Q: Where is the safest location for a newborn to sleep?
A: Until infants turned one-year-old, they should sleep on their back for naps and overnight. We know that this decreases the risk of SIDS related death than babies who sleep on their stomach or side.
Of course, it is possible that your baby will roll onto their side or onto their stomachs. Do your best to always place your baby on their back to sleep, but if you’re infant is comfortable rolling both ways – that means back to tummy and tummy to back – you don’t necessarily have to return your baby to laying flat on back. However, do your best to make sure there are no blankets, pillows, stuffed toys, or bumper pads in the crib or around the baby to decrease the risk of suffocation.
Q: What if I have a baby monitor, then can I have my newborn sleep in a separate room?
A: I always strongly advocate for newborns to sleep in the same room as the parents, at least for first few months. The AAP recommends up to the first year. you can place the baby in a crib, bassinet, or pack and play in your bedroom, close to your bed. The AAP does recommend room sharing because it can decrease the risk of SIDS as much as 50%. Room sharing is not the same as bed sharing. In addition, room sharing does make it easier to feed, comfort, and keep a close eye on your newborn baby.
Parents often rely on wearable home monitoring products to protect babies from SIDS. These wearable devices monitor for apnea. Research has not shown a clear link between apnea and SIDS. Even full-term newborns in the first few weeks of life may have brief periods of apnea. But this is not linked to SIDS.
Q: If a parent chooses to bed-share with their newborn, what are the safest practices (ie, using attached cribs or products such as a dock-a-tot)?
A: There really isn’t enough research on bedside or in bed sleepers to make any safe recommendations. Alongside the AAP, I really can’t recommend for or against these products because there haven’t been any studies to look at the effect on SIDS or if they increased risk of injury or death from suffocation.
In general, I recommend parents only bring a baby into bed to feed if necessary. It’s better to feed the baby in a place outside of bed so you’re not tempted to fall back asleep. The baby should go back in his or her own sleep space when ready to go to sleep. If there’s even the slightest possibility that you might fall asleep, it’s safer to move out of an area that has pillows, blankets, or other sleeping members of the family nearby to decrease risk of suffocation. Never place baby to sleep on a couch, sofa, or armchair. Keep in mind, it is ok to swaddle your baby but make sure the swaddle isn’t too tight across hips and once he or she is beginning to roll over, you should start to stop swaddling.
The risk of SIDS is showing to be higher with infants were born prematurely or with low birth weight, you or any person in the bed is a smoker parentheses even if you do not smoke in the bed), you have taken any medications that might make it harder for you to wake up, alcohol ingestion.
Q: What are the most common newborn sleep concerns?
A: I often get questions about pacifier use. Again, pacifier use is associated with a decreased risk of SIDS. That doesn’t mean it must be used, just an association that has been studied. If pacifier use is introduced, I recommend it is when Infant is at least 3 to 4 weeks old so that breast-feeding has been established.
I also believe tummy time is important because if we recommend “back to sleep” then we should recommend activities to prevent head flattening while our children are awake. I recommend that you continue to incorporate tummy time into your day for baby. Tummy time should always be supervised by an adult. Not only can it help prevent head flattening, but it is also a crucial component and foundation to baby’s motor development.
Q: What sleep training do you recommend, and when?
A: I recommend whatever works best for you, your baby, and your family — and that can be very different from home to home and baby to baby. As long as you choose a strategy and stick with it consistently for 1-2 weeks, I think there’s a good chance you can get sleep training underway with few hiccups.
For all strategies, the most important tip is to stick to a bedtime routine that's consistent from night to night, as hard as it might seem.
Secondly, I suggest both parents be on the same page. Consistency is key.
As far as when to begin: I start talking to parents very early on about how we can create and establish healthy sleep habits so that sleep training doesn’t feel like flipping a switch, but rather a gradual dimming. It’s so important to talk to your pediatrician when you’re thinking of sleep training so we can help advise you regarding safety.