I am a somewhat new member to this forum. I have been working with young children for a little over ten years (five of them as a family child care provider) and have three of my own children. I have a Bachelor's degree in early childhood education and have completed 100's of hours of state mandated training over the years, included courses specifically about SIDS and infant safety. Never once in all of my years did I ever hear the phrase "positional asphyxia." I have always known to put infants on their backs to sleep and to keep blankets, pillows, etc. out of the cribs. BUT if a parent brought a sleeping baby in the car seat in the morning, I never knew that letting the child finish his/her nap in the car seat was dangerous. Also, every baby I have ever taken care of has fallen asleep in the swing at some point. My regulations say, "Sleeping arrangements for infants require that the infant be placed on his or her back to sleep, unless medical information is presented to the provider by the parent that shows that arrangement is inappropriate for that child." When I placed infants down for their naps it was always face-up in a crib with no blankets, but all along they were in danger because I allowed them to sleep in their carriers and in the swing. It just goes to show that even if you have all kinds of specialized training and experience, you don't know everything. I thank heavens that none of the precious babies I have been entrusted to care for have been hurt by my ignorance. I now know and will be able to share this information with parents as well.

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Nice post

When you know better you do better.

Now you know.

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Thank you for this post.

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Thank you.

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I also never knew this until I learned it here.

It was also not mentioned in my recent SIDS training, taken from 2 different sources (once on my own, then again for my EC program classes).

I remember rolling my eyes when I heard that we have to get a sleeping baby out of the car seat, and wake them, then lay them in a crib. Yeah right, I thought!

I have never even owned a swing, I am not a fan of contraptions. I have a friend who's daughter spent most of her first year in one going back and forth back and forth, all freakin day. It drove me bananas every time I saw it.

Now that I am aware of this danger, should I ever have a young infant in my care, I will definately NOT allow him to sleep in a carseat.

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I'd like to know if this is just a recent thing. I was looking over an old infant carrier from my 11yr old and I really don't see how a baby could have an issue in it. Do they make the seats more upright now? When I put a baby in it without the base, the baby is pretty much in a recliner stretched out type of position. I'm just curious. Both of my kids slept in it occasionally and I've had countless daycare babies use it here and there if there's a sleep issue and they all look comfortable, with no head drooping or anything like that. What is it about the seats that causes the problem? Thanks in advance for sharing whatever you may know. Please don't get all riled up over this. I just want to know facts, please.

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When an infant is in a "reclined" position it places their chin to their chest. Due to the proportional difference of their head size to the body, this crimps their trachea leading to slow asphyxiation. Think of parking a car on a running garden hose.

This is not a new thing, it is just something they no longer label as SIDS because we KNOW it can be prevented. It sometimes falls under the category of SUID, but I hope that stops as it really has nothing to do with it.

It is explained and preventable, YKWIM? The number one airway obstruction, and cause of death in infants, is their own tongue (I am a Pediatric Advanced Life Support Instructor and that is a test question .)

check out www.firstcandle.org/

www.heart.org for infant cpr

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I'm thankful for the information as well. While I've never left a sleeping baby alone in a swing or carseat I have let my own sleep in both when they were infants. Never again. Thank goodness I have never left a DCK in either although truthfully up until this point it was only because the situation never came up. I've always been a firm believer that children must self sooth to sleep so my own philosophy prevent me using devices to get them to sleep.

Here are two questions though....

I have worn infants and babies while sleeping in a sling. Is this ok even if they're squished at times? They are next to my chest so I hope that I would notice a change in breathing?

I've let infants and babies sleep in a stroller in they've fallen asleep on a walk. I bring the stroller inside and let them be. They were always very reclined but not flat. My strollers don't go totally flat. Is that ok?

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The key is SUPERVISED sleep. I think you have that covered. You are pretty awesome...

There is always going to be some risk involved in caring for infants. It really is up to the individual how much risk their bathroom mirror is willing to take. YKWIM? Mine is pretty demanding so I take NONE.

