So the Rock-N-Play’s Been Recalled. Now What?
Pediatricians' Tips on Helping Your Baby Sleep Safe and Sound
Popular rocking sleepers have been in the news lately for all the wrong reasons.
Last week, Kids2 recalled all of its rocking sleeping models after reports that say five children have died in its sleeper since they were introduced in March 2012.
Approximately 700,000 products were sold at major retailers including Walmart and Target. The brand names of the sleepers included Disey Baby, Bright Starts and Ingenuity.
Earlier in the month, Fischer-Price chose to recall its Rock ‘n Play Sleeper after 32 infant deaths associated with the product. Fisher-Price chose to recall approximately 4.7 million of the units on April 12, following a report from the U.S. Consumer Product Safety Commission (CPSC).
Less than two weeks later, two class action lawsuits have been filed against Fischer-Price and its parent company Mattel.
While there were claims that the deaths were only associated with the unsafe use of the device, the CPSC stated the deaths occurred “after the infants rolled from their back to their stomach or side while unrestrained, or under other circumstances.”
“And our concern doesn't stop with only the Rock 'n Play or the Kids2 products,” said Justin Smith, M.D., medical advisor of Digital Health at Cook Children’s. “Other sleep aid devices such as hammocks, nests and wedges also can put babies at risk for both suffocation (where a baby turns into a soft surface and rebreathes their own breath) and positional asphyxiation (where a baby's airway is squeezed off by flexion at the neck).”
“It's clear that the safest position in which a baby should sleep is on their back, on their own in a boring, flat surface.”
Dr. Smith: First of all, we want to say that we know the idea of making this transition away from a sleep device or the idea of having another baby without one (when your first baby only slept in one) is scary and overwhelming.
We hear you.
And, believe me, if we could recommend something magical that would help your baby sleep, we would tell you all about it. No one needs to sleep more than pediatricians, especially pediatricians who are parents.
Here are some tips that might help you survive with a baby who is a poor sleeper:
Give your baby their best chance to sleep by maximizing their environment.
Dr. Arnaout: Try to mimic the womb environment. What happened in the uterus? It was a dark, warm, noisy place. A baby is looking for that same type of environment outside of the womb.
Some adjustments that you can make that might help:
• Use a sleep sack that is snug but not tight (if you choose to swaddle make sure that you are stopping after two months)
• Turn on a sound machine to provide some white noise-this mimics the sounds of the blood vessels in mom's tummy.
• Allow your baby to use a pacifier once breastfeeding is established - not only does it help with sleep, it's also protective for SIDS.
• Help your baby go down to sleep drowsy but not asleep, this will help them make those transitions at night when they enter lighter sleep stages.
• Practice, practice, practice - use your sleep routine (or at least an abbreviated version) with every sleep, this helps your baby understand when it's time to go down.
Remember the bottom line is that babies should be sleeping alone in their own crib, staring on their back, with no blankets or pillows.
Dr. Arnaout: "I know this seems out of the blue and unrelated, but - It’s really important to make sure your baby is getting "full feeds". This doesn’t mean any particular number of ounces or minutes of nursing - this just means discouraging “snacking”. I tell parents daily that babies who snack all day are gonna snack all night. Babies who are encouraged to empty both breasts, or fill up on as many ounces as possible during a bottle feed, are able to go longer between feeds and are able to fast for longer periods at night."
We know that the transition out of the Rock N Play is going to be brutal. But you were going to have to make that transition at some point, this probably just accelerated the timeline (or kept you from having to make one at all). So, expect some rough nights and do your best to prepare.
Seek help when you need it. It's more than OK. It's necessary.
Dr. Smith: It's particularly hard to shoulder this burden of poor sleep when you feel like you're on an island. And I know there are parents out there who struggle to get help. But this is a situation where a tired baby, makes for a tired parent and a tired parent doesn't have the same patience to work with a fussy baby to help them through this transition.
