The possible risks associated with the different sleeping practices of the child
Each year, the Member States of the European Union have approximately 19,000 injured children aged 0 to 14 in accidents involving berths. These accidents are serious enough to require a visit to the emergency department.
A new report from the HAS (Haute Autorité de Santé) has recently been released and informs us about the prevention of positional cranial deformities and sudden infant death syndrome.
The objective of our article is to try to explore the different possibly dangerous interactions of children with products, to explore new trends, and to synthesize the risks to which babies could be exposed during periods of sleep when it is not is not under adult supervision.
We will also talk about the benefits of sleep in babies but also on children, and how to optimize it.
1. Sudden Infant Death Syndrome (MSN) and plagiocephaly (flat head syndrome): definitions
SIDS is the sudden death of a young child, aged one month to one year and apparently healthy, while sleeping. The exact French medical term in 2008 is Sudden Unexplained Infant Death Syndrome (SIDS). In 2009, the term unexpected infant death (IMD) is now used to take into account all cases of death occurring suddenly in an infant when nothing, in its known history, could let it be predicted.
Plagiocephaly is a deformation of the infant's skull giving it an asymmetrical shape, often referred to as "flat head syndrome". There is a wide spectrum of head shapes in children, and the prevalence of plagiocephaly increases until four months of age, then decreases with age. In the vast majority of cases, it is a benign anomaly that resolves before the age of two and often results from the baby lying on his back.
What are the consequences of plagiocephaly?
The presence of plagiocephaly can be a marker of developmental delay, which implies a need for screening. Mandibular asymmetry (facial asymmetry) can also be an anatomical consequence of cranial deformity. In addition, plagiocephaly can cause ophthalmological complications (visual field abnormalities), scoliosis, but also a higher frequency of otitis media (although not statistically significant).
The main risk factors for plagiocephaly identified are:
- The position lying on your back
- Preferred position of the head
- Presence of torticollis (functional torticollis forces the infant to rest his head always on the same side, all these attitudes causing clearly unilateral deformities)
- Male sex (boys tend to be more hypotonic and less active than girls in the first months of life)
- Multiple pregnancy
- Feeding method
- Position during breastfeeding
- Developmental delay
- Hypotonia
- Prematurity
2. The risks often encountered
Baby environment
Although you can dream of sleeping for your baby adorned with soft bedding, this vision does not meet current official recommendations to prevent the risk of suffocation, plagiocephaly and SIDS (sudden infant death syndrome).
In fact, most sudden infant deaths are caused by the baby's face being suffocated by being buried under a duvet, in a too soft mattress, a pillow or a quilted bumper. As we will see, the safest sleeping environment in a crib or in a crib or bassinet is a fitted sheet on a firm crib mattress, with no additional bedding accessories or other soft objects in the crib. . Simplicity will be a guarantee of security here.
Many organizations and associations warn that additional accessories such as bedding can pose a significant danger to babies. For example, an infant can get stuck between an ill-fitting mattress and a headboard. Some bed frames that do not comply with current standards may cause part of the infant's body to pass through an area while trapping the baby's head. Beds with bars are normally up to standard to avoid any jamming.
The co-sleep
Another very common practice that can be dangerous is co-sleeping . It's a growing trend among families: more and more mothers are choosing to share a bed with their newborn. This practice is common as it appears to offer many benefits such as encouraging breastfeeding by making nighttime breastfeeding more convenient. Co-sleeping also allows a nursing mother to more easily synchronize her sleep cycle with that of her baby. It also helps babies fall asleep more easily, especially in the first few months and when waking up in the middle of the night. They also sleep more at night because they wake up more often with a shorter feeding duration, which can translate to a greater amount of sleep throughout the night. Co-sleeping can also allow parents to reconnect with their child after being separated from them during the working day.
But do these benefits of bedsharing outweigh the risks?
Unfortunately, this practice goes against medical advice, and should be absolutely avoided with a child under 4 months of normal weight. Studies have shown that bed sharing is the most common cause of death in babies, especially those 3 months and younger.
In some non-Western cultures, bed-sharing is also common and the number of related infant deaths appears to be lower than in the West. Differences in data recording, mattresses, bedding and other cultural practices may explain this.
In addition to the potential safety risks, infants who sleep with their parents learn to associate sleep with being close to a parent in bed, which can become a problem at nap time or when the baby needs to snuggle. fall asleep before the parent is ready. The immediate proximity of the baby can affect the quality of sleep of the parents who will wake up, worried at each noise emitted by the baby or at the slightest of his movements. During the first months, parents must be able to recover and be in good shape to transmit to the baby the serenity necessary for its harmonious development. The baby will feel the fatigue or the lack of availability of his parents and especially of his mother if he is breastfeeding.
