Safe Sleep : TBSTP Position Statement
Safe Sleep- (revised 11/6/2018)
We need some further clarification around Safe Sleep.
As a group who supports a shift in the way families manage this time in their lives and seek to move beyond sleep training, any talk of Safe Sleep simply must include the biological normal way for babies to sleep- with their mothers on a shared surface.
This does not mean that this is the ONLY way Safe Sleep can / will be found and it most certainly does not mean that bedsharing can be practiced safely by all families.
What it does give us is a base to start from.
This base that acknowledges that the idea of a solitary sleeping human infant in a cot in their own room is a social and cultural construct, not a given and most certainly not ‘normal’ from a biological, anthropological standpoint.
This is important for how we frame our view of infant sleep and what is/ isn’t a ‘problem’ and why normal infant behaviour can seem to be problematic for families.
When we recognise our babies all start with an intense need for care and closeness by day and night we can work with their natural needs to make it work for our families.
SIDS AND SUDI are realities we face as parents and there are risk factors that have been recognised that increase risk of it occurring.
Life is all about risk management and the best risk management can be achieved when we are fully informed about the risks so we can make decisions based on our unique situation. No activity will ever be risk free. Risk reduction is the name of the game.
So, as a group, we will advocate for sleeping in safe situations on safe surfaces that have been properly prepared (please read how to do this in documents linked at the bottom).
We will advocate for those who can and wish to safely bedshare to have access to information about this.
How do I safely bedshare?
We will promote the important message that babies should roomshare for at least the first 6 months of life and optimally one year (or longer) to reduce their SIDS risk. Roomsharing also supports the breastfeeding relationship and makes night time care much easier for most families.
Breastfeeding is protective against SIDS and night nursing is part of this.
We will advocate for a range of Co-Sleeping options that keep the baby on a separate surface for those who can not or do not wish to bedshare. Side-carred cots, cots in the same room, floor beds to name a few.
If I can’t / don’t want to safely bedshare, what else can I do?
• Articles- https://www.basisonline.org.uk/room-sharing/
We will encourage parents to place their babies on their backs to sleepuntil their baby is strong enough to turn themselves over (I myself have a tummy sleeper and he’s slept so much more happily once he could get himself onto his tummy but until he could get there himself, he slept on his back), this is what the evidence suggests is safest and therefore as a group, this is what we can safely advocate.
*Please note, that a baby who really struggles to sleep unless they are on their tummy may be experiencing symptoms of discomfort and this could be a sign that something else is at play and it is worth looking in to.
Sleeping on a parent’s chest is often a fabulous way to settle an unsettled baby, particularly little people who have reflux and other discomfort. It must be acknowledged however, that there is risk attached to chest sleeping that is highlighted here by Red Nose,
‘Sleeping baby on the parent’s chest
Sleeping baby on their tummy on the parent’s chest, often skin to skin, is an excellent strategy for settling an infant, and helping them to self-regulate, as long as the baby and their airway are being observed (either by the nursing parent or another adult care-giver). A parent falling asleep with a baby prone (on the tummy) on the parent’s chest and unobserved can be problematic as prone positioning reduces baby’s arousal mechanisms that protect baby’s airway; baby’s nose may become obstructed by clothing, or parent’s body or breast; or an unobserved baby may become positioned with his/her chin to chest, which will also obstruct baby’s airway.’
Many of us here can relate to at least some occasions of chest sleeping, but it would be careless and irresponsible to not mention the risk that is faced because of it. There is additional information on chest sleeping available in the book Sweet Sleep by La Leche League International that offers a different perspective for those interested to know more.
We will share up to date research articles on this topic and highlight gaps in the current research (formula feeding and bedsharing is one such example where more research is needed- see this article by Dr Tracy Cassels- http://evolutionaryparenting.com/bedsharing-and-formula-feeding/ ).
Other gaps in advice currently include-
Twins– safe bedsharing and co-sleeping options and risk reduction
Siblings– sleeping arrangements to keep both infants and older children safe while co-sleeping/ bedsharing
Dealing with gaps and edges in co-sleeping and bedsharing arrangements
Side car cots – no current risk reduction advice other than to say there are no product standards.
Premature babies– what age is it safe to share a surface with a preemie?
