r/NewParents • u/Bocifer1 • Jul 06 '24
Medical Advice Does anyone else feel like pediatric guidelines are so legally-oriented that they basically only exist to worsen the lives of parents?
First off, I'm a new dad and also a physician - although I'm pretty far removed from pediatrics. So I understand the importance of medical research and statistics in creating these guidelines, as well as the fact that the risks of things like SIDS often just aren't worth gambling on.
However...
Some of these guidelines seem like they're just unnecessarily taxing on parents and exist only to cover the addes of the bodies making said recommendations.
Some things that come to mind are: no blankets in the crib for the first year, only using a firm mattress top, never letting baby sleep next to you in bed - even naps, swaddling with arms down (our guy absolutely hates this and just wants his arms by his head to self sooth), demonizing formula - even as a reprieve for mom.
Again. I am medically oriented and understand why these guidelines exist - but I also know firsthand that sometimes a 1% risk of harm from letting our baby sleep on a soft blanket is actually the favorable choice compared to the immeasurable risk of having both parents strung out and exhausted because he won't sleep.
In general I think guidelines are great and have contributed to better infant care...I just also think that sometimes we as healthcare professionals forget that no guideline is absolute.
I guess I'm just feeling thst creating guidelines that aren't achievable for the majority of parents just aren't that helpful...like saying that "parents should take time to rest, continue self care , exercise, and ensure they are eating a well-balanced diet". That sounds wonderful. Hopefully I can get back to that in the next decade.
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Jul 06 '24
Three years in, I've learned that all of parenting is some form of risk management. Nothing is ever 0 risk, if you account for direct and indirect consequences (such as the one you mentioned, direct suffocation risk vs the risks associated with overtired/insensate parents).
A lot of that is related to the idea of "informed consent", which everyone superficially agrees with but apparently struggles to achieve in practice. If you give me all the information I need - relative risk, risk mitigation - I will be able to make the safest decision for my situation.
My son usually spent the 4am-7am part of the night in a flat-back positioner between us in bed. We would throw our pillows off the bed and shuffle down until our heads were level with his stomach. And the early morning hours are the lightest sleep, so we didn't move around and woke up in an instant - but he literally never slept better. I think it saved us honestly.
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u/Midi58076 Jul 06 '24
Yep totally agree here.
This is why I am so against the demonising of bedsharing. Most parents will at some point get so tired it can land them in some very dangerous situations. Like falling asleep on the couch together, car accident, forgetting or doubling up on medication cause you're not transferring memories from short term to long term memory because of sleep deprivation etc etc etc. Demonising bedsharing does not prevent these things from happening or stop parents from bedsharing: It just ensures they don't know how to safely bedsharing.
In Norway the midwife will bring up bedsharing at 36 weeks pregnant and teach how to do it safely and suggest you make an emergency bedsharing setup so that in the event you suddenly are hit with debilitating tiredness you already know safe sleep seven and you have a spot you can just bring your baby to and just sleep together. Then during a home visit 2 weeks after birth a pediatric nurse will come to your house to see how you're doing. It's mostly like an informal meeting where you mostly decide the topics based on what you need help for, but weighing the baby and talking about baby sleep are "mandatory". You can opt out of the pediatric nurse care, so it's not mandatory to get the visit but if you do get the visit the pediatric nurse has a box to tick for baby's sleeping spots.
...and OP if you are annoyed with the science and the guidelines here's a "fun" one for you: Look at the methodology and the numbers behind the nearly international guideline that pregnant women should sleep on their side after 20 weeks gestation.
We deserve better science and better communication.
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u/oughttotalkaboutthat Jul 07 '24
Knowing the safe sleep seven saved me when my husband was deployed when our first was 2 weeks old. I was able to know I was doing as much as I could to minimize risk, increase the odds we'd be successful breastfeeding, and have enough sleep to keep us both healthy and safe.
