Frantic? Baby Sleeping Face Down? What To Do.

Baby Sleeping Face Down

Are you finding your baby sleeping face down? 

Finding your baby sleeping face down is a terrifying feeling.  The founders of SafeSleep® know too well.  They lost loved ones to SIDS who were found face down on a fiberfill mattress.  At the time,  one is 4 months and the other is 7 1/2 months.  Two seemingly healthy infants found sleeping face down and unresponsive on their mattress. 

The AAP has No Clear Guidelines to Address the Situation “When a Baby Begins Rolling Over”

Current recommendations and guidelines from the American Academy of Pediatrics (AAP), and other sources for infant safety, do not address the situation of the infant who rolling over in the middle of the night with no supervision.  Too often, these babies end up in a straight-down position.  Unfortunately, when the baby is sleeping face down, he or she is at a significantly increased risk of SIDS, positional asphyxiation, and suffocation.¹

Baby Who is Sleeping Face Down.

Since one of the founders of SafeSleep® is a leading pediatrician, using scientific data was a must in creating a solution for infants who are rolling over and sleeping face down. 

Finally!  We can now successfully answer the question that the Back to Sleep campaign does not!  What do I do if my baby starts rolling in the middle of the night and is sleeping face down?  (FIND OUT MORE ABOUT THE SAFESLEEP® BREATHE-THRU CRIB MATTRESS)

 

Baby Sleeping Face Down

So Why Would You Trust Us?

I never intended to become a crib mattress designer or manufacturer.  In fact, I was running my own successful design firm when an acquaintance introduced me to a very crude prototype of a breathe-through crib mattress and asked if I would be interested in developing it.  As you can imagine, it was no easy decision.  However, one thing I was certain of, a crib mattress of this type will save a lot of young lives.  It was something I couldn’t ignore.  

I introduced the concept to my sister, a leading pediatrician who has served on several national committees and authored many peer-reviewed publications to advance the health of children.  We knew the concept was brilliant.  We knew this project was too important to infant safe sleep to overlook.

Consequently, we decided to begin the daunting task of researching crib mattresses and the many issues relating to their safety, health, sanitary issues, and comfort.  This research includes a plethora of peer-reviewed published studies on crib mattresses, play yards, SIDS, infant sleep related deaths, plagiocephaly, off-gassing, toxins, Staphylococcus aureus (Staph) and other bacteria, to determine what the best crib mattress should look and feel like. (Our Story)

Some of the more notable studies include:

In creating the safest and best crib mattress, we used scientific testing, American Academy of Pediatrics (AAP) safe sleep guidelines from the 2016 technical report. Consumer Products Safety Commissions (CPSC) findings, the National Institute of Health (NIH) safe sleep guidelines, and interviews with SIDS experts, AAP experts, child safety experts, pediatric lung specialists,  and parents who lost an infant while sleeping.

Our Research

Not only are we familiar with the American Academy of Pediatrics’ (AAP) data on safe sleep; we challenged the Task Force in 2015 that resulted in updated information on crib mattress designs that are completely breathe-through.  These crib mattresses allow a baby who is sleeping face down to breathe normally through their mattress.  Also, they do not not have any fill or core that retains carbon dioxide. 

I have spent time with three of the Safe Sleep Task Force Members including the Chair, Dr. Rachelle Moon.   Dr. Moon and I were both expert witnesses in the same trial which involved the death of a 7 ½ month old baby.  I had the unique opportunity to discuss with Dr. Moon the many challenges the Task Force Faces in creating safe sleep guidelines. 

Further, we consulted with members of the AAP’s Committee of Fetus and Newborns (COFN). The COFN is tasked with overseeing the AAP’s Safe Sleep Task Force’s members, policies, and recommendations. 

