Monthly Archives: July 2020

Will a Breathable Mattress Help Avoid SIDS?

Breathable Crib Mattress to Prevent SIDS

Will a Breathable Mattress Help Your Baby Avoid SIDS?

Over 3,600 seemingly health babies die each year in the U.S.  Will a “breathable” mattress help your baby avoid SIDS (Sudden Infant Death Syndrome)?

In early 2000, the crib mattress buzz word was organic.  Twenty years later, it is now “breathable.”  With so many crib mattress manufacturers claiming to have breathable mattresses, we thought it was time to address the question, “Will a breathable mattress help your baby avoid SIDS?”

What is SIDS

A baby is determined to have died from SIDS if no cause of death can be identified following a death scene investigation, an autopsy, and a review of the clinical history. SIDS as a cause of death is determined only when all other causes have been excluded.

With infant related sleep deaths, the cause of death can be difficult to determine with certainty. Infants who die from sudden death usually pass away while asleep in their cribs. Victims are often found lying face down. There are no signs of trauma. Usually their deaths are not witnessed by another person, which makes it difficult for investigators to piece together how they died.  There are also no clear biological markers.

Slate Magazine

In an August 2016 article published in Slate Magazine under a similar title, Could a Breathable Mattress Help Your Baby Avoid SIDS?, the author believes breathable crib mattresses manufacturers do nothing more than exploit the fears of parents. 

According to the article’s author,

“There was a lot of research in the 1990’s that showed rebreathing is a hazard when babies sleep on soft bedding, like sheepskin, or with a blanket covering their heads. However, there isn’t evidence that sleeping on firm mattresses with a tight-fitting sheets—as is recommended—causes problematic rebreathing in babies, even if they roll onto their tummies. Plus, rebreathing is just one hypothesis for why tummy sleeping might be riskier.”

The fact is, there is scientific data showing that crib mattresses with fiber or other core materials do cause problematic rebreathing in babies.  This is noted in the same pub med resources as the author uses to debunk firm mattresses with a tight fitting sheet as not being problematic.  Logically, if fiberfill mattresses were not problematic, why not suggest infants can tummy sleep? 

The author’s goes on to state,

“More recent research has found that babies sleeping belly-down also have impaired arousability, altered cardiovascular control, and lower blood pressure and cerebral oxygenation, any of which may be important when it comes to SIDS.”

Without knowing it, the author is describing effects of rebreathing exhaled air (CO2).  Impaired arousability, altered cardiovascular control, low blood pressure, and lack of cerebral oxygenation, are all signs of rebreathing.  When an individual rebreathes their exhaled air (CO2), it suppresses their need to breathe and eventually leads to hypoxia and then death.

Rebreathing

According to a March 2019 article in Health, research by Dr. Gordon Buchanan, a neurologist and epileptologist at the University of Iowa reveals,

“Babies and adults who die from sudden death syndromes may be born with brains that aren’t good at recognizing rising CO2 levels in their blood. In sudden death cases, it’s thought that the individuals’ airways get blocked somehow while sleeping in bed — such as by a pillow, a toy or tangled bedding. But it wasn’t clear why the person doesn’t simply wake up and fix the problem by repositioning themselves or by crying out for help.

Buchanan thinks that individuals who succumb to sudden death syndromes may have malfunctioning serotonin receptors in their brains. These receptors are part of our brain’s “suffocation alarm system” and help to ensure that blood oxygen and carbon dioxide (CO2) levels are healthy. But Buchanan thinks that a rare neurological difference causes some people’s brains to be bad at detecting when blood CO2 levels get too high — which is a signal to our bodies that we could be suffocating. Instead of waking up like most people would, those with this defect stay asleep and are seemingly powerless against what’s happening to them.

Dr. Hannah Kinney was the first to be credited with discovering the effects of serotonin levels in an infants brain stem and SIDS 

The problem we face, is there is no way to test to find out which babies do, and which babies do not have a compromised “suffocation alarm system,” so all infants remain vulnerable.

Approved Standards

So, can a breathable mattress help your baby avoid SIDS?  In the Slate article previously mentioned, the author correctly states,

One problem with mattresses being marketed as “breathable” is that there aren’t any approved standards for what this should mean.”

She gives one example of the Nook Pebble Pure mattress that uses coconut husk as part of its fill.  According to Dr. James Kemp, a pediatric pulmonologist at St. Louis Children’s Hospital and SIDS expert, called this “exactly the wrong idea,” noting that a porous interior might actually trap carbon dioxide. A mattress filled with tea tree bark made in Australia in the 1980s and ’90s and marketed as breathable turned out to increase the risk of SIDS, and, according to a study by Kemp, allowed more rebreathing.

Some “breathable” crib mattresses with porous interior and cores are actually shown to be more dangerous than a solid fiber fill crib mattress.