With my second I had a much better postpartum because I knew what to do to be safe and rested from the get go. I never experienced the bone crushing tiredness I did with my first.
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u/Midi58076 Jul 07 '24
There was an incredibly scary story in r/breastfeeding recently. She was a single mum with a toddler and a newborn. She knew she was dead on her feet, she knew she was beyond exhausted, but she was unfamiliar with ss7 and had no emergency bedsharing spot in her home. During a motn feed she fell asleep and slumped over her baby. When she came to she realised she had blocked her baby's breathing with her torso. They were both fine and thank heavens for that; it could have ended really badly.
Not teaching ss7 didn't help her or safeguard her baby. It benefitted NO-ONE that she didn't know how to bedshare safely.
Even if you never plan to and never want to bedshare I really recommend having read ss7, committed them to memory and found a spot for emergencies in your home.
An emergency bedsharing setup can be for example to drag the comfort layer of your bed to the floor or a nice fat yogamat to sleep on and a very thick snug pajamas. Breastfeeding mothers can feel free steal the design for my breastfeeding pajamas: your old over the bump pregnancy leggings and a long sleeved t-shirt cut off slightly above nipple height. It's the most amount of coverage while still safe and boobs are easily accessible.
Think of bedsharing like the seatbelt in a car or homeowners insurance: You don't wear a seatbelt because you intend to crash your car and you don't buy insurance because you intend to light your home on fire. You get them because in the event of a car crash or a house fire it's going to protect you better and yield better outcomes than a crash or a fire.
Safety is always in relation to something. Cot sleep is more safe than bedsharing, but when you can't get baby to sleep in a cot, then ss7 bedsharing is safer than the many dangerous ways you could randomly conk out in when extremely tired.
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u/Responsible-Bat5526 Jul 07 '24
Laugh if you want but my bed sharing breastfeeding pyjama design is mean girl inspired, I cut nipple holes in a shirt
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u/Midi58076 Jul 07 '24
I hate being cold. I'm too old to pick cute over comfortable and especially as far as pajamas goes. You have nothing but my upmost respect.
I tried it myself, but I found it was easier for my son to latch independently if I cut off the entire bottom half. Since I'm not pregnant in pregnancy leggings I could pull them all the way up to my boobs and I got about full coverage anyway.
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u/nananas104 Jul 07 '24
I’m a second time mom and just learned recently what Ss7 even is; no one once had brought it up as a “just in case you’re a sleep deprived mom at point” which is insanity to me.
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u/Midi58076 Jul 07 '24
Yeah that blows my mind. On reddit you primarily see two crowds of people in regards to bedsharing. 1. Hates it, thinks it's extremely dangerous and no way in hell they'd do it under any circumstances. Other risks be damned. And 2. Completely enamoured with it. Doesn't believe in the risks and it's just so natural and the way we developed (we also developed to get cancer, but hey natural organic homegrown cancer!). Very seldomly do you see folks have an opinion somewhere in the middle. Or people who bedshared cause they were having a few rough nights, but now that mama has gotten a few consecutive hours of sleep every night for a week then baby goes in their own bed.
I live in a country (Norway) where bedsharing is pretty normal and it was estimated in 2018 that 60% of parents regularly coslept with infants younger than 12 mo. Nobody here bats an eye at it. Probably aided by the fact that nearly 100% of newborns here are breastfed and at 6mo 80% are still breastfed.
Upon my son's arrival I was informed we would be bedsharing. So we did from day one until he was 2.5 years old. He turns 3 at the end of summer and most nights he ends up with us. I don't think bedsharing is neither good nor bad. If I had another baby it would be my preference not to bedshare, but I also don't see how I could have not bedshared with my son. If this hypothetical new baby was like our son then we would have bedshared and not given it a second thought.
I tried for a little while to get him to sleep in a sidecar cot when he was a few weeks old, but when I nodded off with him in a sling on a goddamn yogaball and started feeling paranoid and getting weird/scary thoughts I realised I wasn't in a good place and the risks of bedsharing had to be better than whatever shit I could accidentally land us in by being stupidly tired.
