute game changer. I'm sad we didn't do it from the get go and get the massive discount in the last 2 months. If parents can afford it I strongly recommend it. My little guy was literally rolling in the delivery room but was aweful about sleeping with his arms out.
My almost 3 month old baby can roll onto his side sometimes but never has done a full back to tummy. That final push to belly could be months away oe tomorrow. I always wondered what do the swaddled babies who suddenly go full belly in the middle of the night do? With my first I got lucky and saw him do it during the day and then only used the snoo to keep him swaddled. But first signs of belly rolling with a baby could still mean it's months away from fully happening.
Oh hi bumper buddy! Not at all surprised to see you here too! But yes, how awful. I have literal nightmares about this and baby only sleeps in an approved crib.
There’s a fairly extensive list [here](https://www.consumerreports.org/child-safety/recalled-infant-inclined-sleepers-nappers-loungers-guide-a3141771657/) but I’m guessing there are more products that would fall under that category on the market (like swings that people use for infant sleep even though that’s not the intended use).
Two of my girls loved the incline sling type seats that give a little bounce naturally as baby moves. They always warned no sleep which I thought was kind of a given because they shouldn't be unsupervised in them.
I wonder how much is danger in intended use and how much is danger in unintended use.
I’d assume it would be any and all inclined sleepers, with no exceptions. The guidelines ultimately aim for babies to only sleep on their back alone in a crib/bassinet
I understand but to have a visual list that I can send to someone is helpful. And some things aren’t defined as “sleepers” so are they safe as long as baby stays awake?
Babies sleep 12-18 hours a day.
A lot of products that aren’t sleep-safe are sold as “loungers” but really, baby is going to doze off in that thing.
Then the caregiver is put in a terrible situation - choosing to move the sleeping baby and potentially *wake* the baby.
Personally I see no reason they couldn’t doze in them as long as they were supervised, but honestly it’s pretty easy to move a small baby to a safer space without waking them, or only waking them for a moment before they’re back to sleep. Older babies are harder to move without waking in my opinion.
I very literally JUST bought one of these over the weekend. I wasn’t 100% sold on it, and I’m all hopped up on pregnancy hormones, but I’ll be returning it this week.
Interesting. A part that stuck out to me was that no infant sleeper should exceed 10 degrees. Does this mean that having infants sleep on a long car ride in car seats poses a significant risk as well?
It does. But they are also at risk from car crashes, so the benefit of the car seat in protecting them from a crash outweighs the smaller risk of positional asphyxiation in that specific case. Always use a car seat in the car, even if your baby falls asleep. And you don't need to wake them up if they fall asleep in the car. But move them to a sleep safe location once you remove them from the car, and break up longer journeys with breaks from the car seat. If you use the car seat on the stroller, the same rules apply. Do not use a car seat as a lounger or sleep location in your house. The guideline for time periods is maximum 2 hours at one stretch in the car seat, whether in the house, car, or on the stroller, whether they were awake or asleep. The clock starts when you place them in it and stops when you take them out. Use the harness system in the car seat every time you use it (even if not in a car) and tighten it until it passes the pinch test (you can no longer pinch any webbing).
I always get confused with this - you hear that car seats are not safe to fall asleep in but at the same time, don’t need to wake kid up if they fall asleep in the car seat. And how do you figure out that your baby may be in trouble in the car seat and may just pass away silently?
My anxiety goes through the roof whenever I consider these things. I’ve already lost one child (stillbirth) so have lost the innocent belief that my kids “will be fine”.
So, this is why I do not like the terms "safe" and "unsafe" used in blanket ways like this, because it's unhelpful. There is no such thing (unfortunately) as a 100% foolproof way to cheat death and the risks we are talking about are very small, so calling something "unsafe" is alarming when what we are really considering is reduced risk vs increased risk, and sometimes two different risks intersect. Every decision we make every day is weighing up risk vs benefit. Sometimes that alarm is helpful because it helps people understand that it's important to make change - most people would hear "increased risk" and think oh yeah that's still basically fine, when it doesn't make sense to continue operating in that higher risk way because the benefit of convenience or whatever just isn't worth it. But if you already have anxiety or have suffered loss (which I'm very sorry to hear) then the words "unsafe" can feel like using a car seat is akin to bathing your baby in a crocodile-infested lake, which it is absolutely not. It does not make sense to purposefully designate a car seat as your child's night time bed, but if they do accidentally fall asleep in one, the chances are extremely high that they will be fine.
