The AAP Says That Most Parents Place Their Children in Risky Sleep Environments

Image Source: Lauren Hartmann
Image Source: Lauren Hartmann

It is a well-documented, scientific fact that sleep is necessary in order to sustain life; and without it you will eventually die. No one is quite as acutely aware of this as new parents. It doesn’t take long for newbies to realize that the phrase “sleep like a baby” actually means that your infant wakes up 27 times during the course of the night.

Parents with babies have tried it all: magical swaddles, white noise, shushing, swaddling, and probably even begging and pleading with an infant who lacks the cognitive ability to be reasoned with, all in often futile attempts to catch those ever-illusive zzzz’s. The sleep deprivation struggle is real, and new parents are tired (like, so tired).

The thing about being sleep deprivation is that eventually you’ll do everything short of selling your soul to the devil himself (some have likely considered that as well) in order to get a good night’s sleep, and the American Academy of Pediatrics (AAP) recent study only served to further confirm this. They recruited a group of new parents and set up equipment in their homes to record their baby sleep habits (both sleep environment and baby positioning) at one month, three months, and six months. It is worth noting that the participants were predominantly college-educated, which is likely why the AAP seemed surprised by its findings.

The study concluded, through review of the video evidence, that the majority of parents in the study failed to follow the AAPs recommended safe sleep practices on a regular basis. They stated that “Most parents, even when aware of being recorded, placed their infants in sleep environments with established risk factors.” Non-recommended sleep surfaces or sleep items (i.e. bedding, bumper pads, pillows, stuffed animals, and sleep positioners) and parents who put their babies to sleep on their side or stomachs were pointed out as the main culprits.

The study also found that “If infants were moved overnight, the second sleep environment generally had more hazards,” (i.e. babies were brought into their parents beds, placed in a swing, etc.).

“This lack of adherence may be at least partly because of persistent cultural norms and beliefs. For instance, decorative bedding products displayed at and sold in retail establishments (and shown in parenting magazines) have influenced what is seen as appropriate by parents. In addition, infant comfort, which includes longer sleep duration, is a priority for many parents, and this goal often results in prone and side positioning and sharing of sleep surfaces.” They opine that, “It is possible that well-intentioned parents consider safe sleep guidelines to be those that are applicable for the onset of sleep but less so in the middle of the night.”

The AAP’s conclusion is that “These objective findings … suggest that current public education and health care provider guidance related to safe infant sleep are not being carefully adhered to, even in a relatively educated, affluent patient population … these findings are a reminder that efforts to improve parent education and understand real-world parent practices must continue.”

Now that we have all the information, I would like to pause momentarily for a group eye roll. OK, moving on …

Here’s what I have to say to the AAP regarding this matter:

1. YES, infant comfort and longer sleep is actually a priority for me (and I would venture a guess that most parents out there feel the same).

Thanks for making me feel like a terrible, negligent parent for daring to hope my baby might sleep through the night (or really for just more than two hours at a time).

2. I (along with the rest of the parents out there) are not idiots.

We know what the safe sleep recommendations are. We didn’t put our babies to bed in their cribs at 9 PM and then bring them into our beds at 1 AM with the thought that, Gee! Isn’t it so great that bed sharing is magically safe now that it’s the middle of the night? We are really just thinking, I’m so freaking tired! and doing what works.

3. Instead of focusing your efforts on further hammering home your guidelines for “safe sleep,” maybe you could help parents make the safest possible sleep decisions in a real-world way.

It’s time to recognize that parents who are desperately sleep-deprived are probably going to do whatever works best to get their babies to sleep, sometimes. Maybe that means that we bring our babies into our beds at 1 AM, because they’ve already woken up six times and we have work in the morning.

Instead of criticizing parents, perhaps you could focus more effort on educating parents about how to bed share as safely as possible? Obviously it’s not ideal, but when has parenting ever been textbook perfect? This abstinence-only approach to bed sharing is destined for failure, much like the abstinence-only sex-ed programs in public high schools.

While I’m sure we can all appreciate the AAP and their dedication to keeping us and our babies safe with their best practice guidelines, perhaps it’s time for them to recognize that sometimes practicality trumps idealism. Maybe it’s time to give parents some real-world tips to help them be as safe as possible while knowing that it won’t be perfect.

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