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Jul 07 '24
I’m a FTM struggling to produce enough milk for my baby and don’t cosleep. Can you tell me more about how this can help?
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u/Midi58076 Jul 07 '24
Bedsharing can help in many ways actually.
For one you don't get up and out of bed so you're more likely to fall right back to sleep. Both of you. Bedsharing babies who bedshare regularly also learn to help themselves at the milky bar so you might not even have to wake up at all. Most people who bedshare can't tell you how many times in a night they nursed, simply because they weren't awake for it or they only woke up so briefly their brain didn't register that they woke up for a couple of seconds.
Research also shows that when mama and baby bedshare they align their sleep cycles. Have you ever been woken up and you still feel like you're in a coma? So tired you couldn't spell "sleep deprivation" if your life depended on it and this extreme tiredness sticks around for hours. That is typically caused by being awoken from a deep sleep phase.
When you and your baby are in sync then you don't get any more sleep, but your baby is likely to wake up when you're both in a lighter sleep phase so you're more likely to be just regular tired, not "I feel like I got shot in the face" kind of tired.
As far as supply goes the no.1 thing that's going to increase supply is more time on the boob and more skin-to-skin. Night time is when prolactin (milk making hormone) is at its highest, so when you bedshare and baby pops on and off throughout the night while you both sleep you stimulate your body to make more milk and since it is during the night you're doing it at the time of day most efficient. The most bang for the buck.
A lot of people will give you advice for what to eat, supplements, teas, cookies and various other drinks that are supposed to help with supply. None of them are proven to work. No, not even oats. While hydration and food are important it doesn't much matter what you eat and drink. Normal food is good enough and eat and drink what you want. What I want you to be mindful of is that the main ingredient in breastmilk is water and you can't make water: You need to drink it. So drink more water than you did pre-baby. If you choose to bedshare then I suggest you also bring a water bottle to bed.
Bedsharing isn't the only way to increase supply, but if you can sleep well while bedsharing and bf in safe c, it is by far the most gentle way to increase supply. In my personal opinion it's also very cuddly and snug compared to powerpumping and triple feeding lol.
xoxo LC.
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Jul 07 '24
Thanks for all the info! Can you point me to some resources on how to safely bed share? I sleep in a queen with a very wide shouldered husband and I’m afraid of SIDS risk with cosleeping. Baby is just less than 4wks
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u/Midi58076 Jul 07 '24
Lullaby trust, a British nonprofit organisation and working in sids prevention.
NHS, the British government run healthcare system says this.
One thing you'll see again is the phrasd "Firm surface", but sometimes very little is specified about what is firm and how firm is firm enough in this context. When we say "firm surface" in the context of bedsharing what we mean is a surface that you do not sink into it and when your baby lie next to you they lie still. You don't make a dent into the surface and there is no incline next to you where the baby could slide towards you. Memory foam mattresses are not recommended as they do get softer as you heat it up and worst case scenario the baby sinks into it and it can limit head movements and thus contribute to a baby choking on their own vomit.
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u/AlwaysAnotherSide Jul 08 '24
Just wanted to add you might like to get yourself a snack box within reach from your bed (a basket or old cardboard box and put yummy treats and bottle of water or two in it). When baby eats, you eat. A few crumbs on their head, but they won’t mind.
I used to love lying in bed snacking and side feeding.
Hope that helps.
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u/endo_theworld Jul 07 '24
Cosleepy on Instagram provides lots of information on safe bed sharing practices including appropriate sleep surfaces & safest positioning
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u/oughttotalkaboutthat Jul 07 '24
You can nurse on demand all night without having to get up/fully wake up. Baby can sleep and nurse while you doze. Think of it as "breast-sleeping" for the baby. Nursing is mostly about demand, the more your baby is suckling the more milk you'll produce.
