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Inclined Sleepers and Other Baby Registry Items to Avoid

From American Academy Pediatrics:

Having a baby is an incredibly exciting time! Many parents set up baby registries for items that they believe their baby will need. However, it’s important to know that some popular products are unnecessary and can actually be dangerous for infants. Examples include inclined sleepers, positioners, and crib bumpers.

Each year, about 3,400 infants in the United States die unexpectedly during sleep. This can happen from accidental suffocation, sudden infant death syndrome (SIDS), or unknown causes.

To help prevent these deaths, the American Academy of Pediatrics recommends that all infants should sleep on flat and firm surfaces. Babies should sleep by themselves, without any bumpers, soft bedding, pillows, or stuffed toys. Crib bumpers and inclined infant sleeper products can cause a baby to suffocate. We also advise against using products that are for infant bedsharing with parents.

New safety standards on the way

A safe sleep environment is so important that the U.S. Consumer Product Safety Commission (CPSC) approved a federal safety standard for infant sleep products in June 2021. Starting in mid-2022, this standard will help get rid of potentially dangerous baby sleep products such as inclined sleepers, in-bed sleepers, loungers, and travel/compact sleepers. These products will have to meet the same CPSC standards that are already in place for cribs, bassinets, play yards, and bedside sleepers.

Here’s why these and other dangerous infant sleep products should stay off your registry and out of your home.

Inclined sleepers and positioners

These are sometimes called baby nests, docks, pods, loungers, rockers, or nappers. Infant positioners and inclined sleepers have been popular items on baby registry lists for years. But until mid-2022, these products are not regulated and have no safety standards.

The CPSC says that sleep products that incline more than 10 degrees are not safe. Soft and plush sleep surfaces are also dangerous. Inclined sleepers allow babies to sleep at a 30-degree angle. Infants placed in these products may fall asleep in a chin-to-chest position, which can restrict their airway. They can also roll out of the devices and become trapped under them. Inclined sleepers have been tied to at least 94 deaths.

With sleep positioners, babies can suffocate after rolling onto their stomachs since they can’t lift their heads. The soft padding can make it difficult to breathe if a baby’s face presses against it.

Crib bumpers

Crib bumpers were long considered staples of nursery décor. They were originally intended to cushion babies from the crib slats. Crib bumpers are dangerous because of the risk of suffocation, entrapment, and strangulation. Plus, older babies may use the bumpers to stand on and climb out of the crib, creating a fall risk. Crib bumpers have been linked to at least 83 infant deaths in the past 30 years.

In addition to traditional padded bumpers, stores now sell mesh bumpers and vertical crib liners. But even these can get loose and become a strangulation risk. Babies can also get trapped between them and the crib mattress.

There is no evidence that crib bumpers—of any kind—prevent injury in young infants.

Cribs today are regulated by the CPSC and have updated safety standards. The slats are closer together to prevent your baby’s head from getting stuck. This means that bumpers are not only dangerous, but unnecessary. Maybe you’re concerned about your child’s leg getting stuck between crib slats. If so, use a wearable blanket or sleeping sack that’s the right size for your baby.

Why are these products still sold?

Unfortunately, the new regulations don’t take effect until mid-2022, meaning that inclined sleepers and positioners will still be available. As for crib bumpers, the CPSC plans to review federal safety standards for them later this year. We continue to urge the CPSC to ban all these dangerous infant sleep-related products.

A bill that would prohibit crib bumpers was introduced in Congress in 2021 too. Known as the Safe Cribs Act, this bill would make it illegal to sell, distribute, manufacture, or import crib bumpers. The bill’s sponsors are concerned that parents will keep buying these products, not realizing that they’re potentially hazardous.

Some stores, online retailers, cities, and states, have already stopped selling or have banned inclined sleepers and crib bumpers. Some companies have also issued voluntary recalls of these products.

Remember

Even in areas where these dangerous products are banned, they can still turn up at secondhand stores or garage sales. It’s important to check the CPSC website to see if products have been recalled before using them. Also, make sure anyone who watches your child knows about recalled and unsafe products.

It’s also important to keep in mind that your baby should only sleep in products that are designed to be safe sleep spaces, like cribs, bassinets, and portable play yards. Other products like swings, reclined seats, bouncers, and other sitting or positioning devices are not safe for sleep. If your baby falls asleep in one of these, move her to a safe sleep space right away.

If you have any questions about safe sleep products for your baby, talk with your pediatrician.

More information

• How to Keep Your Sleeping Baby Safe: AAP Policy Explained
• Help Your Baby Sleep Safely So You Can Sleep Soundly
• Ask the Pediatrician: What is the safes t sleep solution for my baby with reflux?  
• Safe Sleep: Charlie’s Story

Colic Relief Tips for Parents

From American Academy Pediatrics:

Does your infant have a regular fussy period each day when it seems you can do nothing to comfort her?

