BY SYLVIA ADCOCKSTAFF WRITER
Babies should be put to sleep with pacifiers in their own cribs -- not in their parents' beds -- to minimize the risk of sudden infant death syndrome, according to new recommendations issued yesterday from the nation's largest organization of pediatricians.The first new guidance in five years on preventing SIDS deaths from the American Academy of Pediatrics is likely to be controversial, particularly among breast-feeding moms who sleep with their babies in their beds.
"We appreciate that the American Academy of Pediatrics is trying to protect the lives of newborns," said Lisa Parker, a spokeswoman for the Tennessee-based Attachment Parenting International, a support group that advocates the so-called "family bed" approach. "But we have concerns about these blanket recommendations. ... If there are working parents ... nighttime is the only time they can be with their babies."The new policy, which updates the academy's 2000 SIDS guidelines, also says that the only appropriate sleep position for infants is on their backs. Doctors have recommended that for years, but have also told mothers it is OK to let babies sleep on their sides. That is now considered too risky to even be considered an option, because infants could roll over onto their stomachs.Andrew Adesman, chief of developmental and behavioral pediatrics at Schneider Children's Hospital, said he recognized that some of the guidelines would be controversial. "I think that the academy is taking a view focusing on safety first," he said. Adesman says he tells his own kids that as a parent, his three main jobs are keeping them safe, healthy and happy, in that order. "More than 2,000 babies die each year from SIDS," he said.Melissa Mitchell of Sag Harbor is the mother of a 9-month-old and she recently returned to work as a teacher. She said the co-sleeping arrangement works well in her household. "I was sleeping with him at the hospital," she said of her son, Tyler. "It just felt like it was the natural thing to do. ... I can sense him wake up before he even starts to wake up." It would be exhausting, she said, to get out of bed every time the baby needed to be fed instead of being able to fall back asleep with him at her side."The huge upside is the connection with the baby," said Nadgia James, of East Hampton, who shares her bed with 11-month-old Nia. "The physical connection with the baby is crucial."The death rate from SIDS has fallen sharply in recent years, now that parents are warned not to let their babies sleep on their stomachs or amid fluffy bedding or stuffed toys. But it remains the leading case of death in U.S. infants between ages 1 month and 1 year.The academy addressed concerns that have been raised about pacifiers in the past, Adesman said. The use of a pacifier until age 1 will not increase ear infections, which typically occur at older ages, and pacifiers used in infancy will not cause damage to permanent teeth, a longtime concern of parents.The academy recommends delaying pacifier use for breast-fed infants during the first month of life -- when SIDS risks are low -- "to ensure that breast-feeding is firmly established." And it says placing the crib near the parents' bed makes breast-feeding more convenient. Infants may be brought into the bed to nurse, but should be returned to their cribs afterward, the policy says.Laura Reno, spokeswoman for First Candle/SIDS Alliance, a national advocacy group, said her organization strongly supports the new recommendations. She lost a baby son to SIDS 21 years ago.The academy's recommendations are based on new research, including studies that have suggested that sucking pacifiers might help keep vulnerable infants from slumbering too deeply to rouse themselves.James, the mother of the 11-month-old, said there's only one thing for parents to do: "Read up as much you can and go with your good instincts."The Associated Press contributed to this story.
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