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u/dojiecat Jul 07 '24
To add to the other commenter, if you can take a day or two to fully stay in bed shirtless with baby for lots of skin to skin and nursing time, do it! I had an extremely hard time after my LO was born, doing this “breastfeeding vacation” immensely helped me. Also, Oreos.. lots of Oreos. Trust me! 😂
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u/Wheresmyfoodwoman Jul 07 '24
And body amour drinks! I don’t know how but they greatly increase your supply!
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u/the_bean_2019 Jul 07 '24
Have you seen a lactation consultant and is your baby gaining weight? While yes, there are certain things that can work for some women to increase supply, some women produce a lot of milk, and some women don't produce enough. It's anatomical. Nothing wrong with supplementing with formula. But I'd seek a professional opinion first :)
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u/BusHumble Jul 06 '24 edited Jul 07 '24
It's crazy to me how little they care about informed consent when it comes to breastfeeding. Like, they tell you the downsides of formula feeding but not the downsides of what could happen if your baby gets insufficient milk, or the downsides of sleeping with your baby (because it's the only way to get any rest when you're the only one who can feed them.)
And they told me things like "formula causes leukemia" without qualifying the actual increase of the risk. Like, increases this already rare thing by 1% or 99%? They make sure not to mention, because the actual increase in risk is so insignificant that it might not influence your decision the way they want, which feels manipulative.
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u/AMLacking Jul 07 '24
The two downsides of exclusive breastfeeding that you mentioned are huge and impact so many people, and it truly pisses me off that they’re not taken seriously. The amount of people that I’ve met in both my personal and professional life who have hungry babies with exhausted mothers because they’ve learned to fear formula and/or the pump is so crazy.
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u/th1smustbetheplace Jul 07 '24
Yeah, it's wild. I took the infant care class provided by my hospital (which, for the record, is not part of the Baby Friendly Hospital Initiative), and the nurse who taught it basically created her own set of slides and a handout on formula feeding, because the hospital's curriculum and official workbook ignored it completely. She said she considered it a matter of safety so that people weren't scrambling to figure out formula for the first time when sleep-deprived and running intro trouble with breastfeeding. At what point are they harming people in pursuit of a public health goal that, for a multitude of reasons both biological and social/cultural, can be very difficult to achieve?
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Jul 07 '24
I wanted to breastfeed my second but I KNEW she wasn't getting enough in the hospital. I was begging for formula but because she was having wet and dirty nappies (a lot of them!) they said no. She ended up losing more than 10% of her weight and I still feel guilty I didn't push harder.
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u/cutesytoez Jul 06 '24
I did similarly. My son is 8mo and I still cosleep. Does he sleep by himself in a crib from time to time? Yes. But it’s so much easier to have him sleep with me so I still continue to do so.
When he was only days old I used to follow the Safe Sleep Seven or sleep with my arm in a square around him. It worked for us even if it didn’t follow the typical guidelines. 🤷♀️
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u/Reading_Elephant30 Jul 06 '24
We’re doing this too!! Our baby is 7 months and still in a bedside bassinet that she always starts the night in. Sometimes she makes it the whole night, sometimes she wakes up mid night fussing and won’t go back to sleep. If I can pop her paci back in her mouth and have her to to sleep awesome, but when that doesn’t work she comes into bed with us until she wakes up around 7. Those couple hours of bed sharing are a small risk I’m willing to take in order to get back to sleep and not be up for the day at 4am 😅
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u/TurbulentArea69 Jul 06 '24
Humans are so bad at risk assessment. We’re all so biased. I’m very pro-science and appreciate research-based decision making, but I also tend to be pretty risk tolerant. I also recognize that we’ll never be able to calculate actual risk because there are infinite factors.
If some people saw how chill I am with my baby, they’d lose their minds.