The Committee on Fetus and Newborn studies issues and current advances in fetal and neonatal care; makes recommendations regarding neonatal practice; collaborates with the American College of Obstetricians and Gynecologists (ACOG) to consider perinatal issues on which the practices of obstetrics and pediatrics merge and works cooperatively with ACOG on new editions of Guidelines for Perinatal Care.  COFN also oversees the policies and recommendations set forth by the Safe Sleep Task Force. 

We also met with both Dr. James Kemp, Pediatric Pulmonologist at St. Louis Children’s Hospital.  Also present in our meeting was Dr. Brad Thatch, a neonatologist at St. Louis Children’s Hospital (now retired).  Both Kemp and Thatch are recognized as top SIDS researchers.  Kemp is consistently recognized in “The Best Doctors in America” list.  Thatch received the Anaheim Award for Sleep and Breathing Research in Infancy in 2000.  He was also a long-term board member of First Candle SIDS Alliance. 

Both Doctors are credited with extensive SIDS research including identifying rebreathing as the probable cause of many infant sleep related deaths.  Rebreathing is the leading theory behind SIDS deaths and is used for the majority of the Safe Sleep Task Forces’ safe sleep guidelines and recommendations.

I met Dr. Ron Somers on an infant list service.  Dr. Somers created the Australia and New Zealand standard for crib mattress firmness, known as AS/NZS 8811.1:2013.  The SafeSleep® Crib Mattress is the only mattress in the United States that has passed the Australia and New Zealand crib mattress firmness test and received an unsolicited endorsement from Dr. Ron Somers. 

Australia and New Zealand’s standard, also known as “method 1: Crib Mattress – Test for firmness,” is the only standard to formally address the issue of minimum safe firmness for all infant sleep products.  Dr. Somers is the former director of Epidemiology in Australia. 

I spoke and met with Dr. Thomas H. Shaffer, Department of Biomedical Research, Alfred I. duPont Hospital for Children.  He is the Director of the Center for Pediatric Lung Research.  Dr. Schaffer also created and collaborates on the scientific testing used to determine carbon dioxide dissipation levels in crib mattresses.  His testing and methods are used by accredited international testing laboratories. 

In fact, Dr. Ron Somers warns parents in an article published in 2020, for Infant & Nursery Products Alliance of Australia (INPAA).  INPAA is the peak industry body in Australia for infant products.  INPAA works alongside major industry partners with one key goal in mind: to reduce preventable injuries of children.  Somers states, “If you really want to protect your baby from suffocation, you need to be aware of false mattress-safety claims.” 

He goes on to explain, “Rebreathing of carbon dioxide causes suffocation. With many of the so-called air-permeable mattresses, the carbon dioxide (being heavier than air) sinks into the mattress, and it is then sucked up by the baby for rebreathing. In other words, the carbon dioxide does not dissipate. This has been determined by a special test using a mechanical baby that breaths in and out like a real baby. If a manufacturer will not show you their results on this kind of test, don’t fall for their safety hype.” (Here are the results for SafeSleep®) Somers is referring to the testing and methods created in part by Dr. Shaffer.

We also spoke with a few different representatives at the Consumer Product Safety Commission (CPSC).  We also used their data base to find reviews and recalls pertaining to infant sleep products.  Multiple SIDS organizations as well as parents who had lost an infant while sleeping were contacted to help us get a better understanding of additional possible risk factors pertaining to infant sleep. 

We already knew the effects chemicals in mattresses have on young children.  Consequently, avoiding the use of potentially dangerous chemicals was a must.

We are parents too

Even though we are both professionals, we are also parents.  We know the challenges of changing crib sheets, trying to clean up messes in a crib and fussy sleepers.  As parents, we also realize the importance of good sleep for both infants and parents.   So, comfort was a high priority.

As parents we also realize the importance of offering quality at a reasonable price.  Having an aesthetic appeal was also considered with the design and color choices. 