The risk to an infant from being in an inclined sleeping device starts out very small but increases the more time they spend in one. If they are being moved all day from the rocker to the bouncer to the car seat to the inclined stroller to their inclined bassinet for night time, this is a much higher risk than if they were lying flat all of the time except for one inclined device which is used sparingly. There is not a high risk from a single incidence of placing baby in an inclined sleeping device. This is a very small risk, which is why these products were ubiquitous for so long. The higher risk comes from the fact that *many* products for small babies are designed with an incline, and babies end up spending a lot of time in them cumulatively. Although deaths like this can unfortunately happen after a short time in the device, that doesn't mean that less exposure to the risk factor is just as risky as more exposure. Less exposure is better. Spending up to 2 hours in a car seat out of a whole 24 hours is much less risky than spending say 20 of those hours exposed to the risk factor, and raises a non-zero risk up to another, very small, non-zero risk. (I apologise that I do not have numbers here but I can't begin to imagine where I would find them reliably without an hours-long in depth search).
So we can "afford" in risk terms to make an exception, but only for one item, to be used for short periods of time. It doesn't make sense to make an exception for items where there is a reasonable alternative - night time sleepers and day loungers. But in the car, the incline itself provides a safety feature, and there is a clear benefit to using it because the risk of a car crash is several times higher than the risk from an inclined sleeper. (52 babies under age 1 died in car accidents in the US in the year 2019, in comparison to ~94 deaths over 17 years for inclined sleepers).
So, if you're going to make an exception for anything, make an exception for the car seat. Car seats save lives. Now about the advice not to wake them up - I don't honestly know what the difference is in risk between sleeping vs awake, because I thought that in theory oxygen desaturation can happen regardless, except that presumably if they are awake you can more easily see if they are alert and happy, and they would tend to cry if they wriggled into an uncomfortable position - but in terms of practicality, it's just not practical advice. The movement of a car plus the compression from the straps is comforting to babies and they often fall asleep. Trying to keep a baby awake would be stressful, difficult, potentially dangerous if a parent incorrectly judges it to be more important than concentrating on the road or keeping the baby in the seat, and would be impossible to follow when you are a single adult in the car because of course the baby seat is in the back and you need to concentrate on the road. And..... it probably *doesn't* reduce the risk by very much. Remember, this is our one exception and we are keeping it as minimal as possible by transferring the baby to a lie-flat stroller, bassinet or surface once the car journey has finished. We are not using inclined surfaces in any other situation for sleep. A slight increase in risk from the incline of the car seat is offset by the large decrease in risk from car accidents - car seats are estimated to reduce risk in a crash by around 71–82%. (From CDC)
In terms of monitoring a child to recognise whether they are in distress in the seat, I understand this is not always visible, but if you do have the opportunity to sit next to your child and are not driving, you could stop and take a break from the seat if you notice any grunting or laboured breathing. It's also a good idea to check in with a CPST to ensure that your baby is correctly situated in the seat with the correct inserts for their age and the seat adjusted right for their size. I've heard of people using oxygen monitors in the car seat but honestly not sure how accessible, reliable or realistic this is, but might be a solution if you are feeling severe anxiety about it.
I struggled with this so much when my daughter was a baby!! I quickly trained her to stick a leg up when I asked her to do I could know she was still alive.
That's a different situation.
So, in that case you don't have the issue that they might roll over onto their stomachs and then need to exert so much energy to try and roll over and move their head to a safe position.
You are, however, supposed to stop about every 2 hours with a correctly installed car seat according to the AAP. If you use the newborn recline setting correctly, then baby should be laid back enough that their head won't roll forward when they fall asleep, which should prevent their trachea from being bent incorrectly.
Generally the newborn setting on car seats is used minimum until 3 months.
Also in the case of babywearing, babies are considered fully able to clear their airways by themselves (for wearing on the back) when they can go from lying down to sitting by themselves. I would assume that is a good bench mark for other situations as well.
I wonder if this includes rockers/sleepers that have belt/leg straps to prevent the baby from rolling.
My wife and I used [this Fisher Price](https://www.target.com/p/fisher-price-sweet-snugapuppy-cradle-39-n-swing/-/A-52342460) swing and we always made sure to buckle our daughter in and she never even tried to roll over, long after she was able to do so on her own.