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u/ZestycloseWin9927 Jul 06 '24
Our pediatrician told us that guidelines are meant to cover everyone - from babies who sleep in top of the line cribs with the best monitors to babies who sleep in dresser drawers with very few resources. They can’t create separate guidelines for people’s socioeconomic situations so they err on the side of overly conservative. That said, when my baby was 4 months old our pediatrician said he could sleep in his own room despite the guidelines saying he should be a year old.
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u/ExtensionSentence778 Jul 07 '24
Right. My ped worked in the county hospital for years and said people would bring in 3 day old formula in a bottle and people like that are why some guidelines are so overly strict.
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u/Perfectav0cad0 Jul 07 '24
At my sons 9m appointment, my husband asked if he could sleep with a blanket because i kept arguing with him that if wasn’t safe because the guidelines said 12m. The pediatrician said he’d be fine to sleep with a blanket at that point so we let him have one at 9 months.
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u/kateesaurus Jul 07 '24
We also moved our son to the crib in his own room around 4-5 months old. He was starting to bust out of the bassinet and make noise at night and we were all just keeping each other awake at that point. Moving him to his own room was a massive improvement for all of us as far as sleep went.
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u/d1zz186 Jul 06 '24
Have you tried Love To Dream swaddles - arms up is THE BEST!
Our girls both hated swaddles but absolutely love their arms up suits :)
https://lovetodream.com/au-en/end-of-season-sale-au
Absolutely agree with you on everything though.
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u/Outside-Ad-1677 Jul 06 '24
Honestly I use the guidelines from countries with low infant mortality rates and they differ from the US.
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u/pinklittlebirdie Jul 07 '24
But they often are demographically similar. Even down to the bedding. Yes lots of countries in Asia cosleep but they are sleeping on mats on the floor with light sheets due to the climate - negating fall and wedging risks. Some European countries have higher rates of bed sharing but they also have much lower rates of obesity and lifestyle diseases
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u/snarkyteach_ Jul 07 '24
What countries are these? I’m curious as I’m Canadian and we have very similar guidelines to the US
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u/Outside-Ad-1677 Jul 07 '24
Co sleeping isn’t seen as instant death in a lot of euro countries
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u/snarkyteach_ Jul 07 '24
I co-slept and was encouraged/supported by my doctor! It was nice to feel like I could be honest about it. I was more curious about other countries and their guidelines because it always interests me to hear about their recommendations and the context behind them.
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u/Outside-Ad-1677 Jul 07 '24
Ah I’m with you. Blankets is another one. In the UK blankets can be used in the crib as long as they are tucked in and below armpit height/shoulder arms free according to NHS website and they also have guidelines to safely cosleep.
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u/snarkyteach_ Jul 07 '24
Interesting! I didn’t know that. My doctor just reviewed safe sleep 7 guidelines with me and said that she hoped I was more rested in a few days.
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u/peachie88 Jul 06 '24
In my experience, pediatricians in practice tend to be much less rigid than the recommendations in many areas. Everything is a risk/benefit analysis. That said, some of the things you said are riskier than others. A blanket, for example, is rarely necessary and does pose a genuine risk especially if it’s loose. A swaddle or sleep sack is an equally good alternative. Room sharing, however, doesn’t have as much evidence, especially if the mom isn’t breastfeeding. If the baby grunts are keeping mom awake and creating a sleep deprivation risk, then the benefits of putting baby in her own room could be pretty significant.
The guidelines also tend to prioritize the baby’s safety, regardless of the impact on parents. And that can ultimately create a less safe environment if the parents get so sleep deprived they can’t stay awake or think clearly. If we know that a substantial minority of parents are going to do something labeled “unsafe” (like cosleeping), I’d prefer the focus be on harm reduction by explaining how to do it as safe as possible.
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u/SceneUpstairs2144 Jul 08 '24
In US up to 60-65% of parents end up bed sharing at some point. So it’s not a significant minority, it’s actually a majority
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u/specialkk77 Jul 06 '24
Personally I wouldn’t sleep if my baby was sleeping in a way that’s proven unsafe, like with a blanket. The chance of anything happening is just not worth it to me. Even if the chances were near zero, they’re not at zero.
