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Academy: Babies should sleep in parent's bedroom

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At a week and a half old, Caleb Muhle, of Rochester, sleeps most of the day.

Does your new baby sleep in your bedroom? It should, according to a major policy change, just not in your bed.

The American Academy of Pediatrics unveiled its updated safe infant sleeping recommendations Oct. 24 at a national conference in San Francisco. The biggest change calls for parents to bring the crib or bassinet into their bedroom at night as a way to prevent sudden infant death syndrome, or SIDS.

That idea was first recommended after a 2011 study by the University of Massachusetts and has now gained mainstream appeal. Some evidence suggests that the simple change may cut the mortality rate of infants roughly in half, which could save the lives of 1,750 babies each year.

Other safety recommendations through the first 12 months of life include: only allowing infants to sleep on their back, using a firm sleep surface and keeping soft objects and loose bedding away from an infant's bed area. Couches and armchairs are considered "extremely dangerous" places for infants to sleep, while bed sharing is also frowned upon.

Mayo Clinic has followed AAP's safe sleep recommendations for decades and was quick to adopt the best practices. They're now part of Mayo's written recommendations for new parents, and part of its educational counseling from nurses.

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Heads up

Anita DeAngelis, Mayo's perinatal education supervisor, says the new recommendations are building upon the "Back to Sleep" campaign of the 1990s, which urged parents to have their babies sleep face-up.

"Every parent that's in the hospital receives education from the nurse who is caring for the baby, hands-on as well as written materials," DeAngelis said. "It's seen as a very high priority."

More than 3,500 babies die each year in the United States due to SIDS. Minnesota's infant mortality rate of 5.0 actually ranked eighth, with an average of around 350 SIDS incidents annually from 2008-2012, but the Minnesota Department of Health still adopted an Infant Mortality Reduction Plan in 2015 due to what Health Commissioner Edward Ehlinger described as "stark inequalities."

Of particular concern were infant mortality rates of American Indians and African Americans, which were 9.1 and 9.2 in 2012. By comparison, the rates for Asians, Hispanics and Whites were 4.4, 5.1 and 4.3.

While those are all better than national numbers, Ehlinger seeks "to create a state where all babies are born healthy and have an equal opportunity to celebrate their first birthday."

Move the crib

AAP is now suggesting that simply moving the crib or bassinet into the parents' bedroom could reduce SIDS incidents by up to 50 percent, which would significantly improve infant mortality rates by preventing "suffocation, strangulation and entrapment that may occur when the infant is sleeping in an adult bed" or in a different room.

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It's unclear when the last death due to SIDS occurred in Olmsted County. Neither Mayo nor Olmsted Medical Center officials were able to recall a local incident, and Olmsted County Public Health did not have data available.

However, the recommendation isn't exactly set in stone.

The American Academy of Family Medicine has not weighed in since AAP announced its recommendation weeks ago. Additionally, the data cited by AAP and others was created through observational research only. That's only logical, DeAngelis said, since no new parent would agree to put their baby at increased risk for the sake of research.

Practical issue

OMC has yet to adopt the new AAP recommendation, according to Dr. Steven Adamson. He feels that it simply isn't practical for all parents to put a crib or bassinet in their bedroom due to space concerns, and wonders at how it might impact sleep patterns for parents, particularly those who don't work similar hours.

Adamson calls any infant death "tragic," but notes there are already many other ways to reduce SIDS, including breastfeeding, using a firm bed, not smoking and various other things.

"I'm not so sure I want this as the standard of care — 'if you don't have the crib or bassinet in your room, you're a bad parent,'" Adamson said. "I'm not sure I want to hang that over a parent's head.

"For me, I'm going to tell people that's the recommendation. If it works for them, wonderful. If it doesn't, I understand. There are many other things you can do that mitigate the risk of SIDS."

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