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Car seats and carriers: No substitute for a crib

Posted 9/9/2016 by CARMEN HANSFORD, MD
Pediatrician, Elyria Pediatric Care
Clinical Instructor, Case Western Reserve University School of Medicine

Aparna Bole, MD

Carmen Hansford, MD

Babies sleep a lot, and new parents know little ones can fall asleep almost anywhere. But that doesn’t mean babies should sleep anywhere. Contrary to popular belief, car seats, carriers, and other sitting or carrying devices are not meant to be used as alternative sleeping environments. In fact, a recent study suggests allowing infants to sleep in these devices could put their lives at risk.

Keep a close watch

The study, published in The Journal of Pediatrics, analyzed 47 cases of infant and toddler death associated with sitting or carrying devices. Two-thirds of those cases occurred in car seats. And in more than half of car seat–related deaths, babies could not breathe due to incorrectly placed straps. Other cases occurred when infants were positioned incorrectly in the device, restricting their airways.

Strollers, slings, bouncers and swings were also found to have hidden hazards. Deaths from these devices occurred when babies were not positioned correctly in the device and were unable to breathe.

To keep young children out of harm’s way, researchers stressed that babies should not be left unsupervised in these devices, and these devices should not be used in place of a crib or bassinet. Parents should always keep a close eye on youngsters in a carrying or sitting device – whether babies are awake or catching z’s.

Safe and sound

Keeping your infant safe in bed is as simple as A-B-C:

A for air quality. Smoking in the house puts your baby at risk for sudden infant death syndrome, or SIDS. Do not allow smoking around your child. If you smoke, go outside.

B for back to sleep. To reduce the risk of SIDS, infants should be placed on their backs every time they sleep, not on their stomachs or sides. Babies who usually sleep on their backs but are then placed to sleep on their stomachs (during a nap, for example) have a very high risk for SIDS.

C for crib. Your baby should sleep on a firm mattress that fits snugly in the crib. The crib slats should be spaced no more than 2-3/8 inches apart so a child’s head cannot become trapped between them. Keep pillows, blankets, bumper pads and stuffed toys out of the crib. These can block a baby’s nose and mouth.

Avoiding accidents

To keep infants and young children safe in any sitting or carrying device, follow these tips from Carmen Hansford, MD, a University Hospitals Rainbow Babies & Children’s pediatrician at Elyria Pediatric Care:

  • Keep straps securely buckled and always place the car seat on a stable surface when in use.
  • Follow instructions for the device. “Make sure your baby’s head cannot slump forward or twist into a blanket, pillow or other soft bedding,” adds Dr. Hansford.
  • If your baby will be spending a lot of travel time in a car seat or carrier, give him or her occasional breaks from the device.
  • In bouncers, swings and strollers, keep in mind that infants can move into dangerous positions, even if straps are used correctly.
  • When using a sling, make sure that your infant’s face is “visible and kissable” at all times.
  • During naptime or bedtime, it is best to place infants on their backs in a crib or bassinet that has no blankets, pillows or bedding of any kind. Dr. Hansford advises, “If your little one falls asleep in a carrier, check often to make sure his or her neck is straight and face is uncovered.”

Visit to learn more about infant safe sleep.

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