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I have never allowed babies to sleep anywhere other than a crib. Even with my oldest dd (12yo), it was considered bad practice to allow babies to sleep in carseat carriers and/or swings. Also baby slings were a no-no for teeny infants. Back to sleep, she never even had a blanket. I remember this very clearly in my infant cpr/ infant first aid / SIDS training way back then. However, it was not a parent or caregiver class, it was a class full of medical professional, I was the only lay person there.

Now, to be truthful, I do NOT recall it being an issue in any of the rest of my trainings since, not through daycare or foster care. But I also haven't taken infant specific courses since then, just the standard ones required for licensing.

Same reason why I have never had winter coats on my babies in the carseats...it is not okay to have that much fluffiness between the straps & baby. Yet, every year I remind my daycare parents about this, it is always a big surprise that is an issue. It just doesn't seem to be any general education about this stuff, but it is like you have to search it out.

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That's how I feel too. I feel guilty enough as it is that I let my now 12 year old sleep in her swing all the time. I was in the room but if I knew then what I know now.....

Since I'm in Canada it's rare I have an infant in care. They're usually at least 6 months coming to me, often 11 or 12 months old. If I have a child younger than that here it's normally a one time thing. My baby right now is 17 months. My new baby starts Jan 1 and she will be 10 months old.

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Can't say on the strollers but my assumption would be that if they are not completely flat, then they are better off in a crib.

As for baby slings, yes supervision is key. I can't remember what type but there was once a case here in CA where a mom was wearing her infant while she was shopping. When she finished her shopping and head out to the car she took her infant out and the baby has passed away. Again, the key here is SUPERVISION. The mom assumed that her baby would be fine and didn't check on her infant until it was time to put the baby in the carseat.

I don't personally wear babies but if I did I would constantly check on them like every 5 minutes or so just because I think I'd be paranoid that I could suffocate the baby or the babu would stop breathing for some reason .

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I use a pouch sling and my hand is on their back as often as not. I can feel them breathing.

ETA: I don't sling them until they can hold their heads up. It's not safe to use a pouch sling with a floppy necked baby.

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Yes, this is new to me too. I have allowed my own children to sleep in their carseats and swings without giving it much thought. Thanks for educating us on this topic.

I was wondering how often deaths occur while riding in a carseat in the car because of positional asphixia? Or is this a non issue?

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Another good reason to rouse an infant from their car seat is to verify the infant is in good condition when they arrive. If a baby has been mistreated or shaken at home, they may already be displaying the effects of their injuries.

I get babies out of their car seats and wake them in front of their parents and before they leave. I let them know I'll be doing this during the initial interview.

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I have transported only one to the ER while on duty, but have heard of others. (neglect was also suspected in my particular patient)

Typically it was extended drives, like when on vacation, rear facing out of mothers view. Again, this is more of a slow process; their underdeveloped brains never see it coming to put up a struggle . Google "Re-breathing Asphyxia" for more information.

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My daughter was also told NOT to use the strollers that the carseat snaps into.

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Thank you for not being judgmental. I guess I still don't see how the baby's head is going to touch his chest, at least in this seat I have. Think man in his recliner with the seat "pushed" as far into recline as it goes. I know what you're talking about though, because one of my other carseats was always bad for the head bobbing forward and I've seen newer bucket style seats that cause it to happen quite a bit. That's why I was thinking perhaps there's a difference in the angle of how they're made now vs back almost 12 years ago when I bought the seat.

The only reason I question it is that I've had babies here and there who will stand in the pack n play and cry and cry so using the seat makes them sit and relax. The one I have now will sit on his legs and fall asleep sitting up, always waking himself when he bobbles a little. I tried for weeks to get him to lay down, but he doesn't because he sleeps with mom at home. The only way he sleeps is if I buckle him in this seat so he can't sit up. He don't cry more than a minute and he's out. I check on him constantly. His head is never bent over due to the amount of recline. I'm not sure what else to do with him because at 9mo he needs 2 naps a day and he doesn't get any if I try to lay him down. In the past, I've used this as a temporary thing until they forget about the bad little habit they got into and then I switch back to regular napping in the pack n play. If you have any better suggestions for how I can get him out of this habit, I'd love to hear ideas.