Research on Infants Rolling Over and Sleeping Face Down

Researchers from New Zealand show that more than a quarter of infants who died of SIDS in their study are last placed in a back position and rolled to a stomach position.²  These researchers are suggesting an infant’s ability to escape potentially fatal situations during prone sleep may be impaired by inexperience in prone (stomach) sleep.  Later, their findings are supported by Dr. Moon and colleagues in their review of infant sleep related deaths in child care settings.³ 

Unfortunately, infant inexperience in stomach sleeping is now a common unintended consequence of the successful back-to-sleeping campaign.  Notably, we have no way of keeping young infants from rolling,  Far too often, we are finding them sleeping face down.

SIDS Risk and Baby Rolling Over and Sleeping Face Down

The fact is, infants under six months of age represent about 90 percent of all SIDS-related deaths.  The belief is SIDS risks is peaking between 1-4 months of age.  Notably, this is the age infants are beginning to roll over.

In a study on infant sleep, 6% and 12% of 16 to 23-week-old infants placed on their backs or sides are found in a vulnerable (face-down) position.  Additionally, 14% of infants aged 24 weeks or older are in the prone (stomach) position.  Lastly, 18% of those placed on either their right or left or sides, are found in the prone position.4

Nothing to Do with Good Head and Neck Control

Parents are often falsely assured when their infant rolls on their  own or has good head control, they are no longer at risk of SIDS or suffocation.   And if their baby is sleeping face down, they will know to turn their head.

In contrast, scientific test results tell us differently.  According to SIDS researcher Dr. Bradley T. Thach, “The first times babies who usually sleep on their backs or sides roll or are put on their tummy have a 19-fold increase in the risk of sudden death,” Thach says. “We wonder if these babies, who find themselves face down, do not turn their heads to breathe easier.  If so, that is because their reflexes haven’t developed far enough or because they simply don’t wake up?  Many parents believe if a baby can lift its head, he or she is okay to sleep on their tummy, but that is a false assurance,” Thach says.5

Repositioning Baby Who is Sleeping Face Down

Some physicians encourage parents to move an infant who is sleeping face down back to the supine (back) position.  However, turning a baby back over is unrealistic with several position changes per night.  Furthermore, a baby sleeping on his tummy and repositioning him to the back position is disruptive.  Some medical professionals believe repositioning an infant who is sleeping on their tummy can completely discourage parents from using the back position. 

According to a study published in the Journal of the American Medical Association, there is insufficient data on specific recommendations on when infants can sleep in a stomach position.4   Consequently, it is hard for parents to determine the appropriate age when it is safe for their baby to be sleeping on their stomach. 

Carbon Dioxide and Baby Sleeping Face Down

Currently, the AAP recommends a firm crib mattress with a tight-fitting sheet.  However, the firm mattress with tight-fitting sheet shows posing a high risk of rebreathing of carbon dioxide.  In fact, according to a 2000 study published in Pediatrics, the findings reveal  firm mattresses pose a high risk of rebreathing  while infants sleep prone.6   

Further, these findings may be of relevance to recent studies showing that unaccustomed prone sleepers, i.e., infants who typically sleep supine (back) but are inadvertently placed or roll prone (stomach), have an increased risk of SIDS.   For example, these studies show from 43% to 71% of SIDS victims, unaccustomed to prone sleep, were discovered in the face-straight-down position.” 5

Carbon Dioxide Rebreathing and SIDS

Rebreathing carbon dioxide, also known as rebreathing, is caused by a baby sleeping face down or near face down on his stomach and air is trapped around the baby’s nose or mouth.  Consequently, this trapped exhaled air causes the baby to breathe more carbon dioxide than oxygen.  Specifically, if the baby does not wake up or respond appropriately, it leads to death.7

Example of what is happening when a baby is sleeping face down on a fiberfill crib mattress

David Greenblatt, Faculty of Mechanical Engineering, Flow Control Laboratory, demonstrates Infant Suffocation Caused by Rebreathing Carbon Dioxide.