The position of the baby
Statistically, a large majority of babies who slept on their stomachs died from SIDS, although position has not been proven to be the source of infant death. But according to the Haute Autorité de Santé, putting a baby to sleep on his stomach multiplies the risk of sudden infant death syndrome by five. With the CNPP (National Professional Council of Pediatrics), she reaffirms, in a recent study, that "sleeping on the back is imperative to prevent unexpected infant death". Lying in this position (recommended up to a year), the baby has his nose and mouth clear, there is nothing preventing him from breathing.
For centuries, babies in Europe were laid on their backs. The Anglo-Saxon habit of laying them on their stomachs was introduced in Europe in the 1970s to reduce the risk of sudden death. In 1990, Australia, New Zealand and the United States recommended sleeping babies on their backs and this position is also recommended in France. The prone position was justified by better ventilation and by improving the patency of the airways by avoiding the danger of hyperflexion of the spine when the child lying on his back rests his head on a pillow. Laying the baby on his stomach prevents the jaw and tongue from falling back and prevents the inhalation of regurgitated food.
Products intended for sleep can be dangerous
The magazine “60 million consumers” investigated in its new issue the equipment sold to improve the sleep of toddlers. The magazine explains that many of these products sold are potentially dangerous and can lead to an increased risk of suffocation in particular.
Parents can spend a lot of money for their baby to sleep better. This can go through specific childcare equipment: baby wedges, ergonomic mattresses, bed reducers, etc. But some products can be dangerous for toddlers. According to them, “ equipment can hinder the breathing of the newborn, which is done only through the nose and not through the mouth. ” Pediatricians insist: this equipment would increase the risk of turning and obstruction of the nose. Furthermore, “If the head is tilted too far forward, [...] the tongue, by exerting pressure on the back of the mouth, can narrow or block the upper airways,” the magazine states.
However, some childcare equipment designed for baby's comfort does not always respect these recommendations. This is the case for certain poufs, reclined deckchairs or baby wedges mentioned by the magazine. They are not safe because they raise their head, the materials are too soft and they change the position of the baby during sleep. A controversy is engaged between the different actors in which each of the parties develops their own arguments.
For example, deckchairs with a steep inclination (more than 10 degrees) and intended for nighttime sleep were banned in April 2019 by the American authorities after the census of 73 deaths. The recall had been extended to France. In addition, some baby wedges were banned in 2010 after the census of a dozen deaths by asphyxiation. “ When they turned around, the little ones found their faces pressed against the bolster or the upper edge of the product, ” even though they were not held in place by the seat belt, explains the magazine 60 million consumers. It is recommended never to use a bouncer to put a baby to sleep.
3. Recommended solutions
baby's environment
All of these elements mentioned above are the factors of an increased risk of accidents by choking, entrapment and strangulation. You have to use your common sense to keep baby away from all the risks associated with:
- Choking : no soft materials or objects.
- Wedging : use bedding products and means that comply with the European standard with as little sophistication as possible. Whether you choose a bed, a cradle or a bassinet, the ideal for your newborn would be to use a product that already integrates and prevents all mechanical risks such as the solidity of the product, head jamming or members. So, for example, use a child's bed that complies with the current standard and is therefore designed to prevent the risk of head entrapment rather than using "bumpers" to try to rearrange a non-compliant child's bed and potentially dangerous.
- Strangulation : do not give the baby access to objects during sleep. No ribbons, ropes, loose sheet...
- Hyperthermia : adapt your clothing to the temperature of the room. To keep your baby warm while sleeping, use baby sleepwear and sleeping bags instead of blankets. We will see that a bit later.
It's important to remember never to tie or restrain a baby while they sleep. He must be able to keep the freedom of movement of his head linked to his instinct. You should also carefully read the instructions supplied with the bed or cradle, which will tell you how to use it properly and in particular whether or not you can add a mattress and, if possible, its dimensions. Many warnings will allow you to use the product as it should. Do not add additional accessories to the bed, such as a bed bumper, an additional mattress not recommended by the manufacturer, restraint equipment (baby wedge, head wedge, positioning cushion, bed reducer, etc.). ) which can be dangerous because they can, for example, promote prone rollover and/or increase the risk of death by asphyxiation.
What can our common sense advise us after reading the many information available to us?
Apart from specific medical situations, simplicity seems to be the best guide to avoid all the risks mentioned above related to the equipment during the baby's sleep. We can't repeat it enough: what a baby needs to sleep in a crib, bassinet, or bed is an appropriately sized flat surface with a firm mattress free of extra accessories (duvets, blankets, stuffed animals). These could cover and suffocate the child. The surface must be limited by barriers presenting no risk of entrapment or suffocation. The bed sheet should be snug and secure.