We will continue to work to see that these gaps are remedied.
Further advice we do have-
There is information about safety concerns with the use of baby sleep positioners and wedges- read more here- https://www.lullabytrust.org.uk/are-sleep-positioners-safe-for-babies/ Red Nose also advise that sleep positioners do not meet Safe Sleep Standards.
Baby nests and pods (small, portable beds for an infant that have padded or soft sides), such as Dock-A-Tot/Sleepyhead and the many other names used for these items, do not meet Safe Sleep Standards for most countries including- Australia, UK and Canada.
Red Nose document- https://rednose.com.au/article/sharing-a-sleep-surface-with-a-baby does includes information and advice for other ‘boxes’ that may be used in co-sleeping arrangements such as the Finnish Baby Boxes, Wahakura and Pēpi Pod.
Above all, we will advocate for families to keep responding to their little one in the night. What else could possibly be safer than attending to your child day/ night?
So please, let’s keep our support, advice and advocacy safe and true.
So we are all on the same page, here is our Admin procedure for Safe Sleep in the group-
#Admin Procedure for Safe Sleep in The Beyond Sleep Training Project
We are faced many times a day with Safe Sleep issues that spring up in posts. Sometimes it’s the post itself, sometimes it’s a photo attached to the original post, it may be a comment made or a photo contributed to the thread.
As an admin team, we need to be sure we are doing our very best to ensure that each and every safe sleep red flag that is raised is dealt with fairly and with education and safety for that family and the group in mind.
As an extremely large and active group, it can be hard to keep up with the fast-moving and somewhat unreliable flow of a Facebook feed and threads can quickly become lost or missed.
To keep up, currently, we have
sentries all keeping eyes out for safe sleep issues,
It is also a responsibility for YOU as a member to play your part in reporting any problematic threads you see.
Moving forward, this is how our Admins will approach Safe Sleep issues as your group admins-
SAFE SLEEP ISSUES
Issue in Pending Post-
Admin to post with an immediate #admin comment flagging #safesleep concerns and link to resources and advice that educate about these concerns.
Issues with a photo-
This is hard. Especially because if there is a photo taken, it can very easily be assumed that the Sleep was supervised, BUT babies do die from sleeping on unsafe surfaces in unsafe environments and no matter how cute a picture may be, we have a duty of care to raise #safesleep issues wherever we see them. Sure, that can be a massive killjoy and yep, we will probably feel like a-holes doing it, but we’d rather be seen as a big bunch of meanies and know that the Safe Sleep message has been received than leave it and learn of the consequences the hard way.
Please expect to see a #admin comment and Safe Sleep education on an image if it isn’t safe.
Issues with comments-
if a commenter is promoting an unsafe sleep practice, in the first instance, we will #admin comment and educate as we advise with pending post. If the comment is then repeated by this same commenter, it will be deleted.
Our participating members have an obligation to not spread/ normalise unsafe practices. “Well I did XYZ and my child was just fine…” is a dangerous message to give anyone. Families need to come to their decisions about what they believe is ‘acceptable’ with informed education, not just because others did it and their child didn’t die.
One comment, yep, fair enough, education needed on the topic so that person can fulfil their obligation, but more comments are a flag that despite knowing that something is unsafe, this person is going to continue sharing their message which is an unacceptable risk for our whole group.
Anyone with multiple offences will be PMd by admin to discuss and if agreement cannot be met, that person will be removed from the group.
Informed decisions need to be based on information not anecdotal experience, especially when it is literally life or death.
We will keep working to see gaps in advice are addressed by the experts and we appreciate the challenges are great.
Each family ultimately takes responsibility for deciding what is acceptable or unacceptable in their unique setting. We are not here to tell you what to do. We will share up to date advice and empower you to make an informed decision.
This quote from Professor James McKenna explains this beautifully-
“Aside from never letting an infant sleep outside the presence of a committed adult, i.e. separate-surface cosleeping which is safe for all infants, I do not recommend to any parents any particular type of sleeping arrangement since I do not know the circumstances within which particular parents live. What I do recommend is to consider all of the possible choices and to become as informed as is possible matching what you learn with what you think can work the best for you and your family.”
We appreciate you support on this very serious matter
Your Admin Team
Now, here are our go to articles and sites on all things Safe Sleep-