Thanks for the links too. I will check them out.

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BUT REMEMBER, A CRYING BABY IS AN ALIVE BABY. I rather have a crier at naptime than buckle a child into an unnatural position to induce sleep.

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Have you ever cared for a baby that cries through most of two naptimes every single day because he never sleeps alone at home?

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Also, I asked for suggestions and all you have here is criticism. I already know it's not good. I've tried for weeks to break him of it. I let him sit and cry it out and it has gotten worse so I let him have some much needed rest in a car seat. He fell asleep within minutes. He's not back until Monday so I have until then to hear some better ideas.

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I have. Eventually the infant learns to sleep on their own in my home. It takes some time but it can be done. I've done it plenty of times and it's much the same as teaching a child to to certain things at your home differently than their own home.

Most infants that I get have already learned to fall asleep in their parents arms by being rocked to sleep. Here at daycare I have to teach the infant to fall asleep after laying the infant down while awake. It takes a while (up to 2 weeks sometimes) but it can be done. In most cases the parents continue to put the baby to sleep by rocking him/her or by holding and feeding the infant a bottle but they continue to fall asleep on their own when at daycare.

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This has usually been the case here too, apart from one who would attempt to sleep standing up...a week in the car seat made him forget about that and he went back to laying down to sleep. I've never had a sit & scream baby before. He used to nap perfectly fine until he figured out how to sit up and now that's all he does. I left him be that way for a couple weeks with no improvement. Then put him in the seat for a week to break the habit. Then I went back to laying him down and he'd sit right back up. I let it go for another 3 weeks and just couldn't do the crying yesterday so I let him sleep in the seat again. It's not like I'm not trying the usual cry it out plan. I need somebody's secret trick for special babies who are apparently more stubborn than most.

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Yes, I have and I do understand how it makes you feel.

The walls "cave in" on you, you can't keep your heart from racing and the it makes it very difficult to see the light at the end of the tunnel.

I clip a sleep sheep on the crib alot and set it to ocean sounds. It seems to help alot. I also use a box fan for background white noise.

It does take time for them to adapt to sleeping alone. The parents SHOULD be helping with this since they chose to put him in daycare. It isn't fair to their child, the other children OR you. Unfortunately that seems to be an unpopular opinion these days.

Just a few short years ago it was generally viewed to be a PARENTAL RESPONSIBILITY to prepare children for daycare. Now, I don't see that in any of the parenting literature. Sadly, I think that is going to be followed with a rise in infants dying in daycare, again, like happened in the early 90's.

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Yes, I have. I have cared for multiple babies and children who fit that description. Even my own son was that way.

It is an adjustment for the child and as with most things, adjustments take time. There is no quick fix. Strapping a child into a swing or bouncy chair to calm them is something I have done. It works like a charm. But once they fall asleep, I move them to the playpen. Most of the time they wake up and get angry again. And it is ok for babies to cry. I have never heard of a baby dying from crying. I have heard of babies who have died from positional asphyxia, being shaken by their caregiver, or from being unattended when they sleep (in a crib or elsewhere).

So yes, babies cry for a lot of reasons. We as professional caregivers need to teach ourselves that crying is ok. Crying means the child is breathing. Crying means life. A child who is strapped into a carseat, swing, or boucy chair is easily forgotten (look at how many PARENTS forget their own children in the car on a hot summer day) because they are quiet and put into a small space. It is so easy to assume that a quiet baby is sleeping. It is too easy to be comfortable with that silence. We as caregivers must never be comfortable with silence. We must be diligent in checking on sleeping babies, toddlers, and children.

So yes, I mean it when I say that a crying baby is ok with me. A crying baby means while the baby may be sad or angry, that baby is alive and kicking. And that is what I want.

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Yes, crying does mean an alive baby! How long though do you let a baby cry before it isn't good? Someone yesterday said there own child cried for like 6 hours straight! That sounds like that wouldn't be good for the baby. It seems like their little heart would beat to hard, blood pressure up, and just over all not good.

