Before my two daughters were born several years ago, my husband and I had to decide where our babies would sleep for the first months of their lives. Cribs, cradles, bassinets, playpens—there was an endless amount of options to choose from and we spent a good deal of time researching the safety of each one.
New parents today have similar concerns, especially with several newer products on the market. Walking through the aisles of a large baby store or shopping the sites on the Internet can yield seemingly countless choices.
One of these newer items is an infant sleep hammock. Typically made from mesh, these hammocks are often designed to be attached to a crib and the baby is suspended in the hammock over the crib mattress. The inventors and designers of sleep hammocks claim traditional crib designs can lead to risks due to suffocation and arms and legs getting trapped in between the crib railings. However, sleep hammocks have several risks of their own.
Infant sleep hammocks have not been tested in strong, peer-reviewed studies, nor are they approved by the Consumer Product Safety Commission for infant sleep. There is no evidence that they are as safe as a traditional firm crib mattress.
The American Academy of Pediatrics (AAP) recommends that babies sleep on a flat, firm mattress for every sleep, both at naptime and at nighttime. Much like adult-sized hammocks used for relaxation, an infant sleep hammock is not flat or firm and could lead to unsafe sleep positions in a newborn. In fact, infants sleeping in the hammocks have been photographed in the “chin to chest” position, which has been reported to interfere with breathing and lead to suffocation.
Also, as the hammock is suspended over a crib, a baby could roll out of it without warning, falling to the crib mattress below or even out of the crib altogether, leading to serious injuries.
As mentioned above, the AAP has created guidelines on how babies should sleep safely. Summarized below as the “ABC’s of Safe Sleep,” these recommendations can guide parents and families on which of the sleep options available today would be safest for an infant to sleep in:
A stands for Alone. This means that a baby should sleep alone, in a separate space, for every sleep (naps and night-time). This space could be a crib, a portable crib or a bassinet. Studies have shown that sharing a room with a baby can decrease the risk of SIDS (Sudden Infant Death Syndrome) by half. However, a recent study published by the AAP showed that babies have an increased chance of dying if they share beds with their parents.
B stands for Back. Since 1992, the AAP has recommended that all babies be put to sleep on their backs, not their stomachs or sides. This position has been shown to decrease the risk of SIDS and other sleep-related deaths, because babies are less likely to suffocate on other objects or their own gases when they are on their backs.
C stands for Crib. Babies should sleep in their own cribs (or a safety-approved portable crib or bassinet). To prevent the risks of suffocation and death, the crib should have a firm mattress with a fitted sheet. There should be nothing else in the crib besides a baby, such as blankets, stuffed animals, toys, bumper pads, or pillows, because there is a chance that a baby could roll over and suffocate on these things. When it is cold outside, swaddling a baby during sleep is a safer option than loose blankets in a crib.
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Jamie Macklin, MD is an adult medicine and pediatric hospitalist, currently practicing at the The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital. Her clinical interests currently include quality improvement regarding safe sleep and breastfeeding education.
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