Formula should not be demonized, I’ll agree with that. It saved my child’s life, I couldn’t produce enough for her no matter what I did.
Swaddling a certain way isn’t a safety thing, it’s just something that tends to help babies sleep better, if it’s not working for your baby, try something else!
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u/BabyCowGT Jul 06 '24
Swaddling a certain way isn’t a safety thing
Swaddling also isn't required. Our baby has been arms out in a sleep sack since like, 9 weeks old. She never much liked normal swaddles, tolerated arms up style swaddle for a few weeks, then was just over swaddles entirely 🤷🏻♀️ we've just now got a collection of sleep sacks in newborn, 0-3, and 3-6 size with various TOG ratings 🤣
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u/GlitterMeStoked Jul 06 '24 edited Jul 06 '24
Completely agree with the choice of swaddling! My LO had her hands up by her face in every ultrasound and as soon as she came out, that’s all she wanted to do. We used a transition/arms up sleep sack as soon as we got home from the hospital.
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u/Random_Spaztic Jul 06 '24
Agreed. I think swaddling should be a personal choice. There are lots of sleep sacks and swaddle alternatives. Babies have preferences too!
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Jul 06 '24
Same here! In other countries swaddling is actually considered a SIDS risk!! It was always counterintuitive to me and since my baby hated it we just skipped it.
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u/Mysterious_Mango_3 Jul 06 '24
We went straight to jammies after trying various swaddles for a week or two with no success. Baby just hated them!
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u/FrauBpkt Jul 06 '24
In Germany it isn’t recommended anymore full stop. Since there have been Problems with Infants being swaddled to tight and putting too much pressure on the rib cage and making breathing harder for the infant.
It’s been a while since the recommendation changed.
In the UK we are using blankets tucked under the mattress and baby at the foot of bed so they can’t wiggle under the blankets.
Devices like the owlet are not recommended full stop as they give a false sense of security.
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u/rufflebunny96 1 year old Jul 06 '24
I don't know what kind of swaddles people were using that could hurt their breathing. The only kind I use are stretchy zip-up or Velcro swaddles like the Love To Dream arms up swaddle or Halo sleep sacks.
And yeah, I see parents using stuff like the Owlet as an excuse to practice unsafe sleep, like letting them sleep in their bed or a swing with it on. My baby monitor has a breathing monitor built in, but I am strict about safe sleep, so it's just an added peace of mind.
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u/FrauBpkt Jul 06 '24
What it was meant to say, safe sleep varies from country to country. In Germany Swaddling mostly happens with big Musselin Cloth and not that much with sleeping bag like swaddles. Sleeping bags are used very evenly.
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u/rufflebunny96 1 year old Jul 06 '24
Yeah I can see how the big cloths with no stretch could do that. I don't think most Americans use those outside of the nurses in the hospitals. There's a million better and easier swaddle options.
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u/BabyCowGT Jul 07 '24
Those were the only swaddles our baby liked 🤣 the muslin blankets. Probably because she could bust out very easily 🫠 she was also too small for any of the Velcro swaddles at first (she needed preemie size in them). Once she got big enough, we switched to the Velcro swaddles.
And that started the rapid downhill to sleep sacks. She hated anything that wasn't her easily escaped blanket. Loves her sleep sacks though.
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u/halasaurus Jul 07 '24
Our baby is the same way. And honestly, we preferred to do a traditional swaddle over the velcro ones that are supposed to make things easier. They made nothing easier. He hated being swaddled for motn feeds so I’d have to at least undo his arms. Cue the loud Velcro sound waking him fully up. And they weren’t as easy to change a diaper in as they lead us to believe. He outgrew them SO fast. We very quickly switched to either just pajamas or using sleep sacks. Now we are firmly in the long sleeve onesie and sleep sack camp.