What is the longest time a baby should cry-anyone know?

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Please rethink the sling for naps. I found out at this years safe sleep that a new mother took her infant to the fair, in a sling to keep them close. After an hour or so she went to change her,.... She had passed in that time. From positional asphyxia. I'm thinking it was in Muncie In.

**not sure why this quoted cat. I tried to respond to meyou

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I'm NOT saying to leave babies cry for hours. If that is the case, the parent needs to be called. As always, work with the parent to help the child adjust to crib/playpen sleeping. And you don't need to leave the child alone to cry. You can be with the child while they cry. You can rub their back, talk to them, sing, pat them, etc. Sometimes they cry because they simply aren't ready to sleep. I only let a baby yell for about 10 minutes before picking them up. I will calm them and try again for a nap a short while later.

I am saying that in a case where a child will only sleep in a carseat/swing/bouncy seat without crying vs. a playpen where a child cries, we need to choose the playpen. 99% of the time, a child will learn within days that the playpen/crib is the rest area and will learn to go to sleep without movement (rocking, swinging, vibrating, etc.).

Yes, there are extreme cases of kids who do not adjust to crib sleeping, but I believe that has a lot to do with what goes on at home. I believe that in those type of cases, most of the time the parents aren't making the necessary changes at home to make the baby's days easier in daycare.

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It isn't good to have the high heart rate, tense muscles, etc. for long periods of time. It is very stressful on the baby & caregiver at the very least. I have never heard of a max amount of time...but if there is something wrong or hurting with the baby, I would have the parents take him/her in to the doc.

However... for true colicky babies, their blood pressure remains normal, heart rate normal. Even their muscles are relaxed. All very similar to a sleepy or calm baby, only crying for hours on end. But not stressful to the baby, just us.

My pedi & I talked about this once for quite some time at an appt (so sorry to whoever might have had the appt after us!), he had some research that he was all excited about it. I didn't even have a colicky baby at the time...but I have since messed around with inconsolable babies (daycare and my last 2 of my own), and I was still surprised and how relaxed a crying colic baby can be. Compared to the reflux crying babies that were all stiff, hard to hold, and getting quite upset rather than 'just' crying. Interesting stuff.

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Thank you. I do have the bathroom fan on that's closest to the bedroom where he sleeps and I play piano music loud enough so he can hear it, but like you say, the parents should be helping with this and are not. The mother firmly believes in attachment parenting, which she never mentioned until he was 7months old...grrrrr, and couldn't bear to let him cry it out at all. She knows he cries here, but that hasn't seemed to motivate her to change her ways.

I'm not going to terminate. I have a pretty high tolerance for crying so that's really not the issue here. I'm not looking for a quick way to make a baby sleep so I can have free time. I'm more concerned that this baby doesn't get enough quality sleep in a day. Sooner or later that's going to hinder his development.

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What you're saying sounds like you have not actually cared for that many crying babies. Pat them, talk to them, rub their back, hang out with them while they cry, etc are all means to drag things out at naptime. If you pick up a crying baby after just 10 minutes, they are going to learn real quick that it's ok to just cry because she'll come get me pretty soon. They don't learn to sooth themselves and go to sleep because you're messing with them. Any baby I've ever watched, I've let them cry it out. It might take an hour the first day, 30 min the second, 15 the 3rd and by the end of the week it's over. If you do all the patting and picking up, you'll be there for weeks on end. This child is the first I've encountered that is NOT like that. I can tell you for a fact that standing over him patting him would do no good because he is sitting up. He cries harder when he can see me than when he can't. If I picked him up after 10 min and went back a short time later, we would go through the same exact thing for the entire afternoon and he would still not nap.

I do agree that it has a lot to do with what goes on at home.

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It's a rare thing and always an older baby. I said in a different post that I rarely have babies younger than 6 months and mostly over 10 months when they start. It would be a teething, fussy, sick, cranky, out of the ordinary situation that I would even consider slinging to sleep. It came to mind because I had a sick 17 month old sleep on me in a sling for 2 hours yesterday afternoon. She wouldn't settle unless she was snuggling and I had stuff to do so I put her in the sling, she tucked in her elbows and went right to sleep. Well, coughing, mouth open sleep but still better than a fussy toddler with sinus pressure.