In a travel cot, it is dangerous to add a mattress if it is not provided for by the manufacturer. Avoid having your child sleep in products not intended for this purpose (sofa, armchair, pouf or waterbed). Please note, adult beds are not suitable for sleeping infants, including for a short nap. They often feature cushions and pillows that should be banned from babies' surroundings. Also, don't place the bed near curtains or blinds, where your child could get caught in the cords and strangle.
Even if you're a little disappointed that the crib doesn't look "complete" without bedding, (and we understand you!) you can find comfort in the money you'll save. Why not invest that extra money in high quality bed sheets? And then, you will surely sleep more peacefully knowing that you are taking all the necessary precautions for the safety of your child.
As explained above, it is essential to avoid falling asleep with your baby in your arms, or on your chest. Also, don't sleep on a couch, lounge chair, rocking chair, or even on a bed with a baby.
During walks in a baby carrier or in a sling, remember to install your baby in an upright position, in the open air (face clear). Make sure he doesn't have his head bent too far forward. When your baby is awake, and in the presence of an adult, he can play on his back on an activity mat where he is free to move. It can also be installed for a moment on the stomach, this limits the risk of flattening the skull. In fact, outside of sleeping hours, you can take the opportunity to put baby in different situations, depending on the time of day.
The best baby position recommended today
From birth, lay your baby on his back, flat in his own bed and in a bodysuit, a "sleeping bag" or a "sleeping bag" adapted to his size and the temperature of the room. Never lay him on his stomach or on his side, even if he regurgitates. It is important that you keep the same routine for your baby from the start. When your baby is able to roll over on his tummy on his own, let him choose his sleeping position, but make sure his bed remains clear of any accessories.
Some doctors once thought that sleeping on your side might be a reasonable alternative to lying on your back, but recent evidence has shown it should be avoided for safety reasons. Please note that there are some exceptions to this recommendation, especially for babies with certain medical conditions, which your pediatrician can discuss with you.
This recommendation to put the baby on his back applies to infants throughout the first year of life. However, it is particularly important during the first six months, when the incidence of SIDS is highest. Since 1992, when the American Academy of Pediatrics began recommending this sleeping position, the annual rate of SIDS has decreased by more than 50%.
Pacifiers may also help reduce the risk of SIDS. However, if your baby does not want the pacifier or if it falls out of his mouth, do not force him. If you are breastfeeding, wait until breastfeeding is well established, usually around three or four weeks of age, before using a pacifier. While sleeping on her back is important, your baby should also spend some time on her stomach when awake and being watched. This will allow him to develop the muscles of his shoulders and control his head, and thus avoid the appearance of flat spots on the back of his head.
Baby's temperature and clothing
According to a Canadian study, half of babies aged six months do not sleep eight hours in a row, in particular because of nocturnal awakenings. A light sleep that can be disturbed by physiological needs such as hunger, fatigue but also heat. Indeed, so that baby feels good in his environment, maintain a comfortable temperature in your baby's room and do not place him near air conditioning or heating vents, open windows or other sources of currents. of air. Use sleepwear (like a sleeper) with no other cover ups.
The temperature of the room where your baby sleeps should be between 18°C and 20°C. If it is warmer, the child can sleep in simple pajamas or in a bodysuit.
4. The benefits of sleep on babies and children in general
Sleep is an essential part of your child's mental and physical health. If you can't help your child sleep, don't worry: you're not alone. The American Academy of Pediatrics estimates that sleep problems affect 25-50% of children and 40% of adolescents. Understanding your babies' sleep needs is the very first step to better sleep. By combining sleep hygiene, age-appropriate routines, and careful attention to any sleep disorders, you can help your child sleep better so they can grow up healthy and healthy.
Why is sleep important for children?
Sleep plays a crucial role in the development of young minds. In addition to having a direct effect on happiness, research shows that sleep impacts alertness and attention, cognitive performance, mood, resilience, vocabulary acquisition, learning and Memory. Sleep also has important effects on growth, especially during infancy. In toddlers, naps appear to be necessary for memory consolidation, attention, and motor skill development.
What happens when kids don't get enough sleep?
As all parents know, a child who lacks sleep can be moody and hyperactive. Drowsiness can also affect your child's attention span, with consequences for their performance in school. Even minimal sleep restriction can affect your child's daily life. According to the American Academy of Pediatrics (AAP), a quarter of children under the age of 5 do not get enough sleep. This is concerning because lack of sleep in early childhood has been linked to allergic rhinitis, immune system problems, as well as anxiety and depression. It also appears that lack of sleep during childhood can lead to future cardiovascular risks in the form of obesity, diabetes and hypertension.