Claims of Preventing SIDS

The Slate author states,

 “In designing “breathable” mattresses and claiming that they will inherently keep babies safer, these companies are demonstrating a fundamental lack of understanding of the complexity of SIDS, and, more broadly, of science. “The ‘evidence’ the manufacturers of these crib mattresses provide is not evidence of reduced risk of suffocation or SIDS,” said Dr. Fern Hauck, a member of the AAP’s Task Force on SIDS. “As long as the mattresses meet government safety standards, they can be used, but they should not be marketed as preventing SIDS or suffocation,” she added.”

The reality is none of the “breathable” crib mattress companies mentioned in the article claim to prevent SIDS.  The author uses a very misleading statement.

Since SIDS is a diagnosis of exclusion, there is nothing that can prevent it.  It would be like say you have something that can cure death by natural causes.  The term Sudden Infant Death Syndrome is also misleading, and often confusing, since SIDS is not a syndrome or a diagnosis.  It’s simply a term used if we don’t know what else to classify an infant death as.

Science

No studies exist comparing infants who sleep on various crib mattresses to see which one has fewer SIDS deaths.  This lack of studies includes the recommended firm crib mattress with a tight-fitting sheet. No published studies or valid scientific testing is available that shows if one crib mattress, including the currently recommended firm mattress with a tight-fitting sheet, or sleep surface has a lower/higher SIDS risk.  These gold standard studies do not exist for any of the AAP Task Force recommendations and likely never will; it is not feasible to enroll the number of infants required to get sufficient data.  

We cannot say with scientific certainty if a breathable mattress could help your baby avoid SIDS.  We also cannot say with scientific certainty that a firm crib mattress with a tight-fitting sheet can avoid SIDS.  In fact, we can’t say with scientific certainty that any of the AAP’s safe sleep recommendations will avoid SIDS.  The real question should be, can a breathable crib mattress avoid known SIDS “risks”?  All of the AAP’s safe sleep guidelines focus on risk avoidance.

Risk Avoidance  

Knowing what we now do, the question should be can a breathable crib mattress avoid known SIDS risks? 

Let’s look at the following quotes taken from the AAP’s Safe Sleep Policy Statement ;  

  1. Supine sleep position: “The prone or side sleep position can increase the risk of rebreathing expired gases, resulting in hypercapnia and hypoxia.”
  2. Room-Sharing Without Bed-Sharing Is Recommended: “Bed-sharing might increase the risk of overheating, rebreathing or airway obstruction, head covering, and exposure to tobacco smoke, which are all risk factors for SIDS.”
  3. It Is Prudent to Provide Separate Sleep Areas and Avoid Cobedding for Twins and Higher-Order Multiples in the Hospital and at Home: “Furthermore, there is increased potential for overheating and rebreathing while cobedding, and size discordance might increase the risk of accidental suffocation.”
  4. Pillows, Quilts, Comforters, Sheepskins, and Other Soft Surfaces Are Hazardous When Placed Under the Infant or Loose in the Sleep Environment: “However, such soft bedding can increase the potential of suffocation and rebreathing.”
  5. Avoid Overheating and Head Covering in Infants: “It is not known whether the risk associated with head covering is attributable to overheating, hypoxia, or rebreathing.”

While the studies do not demonstrate a direct prevention of SIDS or suffocation, they rely on the hypothesis of rebreathing of CO2 as a potential contributor for these unexpected infant deaths.   A basic pathophysiological principle is the hypothesis that rebreathing C02 is associated with ALTE/SIDS/asphyxia.  Indeed, no studies have substantiated this hypothesis; however, this is the same hypothesis used by the AAP Task Force to support the majority of their recommendations.

Further, the Task Force recommends air permeable sides when bassinets are used. This recommendation is based on a retrospective review and analysis of infant deaths occurring in bassinets between June 1990 and November 2004 that were reported to the CPSC (Pike/Moon 2008). The authors identified at least six infants who were found with their “face wedged against the side of the bassinet.” While there is no mention of any bassinets having air permeable sides in the study, the study authors (including R Moon who is on the AAP Task Force) recommends “a bassinet with vertical sides of air-permeable material, such as mesh, may be preferable to one with air-impermeable sides.”  The Task Force makes the recommendation for air permeable sides based on infants with face wedged against side of sleep environment.   Logic would dictate that air permeable mattresses as being preferable to air impermeable mattresses to address infants face-straight- down on firm mattresses.

Breathable vs. Breathe-Through

Not all breathable crib mattresses are air permeable.  An air permeable crib mattress allows an infant who is face straight down to breathe normally right through the crib mattress without rebreathing their exhaled air.

There is only one mattress on the market today that has been scientifically tested and concludes it significantly reduces the risk of carbon dioxide rebreathing and is completely breathe-through.

The Science of “Breathe-Through”

Safe SleepTechnologies is a company that does understand the complexity of SIDS, and, more broadly, of science.  The four founders all lost a loved one to SIDS.  One of the founders is an AAP member and chairs one of the AAP’s committees.