I'm a big lover of the sling but I also realize it's not a safe option for the littlest ones.

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SOrry to be so,..... Idk snaPpy. About these things. I just,... Well it's been a rough day. Ugh. Where's that easy button?!!

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Totally ok. I knew what you meant and I didn't take it as a snap.

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Could someone please tell me what the age range is for this danger? Birth to what age? I'll be adding a newborn in a few weeks, and I'm so glad to read this. But, at what age can I take him out in a stroller or in a car seat when he might fall asleep? Is it safe at 6 months? Ten months?

Thank you so much!

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Ditto, I also learned it here

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I have a 4 mo little one who started 2 wks ago and it's taken that amount of time to get her on a routine nap schedule and to get her to nap. In the beginning she would fight her naps. So I would go in every 7 min and whisper to her...I found that her eyes would be shut and her hands would be in her mouth ...a type of soothing mechanism perhaps? She had already been feed and played with and diapered...I watched for these signs and noticed a pattern with her and about 10 each time she'd quiet her self down and fall fast a sleep...now mom and dad would bundle her and give her a blankie toy she could hold on to. What I would do is put her in a baby rapp and give her her toy and then leave weight 7 min go in and talk to her some come out and after a few min as soon as I hear her quiet go back in with the door slightly open so I can squeeze in and out as not to wake her if the door squeaks. I have the fan on for white noise but I also have the tv on and also music. Tons of diff. sounds so she gets used to noise. When I hear she's quiet I go in and remove her toy. Back in the diaper bag it goes. She never puts it near her face bc her hands are up and it clenches the toy. And she doesn't sleep with a pacifier!! I love that ...break them of that quickly so it's not a problem later on. Hope I didn't high jack this sight...but that is normally what I've done with infants and if they fall asleep in the swing I stop it pick them up and in their pnp they go. Sometimes they cry and I repeat the process as if I where to lay them down for their nap.

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Babies are at risk for SIDS up to one year old.

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I understand all that is being said about car seats and I don't use them as beds but if it is such a problem don't you think it is a design flaw in the manufacturing? People travel, babies fall alseep on car rides all the time. What are people suppose to do that are making a 4 hour drive to Grandmas for Christmas, shake the baby every 5 seconds to make sure that he doesn't go to sleep. Who does that? Seems to me that if it is really such a problem then something would should be down with the way that car seats are constructed. Just my opinion!

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PLEASE tell me that you're not using a car seat that was made 12 years ago!!!

They have expiration dates. Your seat is probably *at least* 6 years past it's expiration date.

Car seats these days are much safer than they were 12 years ago. If a seat today is causing the baby's head to flop too far forward then that is more likely a problem with the user's installation, not the design of the seat itself!

It's true that car seats are not designed for babies to sleep in--they are designed for babies to survive a car accident.

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No, but you can have a mirror back there so you can see into the car seat, and check to make sure you can see baby breathing, that baby is a normal color, that baby has changed position, maybe reach back and poke the baby to make sure they twitch. That's the purpose of the mirrors that go on the back of the seat. You just have to make sure that the mirror is secured properly (ideally, hooked into the rear anchor) so that it doesn't become a hazard in an accident.

You can also make sure to practice safe car seat usage in the first place--that the seat is properly installed, both tight enough and at the correct angle of recline, that you are not overdressing baby in the seat (NO SNOWSUITS OR HEAVY COATS!), that you aren't using those thick fleece car seat inserts (which are NOT recommended by the manufacturers, btw) which could be a breathing hazard AS WELL AS interfering with the proper function of the seat in an accident. Make sure your baby is correctly strapped into the seat--straps at the right settings, tight-but-not-too-tight (shouldn't be able to pinch any of the shoulder strap up with your thumb and forefinger), and that the chest clip is at the correct height (even with baby's armpits).