In adolescents, insufficient sleep can have long-term effects on school performance and mental health. Many major health associations and groups consider chronic sleep loss in adolescents to be a public health issue. It is a risk factor for substance abuse and mental health issues, as well as more immediate issues such as car accidents and sports injuries.
A few tips to ensure your child gets a full night's sleep...
Sleep needs change as your child grows. But whether you're dealing with a two-year-old toddler or a stubborn teenager, research shows that a regular bedtime routine is helpful in ensuring your child gets enough sleep. Whatever activities you choose, try to do the same ones every day in the same order so your child knows what to expect. A typical bedtime routine might include turning off computers, television screens and other bright lights, putting on pajamas and brushing your teeth, reading a light book, singing a lullaby or taking a bath.
You can promote restful sleep in your children by following basic sleep hygiene rules:
- Maintain a regular bedtime
- Make the bedroom a screen-free zone, even during the day
- Use dark curtains to block out light, or a nightlight if they're afraid of the dark
- Promote a healthy diet
- Keep the bedroom quiet
- Avoid heavy meals and sugary treats before bedtime, and opt for a healthy bedtime snack if necessary
Regular exercise is important, but don't fall into the trap of wearing your child out so they can sleep better at night. More often than not, this will tire him out and make it harder for him to fall asleep. The morning is also important. While it's tempting to let your kids sleep in on the weekends, it can disrupt their sleep schedule and make it harder for them to wake up on weekdays. Try not to over-schedule extracurricular activities if you notice that they are having a detrimental effect on their sleep time. If you practice healthy sleep hygiene and your child always feels drowsy or has trouble falling or staying asleep at night, it may be time to see a doctor to see if he has a sleeping problem. sleep. You can also ask their teacher to update you on their level of attention. Difficulty concentrating, hyperactive behavior or learning problems may indicate that he is not sleeping properly.
Problems that may seem minor to us are often very important for a child. Thus, events such as a new sibling, teething, illness, a different place, a change of schedule or minor complaints such as allergies, colds and ear infections can interfere with sleep. your child. Some of the most common sleep disorders in children include night terrors and nightmares, sleep apnea or sleepwalking.
Other recommendations for the health of your baby:
Here are 12 valuable little extra tips to help you take care of your baby.
- Never give your baby sleeping pills.
- Respect his sleeping pattern.
- Don't get him used to falling asleep with his bottle.
- Protect your baby from exposure to tobacco, before and after birth.
- Some allergens and chemicals lurking in the everyday environment are potentially toxic to babies. A few precautions can limit the risks: remember to ventilate your child's room but also the other rooms for 10 minutes every day, even in winter to avoid the accumulation in the air of chemical substances (varnishes, glues, etc.)
- Reduce the number of cleaning products and prefer single-component products (alcohol vinegar, black soap, etc.) in moderate doses.
- Do not use home fragrances, incense, candles, as they are often high in harmful chemicals.
- Avoid work, especially painting, within 6 months after birth.
- Check that toys and childcare articles (including pacifiers, activity mats, changing mats, etc.) are CE or NF approved. The regulations on toys and their composition are not the same for children under 3 years old and for those over 3 years old. It is important to respect it.
- Wash textiles (stuffed animals and clothes) before first use and regularly, due to the possible presence of undesirable chemical compounds.
- Avoid taking your child out during very hot periods and when pollution peaks (especially late afternoons). Avoid areas with heavy road traffic, especially during rush hour.
- Avoid the use of cosmetic products in the first months, both for you and for your baby; Plant treatment products (against insects or fungi) often contain pesticides that are harmful to you and your child: limit their use.
To conclude, baby is a very fragile being. It is important to take care of him and to be aware of all the risks he may incur. By educating yourself on the subject (and you did it by reading this article), you have already done 3/4 of the work. It will now simply be a question of appealing to your good conscience. If you have the will to do well, we are convinced that everything can only go well. I hope I have helped you more in this process, and I invite you to visit our article which discusses the secret of good nutrition if you want to know more health tips ❤ ;)
https://www.verywellfamily.com/baby-bedding-avoiding-the-dangers-284446
https://www.sleepfoundation.org/children-and-sleep
https://www.childsafetyeurope.org/publications/info/product-safety-guide.pdf
February 2020 drafting report “Prevention of positional cranial deformities and unexpected infant death” by the CNP de Pédiatrie
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