I know that sometimes partners need to go to work the next day and feel like they can't work on shortened sleep. But, keep in mind, that staying home and parenting after no sleep is no walk in the park either. Find creative ways to share the burden. It's amazing what one good night of sleep will do to prepare you for a few difficult nights.
If both parents are working and your baby isn't sleeping well, seek out friends or family who might be willing to take a night or even just a few hours for you. Friends and family, when you hear that mom and dad are struggling to get sleep...don't ask what you can do to help, ask what night they want you to come over.
Dr. Arnaout: I think one of the hardest things for me to realize with my first baby was that we were gonna have good nights and bad nights, and one day…I’d sleep full nights again.
Dr. Smith: I think it’s important for parents to know that safe sleep is accessible for all babies. What doesn’t work one night may work the next, as the child grows and develops. And kids’ sleep is phasic - you’re gonna have weeks where they rock it, and nights when you’re totally questioning your life decisions.
Recognize your exhaustion as temporary! It will get better!
The more weight your baby puts on and the more self-calming mechanisms they develop as they grow will both help you climb out of the early infant months well-rested and feeling confident your child is safe while they sleep! And as always - if you need help - ask your pediatrician! We are honored to be a part of your “village” and have helped thousands of families during this trying time.
We know that this topic is one that inspires a lot of passion. No one wants to make a family feel guilty who has used the Rock n’ Play in the past or who are currently struggling with what to do. But, the reality is, that new information is almost always a good thing. And this information says that these devices are not safe. While we'd love to compromise, we can't advocate for using a device that causes infant death, especially when used as directed.
What about babies with reflux?
Dr. Arnaout: "One morning, I woke up to find that my first baby, who experienced pretty bad reflux, had barfed all over the place sometime in the night. It was everywhere - in his hair, his ears, and soaked into his sheet and sleep sack. I felt horribly guilty for not hearing it or being there to help - even though I was laying in bed right next to his bassinette. I was an exhausted mom, and looking back, I needed to forgive myself. I was worried that morning - what if he had choked? Aspirated? But then I remembered all the protective reflexes babies have to protect their lungs - namely, gagging and coughing - that gets it all out, and allows them to breathe again.
There is some thought that tucking a blanket or wedge under the mattress to elevate the baby might help, but lately, research has proven that elevation may not really help: "The supine sleep position does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux, because infants have airway anatomy and mechanisms that protect against aspiration.”
What do you think about baby monitors?
Dr. Arnaout: I think monitors are both helpful and not helpful. The AAP says babies are most safe in the parents’ room in the first year, in their own sleep space (crib). But my kids were noisy little people - and I am a light sleeper who would jump up at every single noise. I’ve eventually used monitors with both of my kids when I moved them to their own room and depended on them to let me know when my baby wasn’t feeling well or was hungry. But I always turned the volume on low, and it only alerted me if the baby was yelling pretty loud. I did this because all babies make noises while they sleep: snort, sigh, cough. Refluxy kiddos are honky and loud sometimes when they sleep because the tummy acid juices and milk sometimes irritate the back of the nose as it goes up and down.
Get to know Justin Smith, M.D. and Diane Arnaout, M.D.
Justin Smith, M.D., is a pediatrician in Trophy Club and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at firstname.lastname@example.org.
He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.
Get to know Diane Arnaout, M.D.
Dr. Diane Arnaout is a pediatrician at the Cook Children's Forest Park practice. If you would like to see her at Forest Park, call 817-336-3800 or click here for an appointment. Dr. Diane has been a Cook Children’s physician since 2011.
She got her undergraduate degree at Texas A&M University, went to medical school at the UT Health Science Center in San Antonio, and completed her pediatric residency in the Texas Medical Center at UT Health Science Center in Houston.
She is board-certified by the American Board of Pediatrics. She has two small kids, whom she credits as being her toughest (and best) teachers. She loves being a pediatrician and loves to teach parents all about their childrens’ health daily, both in-person and online.”