The SafeSleep®Breathe-Through Crib Mattress was designed with the idea that baby’s do not always arouse when rebreathing harmful carbon dioxide.  Ten years ago, SafeSleep® founders challenged an industry standard by creating a crib mattress with no fill and replaced it with free-flowing air. 

These efforts have been recognized by top medical professionals and even prompted the American Academy of Pediatrics to recognize their crib mattresses with no fill and air permeable surfaces as safer for the infant who rolls in their 2016 Safe Sleep Technical Report.  

The SafeSleep® Breathe-Through Crib Mattress is designed to prevent harmful carbon dioxide from accumulating so that if an infant is face straight down and cannot arouse,  they will not rebreathe their exhaled air.

The SafeSleep® Breathe-Through Crib Mattress has been tested for carbon dioxide retention and has a ten-fold decrease in carbon dioxide retention when compared to a fiberfill mattress with a tight-fitting sheet.  It takes 2 minutes for carbon dioxide to dissipate on a firm crib mattress with a tight sheet; it takes less than 1/2 a second for it to dissipate on the SafeSleep® Crib Mattress.  An infant takes a breath every 1-2 seconds, meaning the carbon dioxide (poisonous gasses) on the SafeSleep® Breathe-Through mattress are gone before the infant takes their next breath of air – even if face straight down and does not arouse.

We can say with scientific certainty that the SafeSleep® Breathe-Through Crib Mattress significantly reduces the risk of carbon dioxide rebreathing even if the infant is face down or tummy sleeping.

 

Are there warning signs of SIDS?

Crib Mattress to Prevent SIDS

Are there warning signs of SIDS?

SIDS (Sudden Infant Death Syndrome) has no symptoms or warning signs. Babies who die of SIDS seem healthy and normal.  They show no signs of struggle. 

Diagnosis of Exclusion

A baby is determined to have died from SIDS if no cause of death can be identified following a death scene investigation, an autopsy, and a review of the clinical history of the infant.   SIDS is a diagnosis of exclusion, meaning he cause of death is labeled as SIDS only after all other causes have been excluded.

Carbon Dioxide Rebreathing

While there are no warning signs of SIDS and the cause of SIDS is unknown, many clinicians and researchers believe that SIDS is associated with problems in the ability of the baby to arouse from sleep to detect low levels of fresh oxygen.  Rebreathing carbon dioxide leads to hypoxia, and eventually death. 

SIDS is a big concern of most parents because there are no warning signs of SIDS.

Face Down Sleeping

When babies sleep face down, they can re-breathe exhaled carbon dioxide if sleeping on a fiber filled mattress or pad.  Babies who sleep on their tummy with their hand or arm close to their face can also re-breathe.  Normally, rising carbon dioxide levels activate nerve cells in the brain stem, which stimulate the brain’s respiratory and arousal centers. The baby then wakes up, turns his head, and breathes faster to get more oxygen. SIDS babies fail to rouse to get fresh oxygen.  Rebreathing of carbon dioxide eventually suppresses their need to breathe and they never wake.  SIDS babies simply pass in their sleep with no warning signs.

Triple-Risk Model

The “Triple-Risk Model” for SIDS has been proposed to explain how SIDS occurs, and why there are no warning signs of SIDS. The model holds that SIDS occurs when three conditions exist simultaneously:

  • the infant has an underlying (e.g., brainstem) abnormality that makes him unable to respond to low oxygen or high carbon dioxide blood levels
  • the infant is exposed to a triggering event such as sleeping face down on its tummy
  • these events occur during a vulnerable stage in the infant’s development, i.e., the first 6 months of life

The underlying abnormality is low serotonin levels in the brain stem.  We currently have no way to test infants to find out which ones do or do not have low serotonin levels.  The vulnerable stage in the infant’s development is believed to be a rapid brain growth phase.   Conception to birth is a human’s most rapid growth phase and birth to 1 year is the second.   Infant’s internal organs are growing quickly.  Unfortunately, we have no way to determine when an infant is growing through a rapid brain growth phase, so all infants remain vulnerable.    The Triple Risk Theory helps explain why there are no external warning signs for SIDS.

Risk Reduction

There is currently no way to “prevent” SIDS from occurring; however, you can vastly reduce your baby’s risk of SIDS by:

  • putting your baby to sleep on his back
  • keeping blankets, pillows, stuffed animals, bumpers, and other stuffed objects out of his crib
  • overheating your baby or his room when he sleeps
  • not smoking when you are pregnant and not allowing anyone to smoke around your baby
  • breastfeeding
  • Using an air permeable/breathe-through crib mattress that does not trap carbon dioxide even if your baby is sleeping face down or on their tummy

Over 3,400 infant deaths are classified as SIDS each year in the U.S., and there are no warning signs for these SIDS deaths.  The best a parent can do is make good choices to keep their sleeping baby safe.  The best way to keep your baby safe is to make sure when you put your baby to sleep for nap or night, you do everything possible to make sure there is nothing in your baby’s crib that can cause the build up of carbon dioxide should your baby roll to their tummy.  The creators of the first air permeable/breathe-through crib mattress found out the hard way what can happen when an infant rolls over on while sleeping on a fiber filled crib mattress.