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Exactly their are other things to do in make sure bab is safe while trransporting than waking the bab up.

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SilverSabre25 addressed nicely what one shoudl do instead of wake up the baby every few secounds.

Thje design of the car seat in NOT flawed it is designed to save the life of a baby if the care is in a crash and that is what it does. While the position the car seat puts a baby in is far from ideal for sleep it is what is best, with the information we have so far, if the car is in a crash. If at some point we learn a better postion to put the baby in if the car is in a crash then we will do that.

Utill and unless we learn a "better" way for a baby to be safe in the event of a car crash, we will have to NOT use the car seat ANYWHERE other than the car.

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Thanks myangels. I knew that SIDS was up to one year, but I wasn't clear on whether positional asphyxia was a danger up to one year.

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An article like the following does not help! Articles like this are why people "never knew."

http://newbornbaby.com.au/newborn/ca...baby-cat-naps/

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Ugh

Did you catch the "From The No-Cry Nap Solution: Guaranteed Gentle Ways to Solve All Your Nap time Problems"

Best way to start your course in "no cry" parenting is to do the "no cry" sleep solution. Then you can do the "no cry" discipline and the "no cry" eating and the "no cry" get to day care and the "no cry" battery operated toy play and .... what else am I missing?

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I wish we didn't have to feel guilty or explain ourselves for letting a baby talk.

Wow. I just saw that book on Amazon. It has 4.5 stars.

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http://www.pantley.com/elizabeth/books/index.html

whahahahahahahaha



I'm SO good

Look at the NO CRY books

I'm in the WRONG bizness



I blew it on the "no cry" potty training and "no cry" separation anxiety

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Eh, I like a little science fiction every now and again myself.

I can't wait to see her kids on TMZ or The Dirty one day.

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I just spoke with a family where the baby sleeps every day and night in a bassinet swing.... all daytime and all night time sleeping. Never spent a night in a crib in its life.

I told the Mom that the baby would likely be hoarse from crying when she was faced with NO motion sleep. She was like: I told her that I could NOT allow that and that we aren't allowed to rock the child while sleeping. We can rock them TO sleep but once they fall asleep they must be put to bed.

I don't do rock to sleep anyway so bottom line would be a kid who would be crying a lot during nap. Only way to get them used to it is to just do it.

Getting a baby to sleep lying still on a firm surface is going to result in a LOT of crying. There's no "easing" into it. It's litterally one extreme to the other. The babies little brain doesn't know calm still sleep. All the motion sleep and consequent "cat napping" DOES change the brain... I believe. I really wonder if there is a correlation to when cheap battery swinging sleep became available and the rise of ADD, ADHD, etc.

When I started doing care there were just crank swings... then battery swings but they were EXPENSIVE to run. Once rechargeable batteries became available I started seeing a dramatic increase in swing motion addicted babies.

Now there's every possible version of swings from sit up to lay down... back and forth... side to side. There's NO training about using them ONLY when the kid is awake and you are within sight.

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That part I really don't know. My DS and I both have ADD/ADHD respectively but neither of us had swings.

I did not have one due to poverty but my son did not have one due to education.

A leading researcher in SIDS TOLD me not to use one. He said he NEEDED to have clear results on the "Back to Sleep" study so DS was ONLY to sleep flat, on his back, on a firm surface. He was on monitoring equipment 24/7.

He said he would exclude us from the study otherwise. He obviously suspected SOMETHING. Maybe we will read about it in another 20 years....

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Great idea, I will be practising this from now on.

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Bumping back up to help answer a question from another thread (this morning) relating to infant positional asphyxiation.

It is a lot of information to repost with such limited time this morning, please forgive the slight sidestep of etiquette.

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It isn't your ignorance, this is just not talked about enough. I think they should make sure parents read info like this prior to leaving the hospital with an infant! I never knew this either and I used to put my son in his swing for naps all the time when he was little or worse yet, I would put him in it while I went back to bed if I had to get up for work shortly! At least when he was napping I was awake! Thank God nothing happened to any of us who have done this!

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