Papa's Gonna Give You...
Encouraging New Fathers to Create Safe Sleep Environments

Every year on Father's Day we honor fathers for all they do, including keeping their families safe and secure. Being a father can be tough, especially after the birth of a baby in the very early, often sleep-deprived, days and nights. Getting everyone a good night of sleep can be a challenge and can put convenience and safety on a collision course.

Fathers can play an important role in making sure their babies' sleep environments are safe and secure. This issue of iNCite presents sleep recommendations from the American Academy of Pediatrics and the N.C. Division of Public Health and offers tips new fathers can use to help their little ones (and perhaps even mom and dad) get a good, safe sleep.

Dangers of Co-sleeping

In an effort to get everyone some much needed sleep, parents may practice co-sleeping (also called bedsharing), or sleeping with their infant in the bed with them. One study has shown that approximately 13% of U.S. infants co-sleep routinely and nearly 50% share a bed for part of the night (1). Advocates of co-sleeping point out that the practice facilitates breastfeeding, bonding and a restful night for the entire family. The American Academy of Pediatrics, however, warns that bedsharing can be dangerous, even fatal, for babies under certain conditions and advise against it (2).

The N.C. Medical Examiners' office has documented cases of accidental suffocation and death attributed to co-sleeping; these are preventable deaths. In addition, the relationship between co-sleeping and Sudden Infant Death Syndrome (SIDS), the unexplained death of a healthy infant, has been examined by many studies. The risk of co-sleeping has been found to be higher when the baby is less than 4 months old, shares a bed with a parent who smokes, or sleeps with an adult who is overtired or has consumed drugs or alcohol. Other factors that increase the risk are when an adult sleeps with a baby on the couch , when the baby is in bed for a long duration of time - such as for an entire night, and when there are multiple people in the bed - especially when the baby sleeps between two parents (2,3).

Baby's Safe Sleep Environment

The best place for baby to sleep is in its own crib or bassinet. There is growing evidence that room sharing (when the infant sleeps in his/her own crib or basinet in the parent's room) is associated with a reduced risk of SIDS. As a healthcareprofessional, you should advise parents to place the baby's crib or bassinet in their bedroom if they wish to keep their baby close.

Share these tips with new fathers to help make those first nights a little bit easier on mom and dad (and safer for baby) and encourage fathers to:

Learn about safe sleep.

• Always place healthy babies on their backs for nighttime sleep and for naps
• Use a sleep place like a crib, bassinet or playpen designed for babies. Do not put the baby to sleep in a bed, sofa, chair or car seat, or let the baby sleep with anyone else who is sleeping
• Never put your sleeping baby on pillows, cushions, sofas or loose bedding
• Keep excess bedding, toys, stuffed animals and pillows out of the crib while baby sleeps
• Do not cover the crib or your baby's face with blankets
• Don't allow older siblings to sleep with your baby
• Prevent overheating. Keep room temperature between 68°F and 72°F and never more than 75°F.
• Make sure your baby breathes air that is free of smoke -don't allow anyone to smoke near your baby or in your home or car

Pitch in to support his breastfeeding partner.

While dads can't nurse the baby, a father can support his partner while she takes on this responsibility. He can bring the baby to her in bed and return the baby to its bassinet or crib after she has finished. He can also offer to bring his partner a glass of water or extra pillows for comfort while she is nursing.

Do his share of bottle feeding.

Parents can set up a schedule ahead of time and decide who will get up to feed the baby. They may want to take turns feeding the baby or assign "shifts". This way, both dad and his partner might get some periods of sleep during the night.

Learn how to soothe his baby.

It takes time and practice to figure out how each baby likes to be held and soothed. Some prefer a close cuddle while others prefer to face outward. Gentle rocking, walking or "shushing" sounds also calm some babies. Encourage dad to experiment to see what works best for his little one, and get in some great bonding time in the process!

Take care of himself.

Mothers hear this message all the time and fathers can benefit from the same advice. Encourage him to take some time for himself during the day: take a run, watch a TV show or do something else he enjoys so he can return to his partner and baby ready to take on the challenges of the next night ahead.

References:
1. January 2003 Archives of Pediatrics and Adolescents Medicine;
2. AAP Task Force on Sudden Infant Death Syndrome. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding Sleeping Environment, and New Variables to Consider in Reducing Risk. Pediatrics November 2005; 116(5): 1245-1255.
3. Blair PS, Fleming PJ, Smith IJ, et al. Babies sleeping with parents; case-control study of factors influencing the risk of the sudden infant death syndrome. BMJ. 1999;319:1457-1461