SafeSleep®

Since there are no warning signs for SIDS, all infants remain at risk.  The SafeSleep® Breathe-Through Crib Mattress  has given over 80,000 parents piece of mind.  Why?  The SafeSleep®”Completely” Breathe-through Crib Mattress has been tested for carbon dioxide retention and has a ten-fold decrease in carbon dioxide retention when compared to a fiberfill mattress with a tight-fitting sheet.  It takes 2 minutes for carbon dioxide to dissipate on a firm crib mattress with a tight sheet; it takes less than 1/2 a second for it to dissipate on the SafeSleep® Crib Mattress.  An infant takes a breath every 1-2 seconds, meaning the carbon dioxide (poisonous gasses) on the SafeSleep® Breathe-Through mattress would be gone before the infant takes their next breath of air – even if face straight down

The hollow frame below the open weave top layer is filled with nothing but constantly circulating, pure organic air, creating the ideal oxygen rich sleep environment for your baby.  Check out all the features and benefits!

Will a Baby Wake if They Can’t Breathe?

Safest Crib Mattress

Will a baby wake if they can’t breathe?

Most babies will wake if they can’t breathe.  But some will not wake if they can’t breathe.  The issue we face is, we don’t know which babies will wake and which ones will not. 

The two main reasons infants stop breathing is airway obstruction and the other is carbon dioxide rebreathing. 

Airway Obstruction

Airway obstruction occurs most often when an infant’s nose is obstructed.  One example would be an infant sleeping on soft bedding that is blocking his nasal passages.  Infants are obligate nose breathers.  This means they breathe primarily through their nose.  This usually changes at around six-months of age but will differ for all infants. 

Carbon Dioxide Rebreathing

As adults, we have a trigger or a defense mechanism when we sleep that if our carbon dioxide rises, we wake up and turn our head on the side or we roll when we are rebreathing our exhaled air, we will turn your head to get oxygen.  It is believed that some infants do not have this trigger, and these infants will not wake if they can’t breathe.  This is known as the “arousal defect.”

The arousal defect  prevents some infants from waking up even when they’re not getting enough oxygen.  It is believed these infants have low serotonin levels in the brain stem or high levels of serotonin in the blood.  There is currently no way to test babies for these serotonin levels until after death.  Many SIDS infant’s have been shown to have low serotonin levels in the brain stem at death.  Dr. Hannah Kinney was the first to discover these findings.  Her research has helped shed light on why seemingly normal babies do not wake if they can’t breathe.   

It is believed that these vulnerable infants will not wake if they can’t breathe or respond (turn their heads) when they are rebreathing their exhaled air.  If these infants continue to rebreathe their exhaled air, it will eventually suppress their need to breathe leading to hypoxia and eventually death. 

These vulnerable infants do not wake if the are rebreathing, and instead sleep quietly through their last breath.  SIDS is a silent killer.

American Academy of Pediatrics Safe Sleep Task Force Recommendations

In 2011, the American Academy of Pediatrics Task Force on SIDS decided to expand the safe sleep recommendations to include recommendations to reduce the risk of rebreathing and other sleep related infant deaths.  As noted in the policy statement,

“It is unknown whether the nonsupine (tummy) position by itself increases the risk of suffocation, and we have therefore not included suffocation as a rationale for supine sleeping in either the Policy Statement or the Technical Report. Moreover, the similarity noted in risk factors should not be construed as implying that SIDS is caused by suffocation. Indeed, they are two separate entities. Unfortunately, at this time, there is no unique cellular pathology or biological markers that enables medical examiners, coroners, or pathologists to differentiate SIDS from suffocation deaths.  Consequently, a determination of the cause of death must be made in the absence of this information.” 

Current Recommendations and Carbon Dioxide Rebreathing

If you look at the current safe sleep recommendations published by the AAP Safe Sleep Task Force, you will notice most of the recommendations center on eliminating the risk of an infant rebreathing carbon dioxide.  These recommendations are based on years of studying  why some babies don’t wake if they can’t breathe.  These recommendations include:

  1. Supine sleep position: “The prone or side sleep position can increase the risk of rebreathing expired gases, resulting in hypercapnia and hypoxia.”
  2. Room-Sharing Without Bed-Sharing Is Recommended: “Bed-sharing might increase the risk of overheating, rebreathing or airway obstruction, head covering, and exposure to tobacco smoke, which are all risk factors for SIDS.”
  3. It Is Prudent to Provide Separate Sleep Areas and Avoid Cobedding for Twins and Higher-Order Multiples in the Hospital and at Home: “Furthermore, there is increased potential for overheating and rebreathing while cobedding, and size discordance might increase the risk of accidental suffocation.”
  4. Pillows, Quilts, Comforters, Sheepskins, and Other Soft Surfaces Are Hazardous When Placed Under the Infant or Loose in the Sleep Environment: “However, such soft bedding can increase the potential of suffocation and rebreathing.”
  5. Avoid Overheating and Head Covering in Infants: “It is not known whether the risk associated with head covering is attributable to overheating, hypoxia, or rebreathing.”

