I hate infant sleep positioners. They are not safe or helpful. If you have one or know a family/friend who uses one for their infant, throw it out. Trash compact it. Stomp on it. Cut it up in bits. This is one rare thing you should feel good about putting in landfill.

When I was first started in practice, I didn’t even know sleep positioners existed; I was shocked at how many parents told me they were using them. We are led to believe (by manufacturers) that positioners confer safety by keeping babies on their back. Since 1994, the Back to Sleep campaign has helped parents become vigilant (yes!) about putting babies to sleep on their backs. But after my sons were born, and while roaming the super-store aisles for bottles, crib sheets, overpriced silicon, and breast pads (oh the glory), I realized why parents get so confused.

In the infant sleep section, I found plenty of products designed for babies I would never recommend. Never. Sleep positioners, head positioners, comforter-like blankets for the crib, bumpers and stuffed animals. Many products went against what I was taught in my pediatric training and what I’ve learned thereafter. Like so many things in life and medicine, less is more. When asked about setting up a safe infant crib I say, “Boring, bare, basic.”

In 2005, the AAP (American Academy of Pediatrics) issued an updated guideline on the prevention of SIDS. Though the message has been effective, sleep positioners have persisted to sell. Two weeks ago, prompted by 12 deaths (over 13 yrs)  due to sleep positioners, the AAP reiterated their position citing the dangers from sleep positioners after the CPSC and FDA (photos seen here) sent out a warning. Even though these positioners go clearly against safety data and medical advice, companies have kept them on the market.

Why?

Fear. Plenty of products designed for infant sleep target those parents who fear sudden infant death syndrome (SIDS). Which, to be honest, is most of us. Products like sleep positioners claim to keep babies on their backs yet go entirely against what we know in protecting infants from unexplained death or SIDS.

The bad news: SIDS, although extremely rare, is the number one killer of infants beyond the neonatal period.

The good news: Over the past decade and a half, the rate of SIDS has been cut in half since pediatricians and providers have advised placing babies on their backs to sleep. In half. Getting rid of a positioner is one change that could prevent an avoidable death. A positioner is made of soft bedding material. Boring, sparsely decorated cribs with firm mattresses, are the preferred, perfect sleeping environment for babies.

Boring, bare, basic is best.

When you leave the hospital, you need very few material goods: breastmilk (or formula), a bare crib or bassinet (with a firm mattress), diapers & wipes, a few outfits, and thin receiving blankets. And the non-material one: love. But that comes naturally.

The causes of SIDS are poorly understood. I don’t necessarily like talking about SIDS on a parenting blog where I am committed to minimizing fear. The below information is not to scare you, rather inform you of ways to minimize the risk. Research continues on preventing SIDS. Theories of what causes SIDS surround concerns for suffocation from soft bedding, re-breathing of the air when babies sleep on their tummies, and overheating. Goals for families to reduce the likelihood of an event demand constructing a safe sleeping environment.

Preventing SIDS:

  • Position: Always put your baby to sleep on their back. Remember since the 1990′s death from SIDS has been cut in half since we’ve advised back sleeping. There is no questioning this. Always put a baby to sleep on their back. If your baby rolls over, after you’ve placed them on their back, there is no need to continue re-positioning them.
  • People: Tell Grandmas, babysitters, nannies, & the nice-friend-that-helps-you-out to always put your baby to sleep on their back. Babies who are used to sleeping on their back, who are then placed on their tummy by a different caregiver, are at far increased risk of SIDS.
  • Bedding: avoid soft bedding, sleep positioners, head positioners, bumpers, stuffed animals, thick blankets, or pillows of any kind in the first year. Talk to your pediatrician if you have any concerns or want to clarify. Boring, bare, basic.
  • Lifestyle: Babies who have parents who smoke are at increased risk for SIDS; avoid cigarette smoke and help loved ones quit. Your baby is the perfect reason.
  • Pacifier: Pacifiers have been shown to decrease the likelihood of SIDS (the why behind this recommendation is debatable). Offer a pacifier for your baby after 1 month of age when feeding is well established. If the pacifier falls out during the night, there is NO data to support your need to put it back in a baby’s mouth. (Just try to get some sleep while baby is sleeping!)
  • Cool: Don’t jack up the thermostat because there is a baby at home. Ideal temperatures for sleeping infants is about 65-68 degrees. New data suggests that using a fan to circulate air (not directly on the baby) may improve the condition as well. Keep the room cool. In the summer use a circulating fan to keep the room comfortable.
  • Where: The AAP recommends babies sleep in their own crib or bassinet in their parent’s room until 6 months of age. This makes overnight feeding easier, too (quick commute).
  • Inform: Know the facts so you don’t make false assumptions and increase your worry. Share what you know.
  1. SIDS is rare, but more common in infants who have a family member who died of SIDS or have parents who smoke. If you are concerned about your family’s history, talk with your pediatrician.
  2. SIDS is most common between 2-4 months of life with 90% of cases occurring in babies under 6 months of age.
  3. SIDS is possible up until a baby turns 1 year of age. Follow precautions and back to sleep positioning until your infant turns 1 year of age. Following these precautions decreases risk.
  4. SIDS risk can be decreased by following recommendations and clearing out the crib of soft clutter. Remember SIDS cases have cut in half since we started recommending following these guidelines.