To cut the risk of sudden infant death syndrome (SIDS), parents should let their babies sleep in their room, but not in their bed, and put them on pacifiers in the night, the American Academy of Pediatrics (AAP) said in the guidelines issued at the occasion of the National SIDS Awareness Month.
SIDS, the number one killer for infants between the ages of one month and a year, claims around 2,000 babies in the US annually. Among other recommendations to cut the incident of SIDS are placing the baby on its back and not its stomach while sleeping, using a firm surface instead of a soft one for the baby's bed and keeping soft toys out of the crib.
Parents have also been warned against smoking during pregnancy and in the presence of the baby. The main recommendation, however, is letting the child sleep with a pacifier. According to AAP estimates, babies who sleep with pacifiers face a 61 per cent lowered risk of SIDS that those who don't. This might be because pacifiers help clear airways and prevent babies from babies going into deep sleep and rolling onto their stomachs.
However, the suggestion to keep children on pacifiers in the night and keep them out of parents' bed has invited flak from certain lobbies. Many feel that breastfeeding in the night is better than putting the baby on a pacifier.
“The breast-feeding community is very upset. Basically, they are telling us to use an artificial substitute for something a mother usually does,” said Katy Lebbing of La Leche League International. Agreeing with her was Jeanne Stolzer of the Attachment Parenting International (API), a group that advocates physical proximity between parents and children. “To stick the latex nipple in the baby's mouth may be more convenient than to pick her up and hold and nurse and cuddle her but baby mammals need their mommies,” she said.
“These (AAP) recommendations do not accurately reflect the findings regarding co-sleeping and SIDS, do not acknowledge the importance of breastfeeding and shared sleeping for infants' development and are unnecessarily cautious in regard to the potential risks associated with co-sleeping. Further, the recommendations may inhibit parents from making informed, educated decisions that will have a strong impact on their infants' development, both cognitive and emotional,” a statement released by the API said.
The AAP countered this contention saying that the guidelines came after reviewing certain studies that show that pacifiers help cut SIDS risk. “There are other investigators around the world who are reluctant to recommend pacifiers for breast-fed infants. We agonized over it. It wasn't made lightly, because we are all really big breast-feeding advocates,” said Fern Hauck of the University of Virginia, who looked into the studies about pacifiers and helped draft the new guidelines.
But, many also welcomed the new recommendations. “Over 2,000 babies a year are still dying. We should be able to do something about that,” said Dr John Kattwinkel of the University of Virginia, who heads the AAP SIDS task force.
First Candle/SIDS Alliance spokesperson Laura Reno, who lost her son to SIDS two decades back, said her group is a staunch supporter of the new guidelines. “We just want to reduce as much risk as possible. He (her son) was sleeping on his tummy on top of a sheepskin. If I had just known then what we know now. It's a devastating thing for parents and guilt is strongly associated with these deaths,” she said.
Some prefer taking the middle path. “The recommendation is not to have the pacifier in the mouth 24/7. I would think that if people are just using the pacifier as a little something to help the baby settle for sleep, it shouldn't interfere,” said Doraine Bailey, an expert in the field of nursing and breastfeeding.