What Can Parent do to Avoid the Buildup of Carbon Dioxide in Their Infant’s Crib?

Dr. James Kemp and colleagues were some of the first to study the potential for various sleep surfaces to prevent infant rebreathing. In one study of five different infant sleep products claiming to reduce the risk of carbon dioxide rebreathing along with a firm crib mattress with a tight fitting sheet – currently recommended by the American Academy of Pediatrics (AAP) for safe infant sleep.  Kemp and colleagues found the firm mattress and four of the five surfaces designed to prevent rebreathing of carbon dioxide consistently allowed lethal rebreathing of carbon dioxide.  According to Kemp, “Only one product—an air-permeable crib mattress—was able to maintain carbon dioxide levels below this threshold.”  The authors go on to say that “even firm crib mattresses could pose a rebreathing threat when vulnerable infants sleep prone.”

Additional studies show that unaccustomed prone sleepers, including infants who are placed supine and roll prone have an increased risk of SIDS (O’Hoir 1998 and Mitchell EA 1999).  These studies and others have shown that nearly half of SIDS victims unaccustomed to prone sleep, were discovered in the face-straight-down position.  Many of these infants were found on a firm mattress.  Dr. Kemp’s data supports that if vulnerable infants were placed on an air permeable surface, they would experience less risk of rebreathing should they inadvertently roll prone (to their tummy).

About Air Permeable/Breathe-Through Crib Mattresses

Until we can identify which babies will wake if they can’t breathe, and which babies will not wake if they can’t breathe, your best defense is an air- permeable/breathe-through crib mattress that does not allow harmful carbon dioxide to accumulate.

SafeSleep® is the first company to design a market successful, air-permeable crib mattress that eliminates carbon dioxide retention in response to infants who don’t wake if they can’t breathe.  The SafeSleep® was developed by professionals, including a leading pediatrician, who were personally impacted by the loss of a loved one who had rolled in the middle of the night. 

The creators of the SafeSleep® created a crib mattress that eliminates carbon dioxide retention at a faster rate than and infant breathes.  An infant takes a breath every 1-2 seconds.  It takes, on average, two minutes for carbon dioxide to dissipate on most crib mattresses.  For some crib mattresses that claim to be “breathable”, it takes as long as three minutes, meaning carbon dioxide will always be present for baby to breathe in.  

Carbon dioxide dissipates in less than half a second on the SafeSleep® Breathe-Through Crib Mattress, meaning the carbon dioxide on the SafeSleep® Breathe-Through mattress is gone before a baby takes their next breath– even if face straight down.

The SafeSleep® breathe-through crib mattress is the only crib mattress physicians write prescriptions for infants who must tummy sleep for health reasons.  The SafeSleep® is considered the safest crib mattress among leading American Academy of Pediatrics Physicians and Committee Members.

If you want to learn more about the scientific test data on the SafeSleep® crib mattress, visit safesleeptech.com

See how the SafeSleep® crib mattress test data influenced changes to the 2016 Safe Sleep Policy here

Sleep Products for Infants; is yours safe?

Safest Crib Mattress

Are your infant’s sleep products safe?  Most parents believe if a product makes its way to the shelves of big box retailers and etailers, it must be safe.  The grim reality is many are not.  We have seen one recent example, the Fisher Price Rock and Play and other inclined sleep products causing hundreds of infant deaths.

As a SIDS and Safe Sleep content expert, I have been privileged to the juvenile product industry standard’s flaws when it come to safety of infant sleep products.

CPSC & ASTM

The Consumer Product Safety Commission (CPSC), who works closely with the ASTM (formerly known as American Society for Testing and Materials), has a  sub committee on infant sleep products.  The issue is, this committee is made up predominately of sleep product manufacturers.  And the ASTM physician on the committee, wants thousands of well documented deaths before “risking” making product mandates for infant sleep products.

Background

Over ten-years-ago, I challenged an industry standard and made drastic changes to the traditional crib mattress design.  I was fortunate; I had a pediatrician (who is also a mother of four) acting as a free consultant while I was in the design phase of my air permeable/breathe-through crib mattress.  She  offered me both professional and practical advice and introduced me to many prominent players in the medical community.  She has many professional connections through her decades of service as a Committee Chair Member of one of the American Academy of Pediatrics (AAP) sub committees. 