Unfortunately, conventional crib mattresses with fiber fill, vinyl covers, and quilted toppers can cause carbon dioxide to accumulate.  According to Dr. James Kemp and Dr. Brad Thach, these bedding materials act to retard the dispersal of exhaled gasses (carbon dioxide), retaining the gasses near a face down infant’s nose and mouth

Consequently, with each subsequent breath, the infant takes in an air mixture which is progressively less adequate to sustain life. Further, the more conducive an item is to rebreathing (retaining carbon dioxide), the more hazardous the item is.8

Peer-Reviewed Studies

Based on multiple peer-reviewed studies, SIDS experts agree, infants sleeping on the following surfaces show increased suffocation and the risk of rebreathing of carbon dioxide.

  • fiberfill crib mattresses
  • quilted surfaces
  • soft surfaces
  • pillow-like surfaces
  • vinyl pads
  • mattresses filled with tea tree bark and other natural and artificial loose fibers

The Solution to Baby Sleeping Face Down

Finally!  There is now a scientifically proven solution to bridge the safety gap not addressed by the back-to-sleep campaign – what to do when a baby starts rolling over.  A solution that keeps a baby sleeping face down safe

There is a now a crib mattress that addresses the concerns associated with conventional crib mattress should an infant roll.  A crib mattress that allows an infant who is sleeping face down to to breathe normally all night long.  It’s called SafeSleep®.  SafeSleep® is scientifically proven safer than breathable crib mattresses and even some breathe-through crib mattresses.  It no only eliminates suffocation risk, it eliminates the risk of rebreathing carbon dioxide.

By design, the SafeSleep® eliminates safety risks associated with crib mattresses should your baby end up sleeping face down.

Eliminating Suffocation and Rebreathing Risks

Peer-reviewed published research tells us infants rebreathing carbon dioxide (CO2) is a known danger of stomach sleeping.  Another danger is suffocation.  Rebreathing CO2 is actually a form of suffocation.  Rebreathing CO2 leads to hypoxia which is a lack of oxygen to human organs.    

Crib mattresses with fiber fill are known to trap carbon dioxide.  They can also cause suffocation.  Therefore, the design of the SafeSleep® eliminates both suffocation risk and the risk of rebreathing CO2. 

No Fiberfill or Core

To protect babies from suffocation risk, it’s important they can breathe normally when face down.  In order to accomplish this, a crib mattress must be completely breathe-through.  In order to make a crib mattress completely breathe-through, there can be no fiberfill or core material.  Fiberfill and core materials prohibit airflow and they are known to retain CO2.  Consequently, the SafeSleep® has no core or fill material of any kind.  Instead, the base of the mattress is a hollow box with side openings, allowing constant airflow.

Air-Permeable Breathe-Through Surface

Next, the surface has to be air-permeable.  It’s important the surface a baby is sleeping face down on be completely breathe-through.  Remarkably, the SafeSleep® tests for 100% oxygen-rich air while a baby is breathing through the surface.  To be completely breathe-through requires a surface that is made from an open-weave material.  A material that allows air to pass through it at a significantly high rate of airflow.  The SafeSleep has an air-permeability rate of over 330 times other crib mattresses tested.  That’s a lot of air-flow!

A Real Solution for a Real Problem

Developed by People with Real KnowledgeOur Story!

The SafeSleep® breathable crib mattress  is designed to keep an infant who is sleeping on their stomach, or is sleeping face down, safe. 

  • There is no fiberfill or core to trap carbon dioxide.
  • SafeSleep® breathable crib mattress has a hollow center and side openings.
  • The surface is made from an open-cell fabric that allows air to flow up and down.  
  • The surface is 100% machine washable.  
  • No crib sheets are used.
  • No fire retardants or waterproofing chemicals are used.

This revolutionary design creates an oxygen-rich environment, even when an infant is face down all night.   

