How NOT to furnish a baby crib

Cuddle overload!

During my baby shopping days, I went a little crazy with the cot furnishings... bumper pillows, bolster pillows, ordinary pillows, quilts, blankets, cot sheets, draw sheets and lots and lots of cuddly toys. A few days after the cot was lovingly decorated, I received an email with the updated guidelines on preventing SIDS - Sudden Infant Death Syndrome.

Although there is quite a kerfluffle about SIDS in USA, Aussie and Europe, we rarely hear about it in Asian countries. There are many reasons for this... all of them worthy of some consideration.

One is that in SL, small babies are almost always with their mother/grandmother and generally under supervision. I feel antsy about leaving the little Bumtrinket alone even when I go to brush my teeth. I would never dream of having her sleep in another room... as it is, her crib is right next to the bed, and she is only a couple of feet away from me. I can touch her when I want to, I can see her movements and I can hear her breathing. Studies have also shown that close proximity to the parent (mother) helps regulate infant breathing. I think there is a cultural/economic aspect here as well since the vast majority cannot afford the space for a separate sleeping area for a baby.

The other, of course, is breast feeding. Now this is also supported by traditional and cultural values and has been the rule rather than the exception in ancient SL. Exhibit B below is a woodcarving from the Ambekke Devale, and stolen from here.

During the 1970's there was heavy advertising by the milkfood companies, promoting infant formula but thanks to research and heavy lobbying by Prof. Priyani Soysa, Prof Dulitha Fernando, Dr Hiranthi Wijemanne and team, legislation was passed not only to ban marketing (Sri Lanka Code for the Promotion of Breastfeeding and Marketing of Breast Milk Substitutes) but also to allow mothers maternity leave in order to feed their kids (Maternity Benefits Ordinance). Since 2005, there has been overwhelming research evidence that breastfeeding reduces the risk of SIDS.

Source : Unicef, 2009

Our traditional choice of bedding is another factor. Babies sleep on mats or in makeshift cradles made out of a saree or bed sheet. No toxic foam, no soft pillows, good ventilation. Also not much chance of being placed face down as in the West... less chance of suffocation.

Unfortunately, several studies have noted an increase in SIDS in Asia, which is attributed to adopting "Western" practices. In Sri Lanka, opinion is divided as to whether the rarity is due to good practices or due to under-diagnosis.

The American Academy of Paediatrics parental guide to safe sleeping can be viewed here.

My safety tips would be as follows

1. Use a coir (kohu) mattress, with a cotton lining. These are natural, no toxic products like in foam mattresses, allows air to circulate and is cooler for the baby. Make sure it fits firmly in the crib.

2. If you're using cot bumpers along the sides of the crib, make sure they are firmly secured (check every day or even more often).

3. No loose bedding or bits of cloth/blankets on the crib.

4. No pillows.

5. No soft toys.

6. Burp the baby well, hold upright for 10-15 minutes afterwards, and then lay the baby on his/her back (not on tummy).

7. Any "tummy time" must be supervised.

8. If the baby is sleeping on your bed, make sure you/your partner don't fall deep asleep and roll over or squish the baby.

9. Breastfeed, breastfeed, breastfeed.

10. Make sure baby's immunization is upto date.

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Edit:

11. Sleep in the same room as baby

12. Supervise constantly

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Sources:

Department of Census and Statistics (2003) Sri Lanka Demographic and Health Survey 2002, Department of Census and Statistics, Sri Lanka: Colombo.

Fernando, R & Abayasinghe, N (2008) Sudden infant death syndrome/unexplained infant deaths in Sri Lanka, Medicine, Science and the Law, 48, 4, pp. 325-328.

Nelson, EAS, Fujita, T, Sawaguchi, A & Knight, B (1998) Is the incidence of SIDS increasing in Asia? International Journal of Legal Medicine, 111, 5, pp. 278-280.

Reid, GM (2006) Sudden infant death syndrome (SIDS): Microgravity and inadequate sensory stimulation, Medical Hypothesis, 66, 5, pp. 920-924.

Unicef (2009) Infant and young child feeding programme review: case study - Sri Lanka, New York: Unicef.