We both lost a loved one to positional asphyxiation, classified as a SIDS death.  Product safety and testing for my design was paramount.  Without her connections, I believe finding the proper testing methods and scientific data to create a product that we could prove is safe, would have proven difficult. 

Testing requirements

The sad reality is infant sleep products do not require much testing at all.  Infant sleep products must meet flammability requirements which often results in adding harmful chemicals to fiber and foam filled products.  And if you want to call yourself a “standard size crib mattress,” you must conform to size requirements, and that’s it.  The CPSC asks that you use proper labeling of your fiber content, but it’s not mandatory.

The lack of standards and available testing methods makes it difficult for manufacturers to know if their sleep products are truly safe, let alone consumers.  So, who is responsible for unsafe infant sleep products making their way into the homes of unsuspecting consumers?

Infant’s spend 70% of their first year sleeping.  The safest thing all parents should own is a sleep product.

No easy task

It was no easy task, but we were determined to keep safety and testing as our two main criteria for our new design.  Once we identified all the risks associated with conventional crib mattresses and infant sleep products, we had to search for medical professionals willing to test our product.  Some tests didn’t even exist.  We had to convince a few medical professionals to develop testing.   

We needed to make sure our infant sleep product not only conformed to the few current regulations in play, we needed to make sure it conformed to the AAP’s Safe Sleep Policy Recommendations.  This was no easy task finding testing available to make this possible.  The AAP was just about to publish their 2011 Safe Sleep Policy, so we found out as much as we could about updated recommendations.  There were no new updates for crib mattresses.  The AAP continues to recommend a firm crib mattress with a tight-fitting sheet even though there is no test data to support a firm crib mattress with a tight-fitting sheet as being safe. 

Testing versus retrospective analysis

When I say there is no test data, I mean there is no gold standard testing where babies are placed on different types of crib mattresses to see which ones will survive on a certain type of crib mattress and which ones will not.  As you can see, this type of testing would be unethical.   The closest testing of this type was done by Dr. James Kemp who used baby bunnies.  The AAP Safe Sleep Task Force members must go by what is called retrospective analysis.  This means, the best data they have is to sift through thousands of infant death reports and find correlations of infants in a certain age group, gender, weight, etc.. and try to determine why some infants lived and others died.  For example, let’s take the “back-to-sleep” recommendation.  These scientists found that infants fitting similar profiles were more likely to die if they were on their tummy while sleeping than on their back.  The recommendation for a firm crib mattress is based on infants dying on soft mattresses.

Inherent flaws

Retrospective analysis data can often be flawed, and it is subject to interpretation by the scientists.  Death scene investigations are not always standardized.  There is a significant effort in this direction, but we are not there yet.  It is up to the medical examiner or pathologist to determine the cause of death and take notes on the series of events and the scene.  You can have two examiners look at the same scene, and there is a high probability one examiner will include certain data and exclude data the other examiner would not.

Firmness testing

Even though the AAP recommends a “firm” crib mattress or sleep surface based on death scene investigations, no standard for firmness in the US exists.  More importantly, there is no available firmness testing.  There is also no testing available to determine if a sheet is safe or not.  According the most recent AAP safe sleep recommendations, a sheet that is designed for the mattress you are using is recommended.  The issue is, crib mattress manufacturers are not the ones manufacturing sheets.  There are no clear guidelines for consumers to ensure they are buying the proper sheets for their particular mattress.

We were not concerned about sheet testing since our products do not use them.  We knew they have been linked to many strangulation deaths, so they were out for our design.

However, we were interested in making sure our products met firmness standards.  I happened to e-meet a doctor on a SIDS infant list serve who is a child product safety expert in Australia, Dr. Ron Somers.  Dr. Somers developed a test to measure crib mattress firmness and established a standard in Australia and New Zealand.  Not only did he test our mattress free of charge, he helped get them into multiple child-care facilities in Australia.  He also gave our product an unsolicited endorsement

The point is the firmness test was not available in the US.  We had to ship our product to Australia to have it tested. 

Asphyxiation – airway blockage & rebreathing

Our next big safety concern with conventionally designed crib mattresses was the risk of asphyxiation.  Asphyxiation is two-fold in reference to crib mattresses and other sleep products. 

First, there is asphyxia, commonly know as suffocation, when airways are blocked.  A soft fiber-filled mattress or a quilt would be perfect examples of how an infant’s airways could become blocked if face into them.