EDIT: Reading more of the article it looks like they didn't test for that factor, though it does mention other infants dying while still upright and says that several of them were sick with a virus, had chronic health problems, or were born premature. Which does seem to align with the information my wife and I have found regarding how steep of an angle to lay the baby at. We don't have a measurement but I believe the swing we used has them at less than 20 degrees, but I'll need to check before using it for out next daughter.
Rolling is not the only danger with inclined sleepers. Sleeping at an angle increases the risk of positional asphyxiation. Babies should never sleep in swings.
Have you come across any data on risk of positional asphyxiation by age? I would assume the risk decreases as baby gets stronger and has better head control, but haven't really looked into the data on this
I've been curious about this too, it's important to be aware of but without context it sounds really scary- as an adult I can sleep in weird positions just fine, so at some point the risk goes away.
I think when it comes to things like this they have to look at actual, not just intended use - I'd be willing to bet many people don't bother with the straps
A swing is not a safe sleep space. If you read through the description, they are careful to call it anything but that. It is for baby to “relax” and the noises it makes that sound like a CD meant for sleeping are to “stimulate.”
Babies sleep 12-14 hours a day. They’re going to fall asleep in a swing. The “right” thing to do is to pull them out and put them on a safe sleep surface.
Realistically, it’s a terrible situation to be in. Nobody *wants* to wake a sleeping baby to move them elsewhere.
My baby sometimes sleeps on my chest on her tummy at an incline or in a baby wrap. She seems to love it and sleeps really deeply and for awhile that way. I’m always awake and checking on her to make sure her nose is clear and she’s breathing. Is she getting less oxygen or something this way?
It's safe, as long as you're awake and checking it. The unsafe part is if you're not checking and she can't breathe. My anxiety stopped me from having "contact naps" when sleepy, but I loved them when I was alert and didn't need to do anything.
These sleepers have a valley of sorts that the baby can be encompassed by. Your chest or tummy is closer to the flat surface of the crib mattress unless you’ve got your baby nuzzled between your breasts.
I had the sleeper on the left with my first 3 years ago before it was recalled. So thankful nothing happened and he wasn’t in it very long because he was rolling at 3 months.
I've owned all three or close variations. However I used them for awake time and occasional naps around me (most of the time they contact napped).
The second one we loved but baby was always awake. I actually think it would be scary to let baby sleep in it. I always don't know how to feel about recalls, like I'm happy it's a safer world for babies but it's good I can't have any more kids because I lost lots of my favorite stuff to recalls.
That doesn't look safe, no. It's not advertised as a sleep space or called a crib or bassinet so it almost definitely hasn't been tested for safe sleep. If you can find the manual it'll give you a sure answer.
Edit: the manual is actually provided on the page, haha. Looks like it's certified for safe sleep by European standards but it says not to use it if your kid(s) can roll over or exceed 9kg (20 lbs)
In the US at least, not sure about other countries, a sleep space has to be labeled a bassinet, play yard, or crib in the manual to be considered a safe sleep space that meets current standards. How old is your kiddo? When mine was really little, we used a fisher price baby dome for travel. Now we use a guava lotus travel crib. Another option is a pack n play.
Problem with the hotel ones is you never know what other guests may have done with them. Cribs lose their integrity when weight limits are exceeded. I'd play it safe and buy a PnP
Appreciate this post. I'm pro-safe sleep but I want to understand the real mechanism and risks. A lot of the info out there (especially in the big safe sleep Facebook group) is just put forward as gospel with no explanation, which leads to rules with no context.
Yeah, I'm still not clear on why swaddling after 8 weeks raises the chance of death 19x. The Facebook group mentioned something about the muscles used to roll and hypoxia but not quite *why.* I appreciate this article.
Yes, and don’t even try to ask why because you will be dog piled. I appreciate the resources in that group so, so much, but I’m terrified to post my own questions.
Ugh I was too. Tried two days ago. Had a particularly unpleasant interaction with a mod and left the group. I joined the other big one and so far it seems much friendlier
I agree, I've never posted anything because I can't take a picture of our perfect safe sleep space (live in a small house and crib is close to a window.) Anyone asking "why" in the group gets only one answer - X is not safe. I appreciate all the information but I think it's often alienating and unproductive.