This is quite common, particularly between 6:00 p.m. and midnight—just when you, too, are feeling tired from the day’s trials and tribulations. These periods of crankiness may feel like torture, especially if you have other demanding children or work to do, but fortunately they don’t last long. The length of this fussing usually peaks at about three hours a day by six weeks and then declines to one or two hours a day by three to four months. As long as the baby calms within a few hours and is relatively peaceful the rest of the day, there’s no reason for alarm.

If the crying does not stop, but intensifies and persists throughout the day or night, it may be caused by colic. About one-fifth of all babies develop colic, usually between the second and fourth weeks. They cry inconsolably, often screaming, extending or pulling up their legs, and passing gas. Their stomachs may be enlarged or distended with gas. The crying spells can occur around the clock, although they often become worse in the early evening.

What Causes Colic?

Unfortunately, there is no definite explanation for why this happens. Most often, colic means simply that the child is unusually sensitive to stimulation or cannot “self-console” or regulate his nervous system. (Also known as an immature nervous system.) As she matures, this inability to self-console—marked by constant crying—will improve. Generally this “colicky crying” will stop by three to four months, but it can last until six months of age. Sometimes, in breastfeeding babies, colic is a sign of sensitivity to a food in the mother’s diet. The discomfort is caused only rarely by sensitivity to milk protein in formula. Colicky behavior also may signal a medical problem, such as a hernia or some type of illness.

Although You Simply May Have to Wait It Out, Several Things Might Be Worth Trying:

• First, of course, consult your pediatrician to make sure that the crying is not related to any serious medical condition that may require treatment.Then ask him which of the following would be most helpful.
• If you’re nursing, you can try to eliminate milk products, caffeine, onions, cabbage, and any other potentially irritating foods from your own diet.
• If you’re feeding formula to your baby, talk with your pediatrician about a protein hydrolysate formula. If food sensitivity is causing the discomfort, the colic should decrease within a few days of these changes.
• Do not overfeed your baby, which could make her uncomfortable. In general, try to wait at least two to two and a half hours from the start of one feeding to the start of the next one.
• Walk your baby in a baby carrier to soothe her. The motion and body contact will reassure her, even if her discomfort persists.
• Rock her, run the vacuum in the next room, or place her where she can hear the clothes dryer, a fan or a white-noise machine. Steady rhythmic motion and a calming sound may help her fall asleep. However, be sure to never place your child on top of the washer/dryer.
• Introduce a pacifier. While some breastfed babies will actively refuse it, it will provide instant relief for others.
• Lay your baby tummy-down across your knees and gently rub her back. The pressure against her belly may help comfort her.
• Swaddle her in a large, thin blanket so that she feels secure and warm. 

When you’re feeling tense and anxious, have a family member or a friend look after the baby—and get out of the house. Even an hour or two away will help you maintain a positive attitude. No matter how impatient or angry you become, a baby should never be shaken. Shaking an infant hard can cause blindness, brain damage, or even death. Let your own doctor know if you are depressed or are having trouble dealing with your emotions, as she can recommend ways to help.

Probiotics in Infant Formula

From American Academy Pediatrics:

Probiotics” (meaning “for life”) is a word you may see when shopping for infant formula and supplements. Some formulas are fortified with these probiotics, which are types of live bacteria. Doctors may also recommend probiotic drops or powders for breastfed infants. These are “good” or “friendly” bacteria already present at high levels in the digestive system of breastfed babies.

In formula-fed babies, probiotics in formulas promote a balance of bacteria in your baby’s intestines, and offset the growth of “unfriendly” organisms that could cause infections and inflammation.

Increasingly, parents can find probiotic supplements outside of formula, including for breastfed infants. Research on the benefits of probiotics is ongoing, with some pediatricians embracing their use for infants delivered by C-section or those whose mothers are given antibiotics during labor.

Possible health benefits of probiotics

The most common types of probiotics are strains of bifidobacteria and lactobacilli. Some research has shown these probiotics may prevent or treat disorders such as infectious diarrhea​ and atopic dermatitis (eczema) in children. Other possible health benefits are being studied as well, including the possibility of reduced risk of food-related allergies and asthma, prevention of urinary tract infections, and relief of symptoms of infant colic​.

More research is needed

With many of these health conditions, the evidence confirming any positive effects of probiotic use is limited and more research is needed. At this time, benefits appear to occur only as long as probiotics are being taken. Once your baby stops consuming probiotic-fortified formula, intestinal bacteria levels return to previous levels. This is different from in breastfed infants, where the bacteria in the gut resulting from breastfeeding​ are more resilient and set the stage for healthier outcomes. 