Second, asphyxiation can occur if an individual continues to rebreathe their exhaled air (carbon dioxide). SIDS experts believe carbon dioxide rebreathing is a common risk factor associated with infant sleep related deaths. It’s believed some infants do not respond by turning their heads when rebreathing their exhaled air.  If an infant rebreathes their carbon dioxide without responding, the carbon dioxide eventually suppresses their need to breathe, making it lethal.  To reduce the risk of carbon dioxide rebreathing, the American Academy of Pediatrics recommends a firm crib mattress, placing baby on their back, no bumper pads, no quilts or blankets, no mattress pads, no sleeping on couches, or sleeping with others, and not allowing a baby to sleep on you.  Some of these recommendations have multiple risks.  For example, co-sleeping is a risk for carbon dioxide rebreathing and overlay/suffocation.    

New products being targeted

We are currently seeing another product being sold in the infant sleep product category that seems to be causing concern with many medical professionals, the Dock-a-Tot.  One pediatrician mommy blog site that warns parents against the product is PediMom.com.  In a recent Facebook (FB) post by PediMom she states,

“I have coded and lost infants due to this contraption. We advocate for no bumpers, right? This is like several big fluffy bumpers placed even closer to your child’s face which increases their risk of suffocation and death.” 

She goes on to say,

“Don’t come at me with, “I only let my baby lounge in it, not sleep in it”. Infants fall asleep in the blink of an eye and NO PARENT can have their eyeballs on their child 100% of the time. It’s impossible and if you’re honest you’ll admit that.”

Another FB pediatrician I follow is Dr. Diane Arnaout.  I love her no-nonsense approach.  Here is her FB message to her followers regarding the Dock-a-Tot,

“I know. I know. You guys love them. You put your baby in bed with you. You feel like they have their own sleep space. The baby feels nestled and cozy. Yay sleep. All is well.  Until your baby turns his sweet little head to the side. Maybe even his body nestles to the side. Maybe his face presses into the “breathable” material. Maybe he breathes comfortably here for awhile.  The air in that little space by his face is breathed in, and out. Oxygen goes in, carbon dioxide goes out. Slowly, there is more exhaled carbon dioxide in that little space than there is oxygen.  What most parents (and even medical professionals) don’t realize is that CARBON DIOXIDE REBREATHING is something researchers believe contributes heavily to sudden infant death. “

She continues on to say,

“The U.S. Food and Drug Administration (FDA)  has begged parents not to use them and manufacturers to stop making them since 2010: https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm227575.htm

From a manufacturer

As a manufacturer, I understand that you can create and produce just about anything for infant sleep and it requires virtually no oversight or testing.   I also understand many manufacturers are more interested in the bottom line than they are in safety.  Until stricter regulations, structured testing, and accessible testing methods are available, we will continue to lose innocent lives to eventually prove an infant sleep product is unsafe and should never have been sold to consumers.

Safe Sleep Technologies is our manufacturing company, and our mission is not only to deliver safer, healthier, more sanitary crib mattresses to families, it is also to lobby for change in safety regulation and testing.  We hope to one day see both carbon dioxide dissipation testing and firmness testing mandated for all infant sleep products.  If you would like to learn more about our Company and story, please visit https://safesleeptech.com

You may also be interested in our successful efforts in influencing changes to the 2016 AAP Safe Sleep Policy and technical report.  https://www.globenewswire.com/news-release/2016/11/14/889732/0/en/Two-Michigan-Women-Influence-Changes-to-the-2016-Safe-Sleep-Policy.html

Firm Crib Mattress – The Truth Please

Breathable Crib Mattress to prevent SIDS

A firm crib mattress – CAN WE PLEASSSEEE SET THE RECORD STRAIGHT?

How many of you are led to believe that your baby needs a firm crib mattress to “properly” support their bone and skeletal growth?  This may surprise you, but it’s not true!

Infants have soft bones

It’s true that infants have soft, malleable bones.  In fact, their skull is like puzzle pieces that flex so they can get out of the birth canal.  Over time, their skull  fuses together and hardens.  Also, a lot of what will eventually be harder bones and cartilage, start out rather soft in infants.  Take an infant’s nose for example, their nose continues to develop after birth.  Infants are obligate nose breathers, meaning they only breathe through their nose, for the first six months.  Their nose bones and cartilage are softer than an adult which allows it to flatten and still receive oxygen.  Their nose bones and cartilage will become denser as they become adults.

Infant Growth Phases

Let’s take a logical approach to setting the record straight about firm crib mattresses.  A human’s fastest growth phase is from conception to birth – 9 months on average.   If this growth phase were sustained, we would grow two feet a year.  Looking at this rapid growth phase, are these babies on a hard or firm surface?  No, they are in liquid which cradles their developing structures including their bones.  It’s the ideal environment nature intended.

A human’s next fastest growth phase is from birth to 12 months, so why during this second fastest growth phase do you want to have them on a firm surface?  I can assure you, it’s not for proper support of their bones and skeletons! 

Examples

Case in point… plagiocephaly, also known as flat head syndrome.  This condition in infants started appearing in the mid 1990’s with the onset of the back-to-sleep campaign.  This condition is attributed to infants sleeping on their back with positional pressure from firm objects on their soft, malleable skulls.  I believe plagiocephaly is convincing enough to realize that a hard, firm crib mattress or sleep surface is not the ideal condition for a baby’s bone and skull development.   