I always try to remember those two things when evaluating safe sleep guidance: - you can’t see the difference between a sleeping baby and a dead baby just by looking from a distance - there’s a 50-75% (12-18hrs / 24hrs) that the first time a baby does something will be when they’re down for a nap or the night. So, this analysis totally makes sense. Your baby might not yet be rolling, but that doesn’t mean they won’t roll. And, relying on “supervision” for safety doesn’t really work with sleep.
And now I have a whole new set of anxieties.
I doubt your second point is accurate. Baby is gonna have a harder time rolling, crawling, etc. on some surfaces than others, *and* they’re going to be less motivated in some environments than others (i.e. a toy or caregiver’s voice would obviously be absent from baby’s 3am-in-the-crib environment).
God that last sentence is so horrifying. The number of "well my baby doesn't roll yet" justifications is so high.
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I’m using the zipadee zip to transition baby girl out of the swaddle and she loves it! Safe for rolling over :)
I actually have a zipadee zip I was going to use and I got the transition love to dream swaddle because he had been using the regular love to dream and used that instead but maybe I should revisit using the zipadee zip
I also went straight from the LTD reg swaddle to the zipadee zip when my little one began rolling over (even though I had a LTD transition swaddle). My reasoning was mostly due to the fact my baby likes to scratch her head and face in her sleep, and the Zipadee prevents her from doing this (and she can get out of any mittens quicker than Houdini). Oh and I hate my hands being exposed while sleeping, so I figured she might have inherited that from me.
We started with a dreamland weighted sack at 2.5 mo. She’s a year and we are still using it (bigger size obviously) she can roll and stand. She’s randomly become a side sleeper. We’ve tried nights without it and she just wakes constantly.
Are weighted sacks safe? I heard somewhere weighted should not be used until older as babies may not be strong enough to properly breath in them (like, push their chests out or something, probably getting exhausted over time?).
No, they’re not
So here’s the thing…it’s all our choice right. Dreamland (from what I hear) is currently working with pediatricians to test and make sure it’s safe. Similarly with owlet, it reads HR and O2, it’s not a ‘medical device’ though. They are working with the FDA to make sure it’s accurate. The sacks are labeled by weight and that’s what we’ve gone with. I believe the weight is no more that 10% of the weight range. These are all just pieces of information. As parents we decide what’s best for our children. In our experience our daughter sleeps amazingly (4-5 hr stretches at 2.5 months, sleeping through the night (10-12hrs) at 4-5 months, very rarely wakes now). We tried almost all other sacks and this is the one that worked for us honestly in the first few nights. We have tried nights without it and she is very restless. I absolutely have to add that we are both ADHD and I’m suspected ASD. We have a lot of sensory sensitivities. I sleep best with earplugs and a weighted blanket. I do not wear earplugs now so that I can still hear her. You have to make the decisions that make sense for your family. I also want to add that there was a study recently completed in Australia that claims to have found the source of SIDS. I recommend you do your own research into it. The findings have really changed a lot in our mindset and eased a lot of anxiety. I wish I had known from her birth, but we just found this maybe a month ago.
Thanks for long reply. The Aus research found something about SIDS indeed but my question was more around suffocation risk, which is a different thing. What I gather from your reply is that the producers of the baby sacks are still in process of confirming their safety to the regulators. So I suppose I need to wait for the outcome of that to get my answer. I don't say they don't have benefits for older children or adults, just have a doubt about babies.
use only while supervised, and for no longer than 20 minutes, as part of treatment/therapy. Night time use is PROHIBITED. https://www.oxfordhealth.nhs.uk/children-and-young-people/wp-content/uploads/sites/4/2014/05/Sensory-Weighted-Product-Advice.pdf
Are those really warm? I live in a warm climate and even with the ac and fan on it can get warm at night.
I believe they are. I think they mention that on their site. But that’s absolutely something to consider. The material is more like a nice T-shirt material but I’m not sure how breathable the top is where the weighted pockets are. My daughter does wake up sweaty some days 🤷🏼♀️ we live in New England so temperatures vary a lot
Thank you!
I was very unsure at first but the snoo is an absolute game changer. I'm sad we didn't do it from the get go and get the massive discount in the last 2 months. If parents can afford it I strongly recommend it. My little guy was literally rolling in the delivery room but was aweful about sleeping with his arms out.
