Herbie Murray
As a new parent, you may be wondering about the best ways to help your 3-month-old sleep. While it's common for naps to be short and inconsistent at this age, there are steps you can take to encourage longer stretches of sleep. One option that may be considered is using a crib wedge to elevate your baby's head, which is said to help with reflux and keep stomach acids down. However, it's important to note that the use of sleep positioners, including wedges, is controversial. While some parents find them helpful, others express concerns about their safety, particularly regarding the risk of suffocation. The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing for the first 6 months, and advises against the use of sleep positioners, wedges, and inclined sleepers. Ultimately, it's essential to prioritize your baby's safety and follow recommendations from trusted sources, such as pediatricians.
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What You'll Learn
- Sleeping wedges are not recommended for babies due to the risk of suffocation
- Sleep positioners are not proven to reduce the risk of SIDS
- Inclined sleeping is not recommended for babies who spit up
- Babies should sleep on their backs, on a firm, flat surface, without loose items
- Room-sharing without bed-sharing is recommended to reduce the risk of SIDS
Sleeping wedges are not recommended for babies due to the risk of suffocation
Sleep wedges are not recommended for babies due to the risk of suffocation. The American Academy of Pediatrics (AAP) and two government agencies, the Food and Drug Administration (FDA) and the Consumer Product Safety Commission, have warned parents and caregivers not to put babies in sleep positioning products. This warning was issued after reports of 12 known infant deaths associated with these products. The FDA has also stated that the modest potential benefits of these products do not outweigh the risks.
Sleep wedges are often sold with the idea that propping up a baby at a slight incline can prevent acid reflux and flat head syndrome. However, flat head syndrome is usually a cosmetic issue that corrects itself over time as babies develop stronger neck and shoulder muscles. While it is important to prevent acid reflux, there are other ways to do so that do not involve the use of sleep wedges.
To create a safe sleep environment for your baby, it is recommended to always place them on their back to sleep, not on their stomach or side. The surface should be firm and flat, and the mattress should be covered with a sheet that fits snugly. Keep soft toys, pillows, blankets, unfitted sheets, quilts, comforters, sheepskins, and bumper pads away from the baby's sleep area. Additionally, avoid overdressing your baby for sleep to prevent overheating.
It is also important to ensure that the crib, cradle, or bassinet used for the baby is safe. The mattress should not be more than 3.8 centimeters thick, and the space between the mattress and the sides should not be more than 3 centimeters. Regularly check for any loose or missing parts or signs of damage, and only use parts from the original manufacturer for repairs. Cribs made before September 1986 are not considered safe due to wider spacing between crib slats, which can trap a baby's head.
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Sleep positioners are not proven to reduce the risk of SIDS
While it is recommended that infants up to 3 months old get 14–17 hours of sleep over a 24-hour period, it is important to be vigilant about their sleep position and environment. The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing for at least the first 6 months, as this is when the risk of SIDS (Sudden Infant Death Syndrome) is highest.
Sleep positioners, such as wedges, are not recommended for use with babies. The U.S. Food and Drug Administration (FDA) and the Consumer Product Safety Commission (CPSC) have warned against using sleep positioners, as they have been associated with infant deaths. These products can pose a risk of serious injury to a baby, including the risk of suffocation.
Babies can scoot up or downward on the positioning device and may become trapped in the product or between the device and the crib, play yard, or bassinet. This can lead to suffocation, whether or not the product makes medical claims. The FDA discourages consumers from purchasing any product claiming to reduce a baby’s SIDS risk.
To reduce the risk of SIDS, it is recommended to always place your baby on their back to sleep, use a firm, flat sleep surface, and keep soft items, bedding, and toys away from the baby's sleep area.
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Inclined sleeping is not recommended for babies who spit up
It is natural for parents to worry about their baby's safety during sleep, especially when the baby spits up while sleeping. While it is common for babies to spit up, it can be alarming for parents, especially when it seems like they have spat up curdled milk or thrown up long after a feeding session. However, it is important to note that inclined sleeping is not recommended for babies who spit up.
The American Academy of Pediatrics (AAP) strongly recommends that all babies sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS). This recommendation applies even to babies who frequently spit up. Research has shown that sleeping on the back does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux (GER). In fact, babies sleeping on their backs might clear fluids better than those in other positions.
Babies have several anatomical features that help protect their airways. The trachea (windpipe) is located anterior to the oesophagus, making it less likely for spit-up to enter the airway when a baby is on their back. This is why the AAP recommends sleeping on the back even for babies with reflux. Once a baby can independently roll from back to belly, they have the muscle strength and neck control to lift their head and sleep on their tummy safely.
Instead of using a wedge or incliner, parents can ensure a safe sleep environment for their baby by following a few simple guidelines. Firstly, always place your baby on their back to sleep, not on their stomach or side. Use a firm, flat sleep surface and cover the mattress with a snug-fitting sheet. Do not put anything else in the crib or bassinet, including plush toys, pillows, blankets, or bumpers. Keep your baby away from secondhand smoke, as it increases the risk of SIDS. Additionally, offer a pacifier to your baby at sleep time, but don't force it.
