HJBR Sep/Oct 2019

Healthcare Journal of BATON ROUGE  I  SEP / OCT 2019 51 Mindy L. Calandro, MD, FAAP Pediatric Medicine Baton Rouge Clinic 30 infant deaths were reported with such devices. These deaths were reported in infants who ended up rolling over to their side or stomach, leading to asphyxiation. Other products such as infant recliners and loungers are also marketed as devices that can help with sleep, but all such de- vices carry similar risks and are not viewed by the AAP as safe sleep environments. With numerous anecdotal accounts from friends and family about why such sleep devices were a “life-saver” for them, it can be hard to convince new parents about the potential danger of these products. So, what then can we advise for parents who, while having their infant’s best interests at heart, are just hoping to climb out of the sleep deprivation hole? I think the first step in educating new parents about infant sleep is to set real- istic expectations for what sleep will look like for both newborns and parents alike. While newborns may sleep a total of 16- 20 hours per day, this sleep will come in small increments, as it mirrors their need for feedings. Newborns, especially those who have not regained their birth weight, should not be allowed to sleep longer than three to four hours at a time. I can’t even begin to count the number of times parents have come into my office saying, “Well, my friend’s newborn has been sleep- ing through the night since four weeks of age, so there must be something wrong with my baby.” No, in fact, waking to feed at night, in otherwise healthy infants, is very common even until six months of age for some. We must be willing to have a conver- sation with these exhausted new parents about what their sleep practices are with their newborn in a manner that does not pass judgement or make them feel guilty. By not opening up this dialogue, we risk parents not even having a conversation with us as providers when it comes to sleep, which can then lead to unsafe sleep practices. While we can use science and studies to educate par- ents on the recommenda- tions for safe sleep, we must listen to what over-tired parents might be telling us, and help them determine what will be sustainable for their family. Perhaps when a breastfeeding mom tells us the baby is co-sleeping in the parents’ bed because she always falls asleep af- ter nursing at night, rather than chastise her for not waking up to put the baby back in their own bed, we can offer the suggestion of sleeping on a simple mat- tress with only a fitted sheet on the floor as an alternative. Or when a dad tells you how the baby will only sleep when being held, which has led him to sleep with the newborn in a recliner, we can respond by recommending appropriate swaddling or a weighted sleep sack to create the sensa- tion of human touch. While it would be wonderful for all parents of newborns and infants to read the safe sleep guidelines and follow these rules, we know that is simply not the re- ality. As with many things in medicine, we must take the recommendations, com- municate them to our patients, and help them devise a plan to carry out those rec- ommendations. This means helping not only make sleeping as safe as possible for newborns, but also remembering that happy and healthy mommies and daddies (i.e. those who sleep), lead to happy and healthy babies. n