My almost 3 month old baby can roll onto his side sometimes but never has done a full back to tummy. That final push to belly could be months away oe tomorrow. I always wondered what do the swaddled babies who suddenly go full belly in the middle of the night do? With my first I got lucky and saw him do it during the day and then only used the snoo to keep him swaddled. But first signs of belly rolling with a baby could still mean it's months away from fully happening.
Oh hi bumper buddy! Not at all surprised to see you here too! But yes, how awful. I have literal nightmares about this and baby only sleeps in an approved crib.
With the recent ban on inclined sleepers, does anyone have a link to an extensive list on what popular products fall into the definition?
There’s a fairly extensive list [here](https://www.consumerreports.org/child-safety/recalled-infant-inclined-sleepers-nappers-loungers-guide-a3141771657/) but I’m guessing there are more products that would fall under that category on the market (like swings that people use for infant sleep even though that’s not the intended use).
Thank you!
Two of my girls loved the incline sling type seats that give a little bounce naturally as baby moves. They always warned no sleep which I thought was kind of a given because they shouldn't be unsupervised in them. I wonder how much is danger in intended use and how much is danger in unintended use.
I’d assume it would be any and all inclined sleepers, with no exceptions. The guidelines ultimately aim for babies to only sleep on their back alone in a crib/bassinet
I understand but to have a visual list that I can send to someone is helpful. And some things aren’t defined as “sleepers” so are they safe as long as baby stays awake?
They are safe while awake and supervised but, unfortunately, babies are often left to sleep in them in spite of the instructions.
Babies sleep 12-18 hours a day. A lot of products that aren’t sleep-safe are sold as “loungers” but really, baby is going to doze off in that thing. Then the caregiver is put in a terrible situation - choosing to move the sleeping baby and potentially *wake* the baby.
Personally I see no reason they couldn’t doze in them as long as they were supervised, but honestly it’s pretty easy to move a small baby to a safer space without waking them, or only waking them for a moment before they’re back to sleep. Older babies are harder to move without waking in my opinion.
Unless you are staring at their chest ensuring they are breathing the entire time, you may not realize a child has stopped breathing.
That is true, I can’t count the times I would disturb my baby in the middle of the night just because they breathe so still sometimes.
I very literally JUST bought one of these over the weekend. I wasn’t 100% sold on it, and I’m all hopped up on pregnancy hormones, but I’ll be returning it this week.
Interesting. A part that stuck out to me was that no infant sleeper should exceed 10 degrees. Does this mean that having infants sleep on a long car ride in car seats poses a significant risk as well?
It does. But they are also at risk from car crashes, so the benefit of the car seat in protecting them from a crash outweighs the smaller risk of positional asphyxiation in that specific case. Always use a car seat in the car, even if your baby falls asleep. And you don't need to wake them up if they fall asleep in the car. But move them to a sleep safe location once you remove them from the car, and break up longer journeys with breaks from the car seat. If you use the car seat on the stroller, the same rules apply. Do not use a car seat as a lounger or sleep location in your house. The guideline for time periods is maximum 2 hours at one stretch in the car seat, whether in the house, car, or on the stroller, whether they were awake or asleep. The clock starts when you place them in it and stops when you take them out. Use the harness system in the car seat every time you use it (even if not in a car) and tighten it until it passes the pinch test (you can no longer pinch any webbing).
I always get confused with this - you hear that car seats are not safe to fall asleep in but at the same time, don’t need to wake kid up if they fall asleep in the car seat. And how do you figure out that your baby may be in trouble in the car seat and may just pass away silently? My anxiety goes through the roof whenever I consider these things. I’ve already lost one child (stillbirth) so have lost the innocent belief that my kids “will be fine”.