Best Crib Mattress

Scientific Data on Air-Permeable Crib Mattresses

Scientific evidence shows some air permeable mattresses have a “significantly” reduced risk of rebreathing of carbon dioxide.9,10  For instance, the SafeSleep® Breathable Crib Mattress has been tested for carbon dioxide retention and has a tenfold decrease in carbon dioxide retention compared to a fiberfill mattress with a tight-fitting sheet.  For example, it takes 120 seconds for carbon dioxide to dissipate from a firm crib mattress with a tight sheet.  However, it takes less than .5 (1/2 a second) for it to dissipate from the SafeSleep® Crib Mattress.10

An infant takes a breath 40-60 times per minute or every 1-2 seconds, meaning carbon dioxide (poisonous gases) on the SafeSleep® Breathable crib mattress disappears before the infant takes his next breath of air – even if their face is straight down.

Conclusion

We cannot keep vigilant watch over our babies.  Sleep is important for parents too.  Finding your baby sleeping face down is a very scary feeling.  The problem is, we can’t keep them from rolling even if we place them back to their back.  Infants assume multiple position changes nightly.  We know the horrible outcome of a baby simply rolling in the middle of the night or at nap time.  We don’t expect parents to just take our word for it, but the science dictates the SafeSleep® Breathe-Through Crib Mattress is the safest choice for a baby sleeping face down.  It’s also more convenient to wash and completely sanitize than any other crib mattress on the market.  

SafeSleep® offers a 60 day free return guarantee.  So you have nothing to lose.

Is your baby sleeping face down?  Give your baby the safety they need.  SafeSleep® is more than a breathable crib mattress, it is completely breathe-through. 

Study References:

  1. Carleton, James N.,  Donoghue, Ann M.,  Porter, Warren K. Mechanical model testing of rebreathing potentialin infant bedding materials.  Arch Dis Child 1998;78:323–328
  2. Mitchell EA, Thach B, Thompson J, Williams S. Changing infants’ sleep position increases risk of sudden infant death syndrome. Arch Pediatr Adolesc Med. 1999;153:1136–1141
  3. Rachel Y. Moon, Kantilal M. Patel and Sarah J. McDermott Shaefer. Sudden Infant Death Syndrome in Child Care Settings. Pediatrics 2000;106;295
  4. Willinger M, Hoffman HJ, Wu KT, et al. Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study. JAMA. 1998
  5. Paluszynska DA, Harris KA, Thach BT. Influence of sleep position experience on ability of prone sleeping infants to escape from asphyxiating microenvironments by changing head position. Pediatrics, Dec. 1, 2004.
  6. Patrick L. Carolan, William B. Wheeler, James D. Ross and RCP*; and James S.Kemp, Potential to Prevent Carbon Dioxide Rebreathing of Commercial Products Marketed to Reduce Sudden Infant Death Syndrome Risk, Pediatrics 2000 105;774
  7. Patel, Aloka L., Harris, Kathy, Thack, Bradley T. Inspired CO2 and O2 in sleeping infants rebreathingfrom bedding: relevance for sudden infant death Journals.Physiology.org/doi/pdf/10.1152/jappl.2001.91.6.2537
  8. Kemp, James S., Nelson, Verna E., Thach, Bradley T.,  Physical Properties of Bedding That May Increase Risk of Sudden Infant Death Syndrome in Prone-Sleeping Infants.  Journal of Pediatrics,July,1994,Vol.36,no.S1
  9. Bar-Yishay E, Gaides M, Goren A, Szeinberg A. Aeration properties of a new sleeping surface for infants. Pediatr Pulmonol. 2011;46(2):193–198 342. Colditz PB, Joy
  10. William W. Fox, MD and Thomas H. Shaffer, Carbon Dioxide Rebreathing Assessment of SafeSleep® Crib Mattress Sample.  Intertek., wouso7330

More information on crib mattresses and baby sleeping face down, can be found here.