Next, let’s look at infant hip dysplasia.  Did you know hip dysplasia is more common in first born infants?  Why?  Because a mother’s womb is the tightest during her first pregnancy and loosens with each subsequent pregnancy. 

Physicians believe a baby’s womb position can increase pressure on the hips.  The positioning of the baby in the womb can cause more pressure on hip joints, stretching ligaments.  It’s thought that babies in a normal position in the womb have more stress on the left hip than on the right hip.  This explains why the left hip on infants tends to be more affected.

Hip dysplasia in infants is another convincing factor supporting that firm crib mattresses, which cause positional pressure, are not the ideal surfaces for infant’s bone and skeletal health.

Why does the AAP recommend a firm crib mattress?

So why does the American Academy of Pediatrics (AAP) recommend a firm crib mattress?  There is only one reason the AAP recommends a firm crib mattress and that is to keep a sleeping baby safe.  The AAP’s Safe Sleep Task Force Members are aware that a baby’s ideal sleeping condition for their bone and skeletal growth is for them to be gently cradled and also to sleep on their tummy.  However, through much research, the AAP has discovered that the “safest” way for an infant to sleep is on their back, on a firm crib mattress or surface. 

The argument is infants are dying on soft surfaces and while tummy sleeping.  Babies are not dying from Plagiocephaly, hip dysplasia and other bone and skeletal issues.  A firm crib mattress or sleep surface does nothing positive to support your bones and skeletons as they develop and grow as some crib mattress manufacturers would like you to believe.

Problem with soft surfaces

Soft crib mattresses and surfaces are known to trap carbon dioxide, exhaled air, and block infant’s airways.  SIDS experts believe carbon dioxide rebreathing is the common risk factor associated with infant sleep related deaths. SIDS Experts believe some infants do not respond by turning their heads when rebreathing their exhaled air (carbon dioxide).  If an infant rebreathes their carbon dioxide without responding, the carbon dioxide eventually suppresses their need to breathe, making it lethal.

Ideal sleep surface for baby

The ideal sleeping surface for your baby is a crib mattress that does not have any fill to cause positional pressure while still being firm to prevent carbon dioxide accumulation or suffocation when your baby rolls over. 

Your baby will sleep for up to a total of 20 hours per day so making sure your baby has a safe place to sleep is crucial.  The creators of the only completely breathe-through crib mattress found out the hard way what can happen if an infant rolls in the middle of the night even if on a firm crib mattress.  The pair (a product designer and a pediatrician) set out to create a crib mattress that addresses all the issues with fiber fill crib mattress in 2010.  In 2016, their design was recognized by leading physicians as the “Gold Standard for safe infant sleep.”

Author:  Julie Andreae, SIDS and Safe Sleep Content Expert

 

A Crying Baby Can be Stressful

Safest and most comfortable crib mattress
A crying baby can sometimes be a very stressful situation especially during a Pandemic.
 
As we have come to know over the past few months, Covid is a changing and difficult time to be a parent with all it’s uncertainties. These uncertainties paired with new lock down orders in many states, can push parent’s stress to new levels. A crying baby can make a stressful situation even more stressful. Crying is normal for babies and a natural way for them to “talk”. 
 

Here are some important facts and tips to help:

A crying baby is normal.  Babies cry the most between 2 weeks and 4 months of age, sometimes more often at night.
 

Here are some of the reasons your baby may be crying. He/She may be signalling to you that  they are hungry, they are too hot or too cold, their is too much noise, their diaper is dirty, they are tiered, they have gas, or they are getting sick. More >

 
Some babies cry more than others, even when there is nothing wrong.
 

So, what can you do?

There are many ways to soothe your crying baby:
· Change their diaper
· Let your baby eat or suck on your finger or on a pacifier
· Undress your baby to make sure there is nothing pinching your baby or wrapped around, finger, toe or penis. Stands of hair or strings can make their way into your baby’s clothing and get wrapped around extremities.
· Swaddle your baby
· Gently rock your baby in your arms
· Go out for a walk in the stroller
· Go for a car ride
· Give your baby a warm bath
· Or run some water, the sound of running water is soothing and calming to even adults
 

It’s ok if you are getting upset

It’s ok if you are getting upset, it just means you need a break.
 
If you are upset or are now crying, follow these steps:
 
· Call a friend, neighbor, or family member and ask them to give you a needed break
· Put your crying baby in a safe place like a crib or play yard and take a moment away for yourself
· Seek care or call your baby’s doctor if they continue to cry
 

Never shake your baby!

Babies have a very fragile brain and shaking your baby can cause blindness, brain damage, and death. More >
 
At Safe Sleep Technologies, we offer real solutions to real problems. Visit out website at https://safesleeptech.com