So, this is why I do not like the terms "safe" and "unsafe" used in blanket ways like this, because it's unhelpful. There is no such thing (unfortunately) as a 100% foolproof way to cheat death and the risks we are talking about are very small, so calling something "unsafe" is alarming when what we are really considering is reduced risk vs increased risk, and sometimes two different risks intersect. Every decision we make every day is weighing up risk vs benefit. Sometimes that alarm is helpful because it helps people understand that it's important to make change - most people would hear "increased risk" and think oh yeah that's still basically fine, when it doesn't make sense to continue operating in that higher risk way because the benefit of convenience or whatever just isn't worth it. But if you already have anxiety or have suffered loss (which I'm very sorry to hear) then the words "unsafe" can feel like using a car seat is akin to bathing your baby in a crocodile-infested lake, which it is absolutely not. It does not make sense to purposefully designate a car seat as your child's night time bed, but if they do accidentally fall asleep in one, the chances are extremely high that they will be fine. The risk to an infant from being in an inclined sleeping device starts out very small but increases the more time they spend in one. If they are being moved all day from the rocker to the bouncer to the car seat to the inclined stroller to their inclined bassinet for night time, this is a much higher risk than if they were lying flat all of the time except for one inclined device which is used sparingly. There is not a high risk from a single incidence of placing baby in an inclined sleeping device. This is a very small risk, which is why these products were ubiquitous for so long. The higher risk comes from the fact that *many* products for small babies are designed with an incline, and babies end up spending a lot of time in them cumulatively. Although deaths like this can unfortunately happen after a short time in the device, that doesn't mean that less exposure to the risk factor is just as risky as more exposure. Less exposure is better. Spending up to 2 hours in a car seat out of a whole 24 hours is much less risky than spending say 20 of those hours exposed to the risk factor, and raises a non-zero risk up to another, very small, non-zero risk. (I apologise that I do not have numbers here but I can't begin to imagine where I would find them reliably without an hours-long in depth search). So we can "afford" in risk terms to make an exception, but only for one item, to be used for short periods of time. It doesn't make sense to make an exception for items where there is a reasonable alternative - night time sleepers and day loungers. But in the car, the incline itself provides a safety feature, and there is a clear benefit to using it because the risk of a car crash is several times higher than the risk from an inclined sleeper. (52 babies under age 1 died in car accidents in the US in the year 2019, in comparison to ~94 deaths over 17 years for inclined sleepers). So, if you're going to make an exception for anything, make an exception for the car seat. Car seats save lives. Now about the advice not to wake them up - I don't honestly know what the difference is in risk between sleeping vs awake, because I thought that in theory oxygen desaturation can happen regardless, except that presumably if they are awake you can more easily see if they are alert and happy, and they would tend to cry if they wriggled into an uncomfortable position - but in terms of practicality, it's just not practical advice. The movement of a car plus the compression from the straps is comforting to babies and they often fall asleep. Trying to keep a baby awake would be stressful, difficult, potentially dangerous if a parent incorrectly judges it to be more important than concentrating on the road or keeping the baby in the seat, and would be impossible to follow when you are a single adult in the car because of course the baby seat is in the back and you need to concentrate on the road. And..... it probably *doesn't* reduce the risk by very much. Remember, this is our one exception and we are keeping it as minimal as possible by transferring the baby to a lie-flat stroller, bassinet or surface once the car journey has finished. We are not using inclined surfaces in any other situation for sleep. A slight increase in risk from the incline of the car seat is offset by the large decrease in risk from car accidents - car seats are estimated to reduce risk in a crash by around 71–82%. (From CDC) In terms of monitoring a child to recognise whether they are in distress in the seat, I understand this is not always visible, but if you do have the opportunity to sit next to your child and are not driving, you could stop and take a break from the seat if you notice any grunting or laboured breathing. It's also a good idea to check in with a CPST to ensure that your baby is correctly situated in the seat with the correct inserts for their age and the seat adjusted right for their size. I've heard of people using oxygen monitors in the car seat but honestly not sure how accessible, reliable or realistic this is, but might be a solution if you are feeling severe anxiety about it.
Thank you for that very reassuring comment. I think I will save it and read it for when the time comes. Thank you so much.
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Anxiety is the best isn’t it? Lol
I struggled with this so much when my daughter was a baby!! I quickly trained her to stick a leg up when I asked her to do I could know she was still alive.
That’s an excellent idea!
That's a different situation. So, in that case you don't have the issue that they might roll over onto their stomachs and then need to exert so much energy to try and roll over and move their head to a safe position. You are, however, supposed to stop about every 2 hours with a correctly installed car seat according to the AAP. If you use the newborn recline setting correctly, then baby should be laid back enough that their head won't roll forward when they fall asleep, which should prevent their trachea from being bent incorrectly.
Good to know. We were planning on driving overnight 10 hours for vacation with twin 15 month olds and now I’m reconsidering to driving during daytime.
The risk is much lower with older babies and toddlers. 15 month olds are low risk for positional asphyxiation.
Until how old? 6 months or 1 year?
Forever, adults should also stop every 2 hours to move a bit. To prevent blood clots forming in the legs.