Remember

Before giving your child infant formula fortified with probiotics, discuss the issue with your pediatrician

More information

• Choosing a Formula
• Probiotics and Prebiotics in Pediatrics (AAP Clinical Report)

Bringing Baby Home: How to Prepare for the Arrival of Your Newborn

From American Academy Pediatrics:

One of the most cautious drives you’ll ever take is the one bringing your baby home with you. Newborns look and feel fragile, and they represent a new of world of uncertainty. Here’s what you need to know to make your transition to parenthood easier.

It’s true: There’s no official instruction manual for becoming a parent.

But relax. You’re not the first parent to wonder why you’ve been entrusted with a little person without an instruction manual. The 40 weeks (give or take) of pregnancy allow time for more than just picking out names; it’s your opportunity to plan and prepare. The more you know about your newborn, the better equipped you’ll be when she arrives.

Once your baby is born, doctors will be looking for a few key signs that she is healthy and ready to go home, says Vinod K. Bhutani, M.D., FAAP, professor of pediatrics at Lucile Packard Children’s Hospital at Stanford University School of Medicine. “First they will want to see that the baby is able to breathe well and maintain her body temperature,” says Dr. Bhutani, who is also a member of the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn.

Newborns must also demonstrate that they can feed well. Regardless of whether she’s breastfed or bottle-fed, all babies should be wetting at least three or four diapers in a 24-hour period, says Dr. Bhutani. And while many newborns have some jaundice — a yellowish tint to their skin — their jaundice will be evaluated before they’re sent home from the hospital. If necessary, your pediatrician will discuss a follow-up plan for monitoring your baby’s jaundice.

Healthy at Home

Most healthy newborns go home after two or three days, yet the transition for parents is just beginning. “It’s OK to be a little scared — the first week after babies are born is when they’re most vulnerable,” says Dr. Bhutani. “Newborns can have multiple medical problems that if left unattended can become serious.”

Dehydration is sometimes a concern for newborn babies that can continue once they’ve left the hospital. Your pediatrician will discuss dehydration with you so you’ll know what to look for, how to respond, etc.

Parents should also watch for signs of infection in their newborn. Infections can be picked up during birth or from people other than the parents handling the baby, such as visitors. “Most people think only of fevers, but newborns can have dropping temperatures or a low temperature that’s of concern,” says Dr. Bhutani. It’s always wise to watch for signs of infection around the belly button or circumcised foreskin, such as poor sucking during breastfeeding, a lack of appetite, poor weight gain, weak crying, and increasing irritability.

Jaundice happens in most every baby, peaking in the first week as newborns learn to excrete the yellow pigment called bilirubin in their stools. “Babies tend to have slow liver function at first and may have some evidence of jaundice as their livers quickly mature over the first several days,” write Drs. Laura Jana and Jennifer Shu in Heading Home With Your Newborn. “The bilirubin level generally peaks by about 5 days for term babies and about 1 week for those born prematurely.” If your baby continues to have signs of jaundice — very yellowish skin and eyes — after day four, consult your pediatrician.

Although most babies remain perfectly healthy after they’re discharged from the hospital, it’s important to watch for any signs of illness and take your child to the pediatrician for evaluation within a day or two of leaving the hospital. “Every baby needs to be seen by a pediatrician on day three, four, or five,” says Dr. Bhutani. “It’s a must.”

Finding a Pediatrician

As a new parent, it’s important to find a pediatrician with whom you feel comfortable. If your child becomes ill, you want to have a good working relationship with a doctor you trust and respect, and who will be there to support you.

Begin by evaluating the pediatrician practices in your local area. Determine whether it matters to you if you have a male or female pediatrician. Be aware that while it’s all the same to infants, some children as they get older feel more at ease working with a doctor of the same sex. If possible, visit the offices and meet the physicians in person. Or find out if your hospital has a “Meet the Doctors” night attended by area pediatricians.

Since you’ll be visiting a pediatrician shortly after bringing your child home, don’t leave this task until the last minute. “You have nine months to plan. You should always choose your pediatrician beforehand,” says Dr. Bhutani.

Quick Tips: Time to Call the Doctor

Watch for these signs that it’s time to call your pediatrician:

• Your newborn’s breathing is faster or irregular
• You notice blueness or a darkness on the lips or face 
• Your newborn has a fever 
• Your newborn’s body temperature has dropped
• You see signs of dehydration (less than 3 to 4 wet diapers in a 24-hour period)
• Your baby’s belly button or circumcision area looks infected
• Your newborn’s jaundice does not decrease by the fifth day 
• Your baby is crying a lot or appears sluggish
• You think your baby is not looking or feeling well

Quick Tips: Choosing a Pediatrician

The following are a few questions from the AAP to help you select a pediatrician:

• What are the office hours? Is emergency coverage available 24/7?
• Which hospital does the pediatrician use?
• Do they accept your insurance plan and how does the office process billing and claims?
• What are the qualifications of the pediatrician? Is he or she an AAP member (i.e., “FAAP,” a Fellow of the American Academy of Pediatrics)?