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Babies should sleep on their backs, on a firm, flat surface, without loose items
It is recommended that babies sleep on their backs, on a firm, flat surface, without loose items. This is because babies who sleep on their backs are less susceptible to ear infections, fevers, and stuffy noses. Sleeping on the back also drastically reduces the chance of Sudden Infant Death Syndrome (SIDS). In addition, babies have a reflex that allows them to naturally swallow or cough up fluids, so they will not choke if they spit up or vomit while sleeping on their backs.
A firm, flat surface is important because babies, especially those under 12 months, are more vulnerable to sleep-related injury and death. This is due to their larger head size in comparison to their bodies, the more pronounced bump at the back of their heads, and the fact that they are still developing head control and neck musculature. As such, babies who are not on a firm, flat surface can end up with their chin resting on their chest, blocking their soft and flexible airway. Soft surfaces also increase the risk of suffocation.
Babies should sleep on a firm surface that quickly returns to its original shape if pressed on and is flat like a table, not a hammock. A fitted sheet covering the mattress is the safest option, even if it seems bare. The mattress should also comply with the size and depth recommended by the manufacturer of the cot, with no more than a 20mm gap between the mattress and the cot sides and ends.
Loose items such as soft bedding, nests, bumpers, pillows, additional mattresses, and toys should be avoided as they can block the baby's airway. Bed sharing is not recommended as it increases the risk of SIDS and sleep-related death. Babies should not sleep on adult mattresses, couches, or armchairs, and they should not sleep in car seats, strollers, or sitting devices.
While some pediatricians recommend using a crib wedge to help with reflux, there is conflicting information on its effectiveness. Some sources state that raising one end of the crib or mattress is not effective at reducing reflux or its symptoms, and it may even be dangerous as it can affect the baby's ability to breathe properly. However, some parents have found that inclining the bed has helped with their baby's reflux symptoms. It is important to consult with a pediatrician or family doctor to determine the safest sleep position for your baby.
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Room-sharing without bed-sharing is recommended to reduce the risk of SIDS
The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing for at least the first 6 months, or ideally, until a baby's first birthday. This is because the risk of SIDS (Sudden Infant Death Syndrome) is highest during this period. Room-sharing is when you place your baby's crib, portable crib, play yard, or bassinet in your own bedroom instead of in a separate room. This allows you to keep your baby nearby, making it easier to feed, comfort, and monitor them at night. While room-sharing is considered safe, putting your baby to sleep in the same bed as you is not. Bed-sharing increases the risk of SIDS and other sleep-related deaths.
To create a safe sleep environment for your baby, always place them on their back to sleep, not on their stomach or side. The AAP has recommended this sleeping position since 1992, and it has significantly reduced the rate of SIDS. Use a firm, flat sleep surface and cover the mattress with a snug-fitting sheet. Do not put anything else in the crib or bassinet, including plush toys, pillows, blankets, quilts, comforters, sheepskins, and bumper pads. Keep your baby away from smokers, as secondhand smoke increases the risk of SIDS.
Additionally, it is important to avoid using sleep positioners, wedges, or other devices that claim to reduce the risk of SIDS. These products can cause suffocation and have been associated with infant fatalities. Instead, follow the recommendations of experts and use a firm mattress with a fitted sheet in a crib or bassinet free from toys, pillows, and other items that could create a hazard. Make sure that all sleep surfaces and products you use have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.
While some parents use wedges to help with their baby's reflux, it is important to consult with a pediatrician before introducing any sleep positioners or wedges. If your baby has reflux, there are other strategies you can try, such as supervised tummy time during the day when your baby is awake and alert. Remember, when it comes to your baby's sleep environment, less is more, and it is always better to prioritize creating a safe and approved space.
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Frequently asked questions
No, it is not recommended to use sleep positioners, wedges, or other devices for babies under six months old. These products can cause suffocation and even lead to death. It is best to use a firm, flat sleep surface and place your baby on their back to sleep.
Some parents use wedges to keep their babies' heads elevated, believing it will reduce the risk of sudden infant death syndrome (SIDS) and help with reflux. However, there is no evidence that sleeping on a wedge prevents reflux.
While some parents believe that a wedge will provide extra comfort for their baby, it is important to remember that babies do not need pillows and can sleep comfortably without them.
Infants up to 3 months old should get 14-17 hours of sleep over a 24-hour period, including 2-3 naps during the day and a longer stretch of "sleeping through the night," which is typically considered 5-6 hours at this age.
It is important to watch for sleepy cues and be flexible, as a 3-month-old's schedule will vary from day to day. Prioritize daytime calories to work towards longer stretches of sleep at night, and establish a bedtime routine with soothing activities like bathing and reading.