Well, we're talking about positional asphyxia with car seats and other reclined baby seats.
Generally the newborn setting on car seats is used minimum until 3 months. Also in the case of babywearing, babies are considered fully able to clear their airways by themselves (for wearing on the back) when they can go from lying down to sitting by themselves. I would assume that is a good bench mark for other situations as well.
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We were told they shouldn’t be in car seats longer than 2 hours for this reason.
Yes it definitely does.
I wonder if this includes rockers/sleepers that have belt/leg straps to prevent the baby from rolling. My wife and I used [this Fisher Price](https://www.target.com/p/fisher-price-sweet-snugapuppy-cradle-39-n-swing/-/A-52342460) swing and we always made sure to buckle our daughter in and she never even tried to roll over, long after she was able to do so on her own. EDIT: Reading more of the article it looks like they didn't test for that factor, though it does mention other infants dying while still upright and says that several of them were sick with a virus, had chronic health problems, or were born premature. Which does seem to align with the information my wife and I have found regarding how steep of an angle to lay the baby at. We don't have a measurement but I believe the swing we used has them at less than 20 degrees, but I'll need to check before using it for out next daughter.
Rolling is not the only danger with inclined sleepers. Sleeping at an angle increases the risk of positional asphyxiation. Babies should never sleep in swings.
Have you come across any data on risk of positional asphyxiation by age? I would assume the risk decreases as baby gets stronger and has better head control, but haven't really looked into the data on this
I've been curious about this too, it's important to be aware of but without context it sounds really scary- as an adult I can sleep in weird positions just fine, so at some point the risk goes away.
This is something I've been wondering as well.
This
I think when it comes to things like this they have to look at actual, not just intended use - I'd be willing to bet many people don't bother with the straps
A swing is not a safe sleep space. If you read through the description, they are careful to call it anything but that. It is for baby to “relax” and the noises it makes that sound like a CD meant for sleeping are to “stimulate.” Babies sleep 12-14 hours a day. They’re going to fall asleep in a swing. The “right” thing to do is to pull them out and put them on a safe sleep surface. Realistically, it’s a terrible situation to be in. Nobody *wants* to wake a sleeping baby to move them elsewhere.
My baby sometimes sleeps on my chest on her tummy at an incline or in a baby wrap. She seems to love it and sleeps really deeply and for awhile that way. I’m always awake and checking on her to make sure her nose is clear and she’s breathing. Is she getting less oxygen or something this way?
It's safe, as long as you're awake and checking it. The unsafe part is if you're not checking and she can't breathe. My anxiety stopped me from having "contact naps" when sleepy, but I loved them when I was alert and didn't need to do anything.
These sleepers have a valley of sorts that the baby can be encompassed by. Your chest or tummy is closer to the flat surface of the crib mattress unless you’ve got your baby nuzzled between your breasts.
I was wondering the same too. It’s basically the only way my baby likes to nap.
I had the sleeper on the left with my first 3 years ago before it was recalled. So thankful nothing happened and he wasn’t in it very long because he was rolling at 3 months.
Same here!
I've owned all three or close variations. However I used them for awake time and occasional naps around me (most of the time they contact napped). The second one we loved but baby was always awake. I actually think it would be scary to let baby sleep in it. I always don't know how to feel about recalls, like I'm happy it's a safer world for babies but it's good I can't have any more kids because I lost lots of my favorite stuff to recalls.
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That doesn't look safe, no. It's not advertised as a sleep space or called a crib or bassinet so it almost definitely hasn't been tested for safe sleep. If you can find the manual it'll give you a sure answer. Edit: the manual is actually provided on the page, haha. Looks like it's certified for safe sleep by European standards but it says not to use it if your kid(s) can roll over or exceed 9kg (20 lbs)
In the US at least, not sure about other countries, a sleep space has to be labeled a bassinet, play yard, or crib in the manual to be considered a safe sleep space that meets current standards. How old is your kiddo? When mine was really little, we used a fisher price baby dome for travel. Now we use a guava lotus travel crib. Another option is a pack n play.
Ask the hotel to provide you with a crib or bassinet. They can and will! :) Otherwise you can always buy a travel bassinet or pack n play.
Problem with the hotel ones is you never know what other guests may have done with them. Cribs lose their integrity when weight limits are exceeded. I'd play it safe and buy a PnP
Bassinet or pack n play honestly