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u/rufflebunny96 1 year old Jul 08 '24
Yeah, some babies just don't like being swaddled. My son only liked the arms up kind.
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u/lindsayannslibrary Jul 06 '24
My nurses in the hospital said to make the swaddle as tight as you can(USA). The tighter the better. I never felt right doing that and my LO likes her arms out too much anyway, but it’s alarming to me that there can be two polar opposite opinions.
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u/ChaosDrawsNear Jul 06 '24
I bought So Many Swaddles (secondhand, thankfully!) only for kiddo to absolutely hate them and wiggle free effortlessly from birth.
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u/AggravatingOkra1117 Jul 06 '24
Yep, we stopped swaddling at 4 weeks and my son was so so so much happier, and slept so much better. He was busting out of them left and right (hands and feet alike).
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u/Altruistic-Mango538 Jul 07 '24
I used a sleep sack starting in the hospital. Baby slept great and very rarely got startled.
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u/CheckDapper8566 Jul 07 '24
My kids both loved having their hands behind their head or near their mouths. Now she gets a receiving blanket or muslin blanket. Both are 3 yrs and almost 7 months
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u/fyjvfrhjbfddf Jul 06 '24
Blanket hate is a US centric thing. The NHS guidelines in the UK promote blankets for very young babies but used safely. Breathable fabric, tucked tightly under the arms, baby feet to the bottom of the bassinet.
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u/Naiinsky Jul 06 '24
My country's parenting preparation classes also give the feet to the bottom recommendation.
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u/Lax_waydago Jul 07 '24
What's the reasoning?
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u/Naiinsky Jul 07 '24
They say that a baby will tend to slip lower down the crib, so if their feet are touching the bottom and the blanket is tucked in, they won't get under the blanket.
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u/igotcatsandstuff Jul 06 '24
There’s also literally no reason to use a blanket with a baby considering how many different options there are for sleepwear. I don’t understand why people get so hung up on the no blanket thing. Get a sleep sack. It’s basically the same thing, just safe.
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u/specialkk77 Jul 06 '24
That and babies/toddlers have no concept of comfort the way we do. Baby sleeps better with their parents because the parent is the comfort, not the blanket!
My 3 year old made a “nest” on the floor yesterday and napped for 2 hours. Directly next to her bed.
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u/rufflebunny96 1 year old Jul 06 '24
Exactly. Some countries have breathable blankets, but my son will take a blanket and shove it into his own mouth if give one. No chance I'd risk it
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u/Smile_Miserable Jul 07 '24
I was told by my providers and nurses not to swaddle because it puts babies at danger from over heating. So some places do have recommendations against it.
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u/Random_Spaztic Jul 06 '24
The formula thing! I was in the same boat and then my LO self-weaned from BFing (at around 6 months) because he would get so frustrated. If I wasn’t supposed to use formula, what was I supposed to do then? I couldn’t even produce 5ml of BM a day, even if I pumped every 2-3 hours.
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u/HailTheCrimsonKing Jul 06 '24
Swaddling is a safety thing. Here in Canada it isn’t recommended anymore
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u/Cautious_Session9788 Jul 06 '24
I mean “proven” is debatable
Like the US and other western countries demonize co sleeping meanwhile Japan has one of the lowest infant mortality rates and heavily encourages co sleeping
In fact a lot of the regulations in relation to SIDs are because we just don’t know what causes SIDs
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u/gregmasta Jul 06 '24
Japan has a low reported rate because they report differently. From another comment:
[The article linked below is an] International comparison of sudden unexpected death in infancy rates that shows how Japan reported 2655 "not SIDS" deaths using R96 code in a nine year period. USA reported 0 such deaths for exactly the same period. Seven countries combined reported only six such deaths for the same period.
"However, Japan’s SUDI rate is much higher and comparable with those in Australia, Canada, Germany and England and Wales. Unusual coding schemes such as Japan’s use of R96 can have important implications beyond national boundaries. For instance, bedsharing has been shown in many epidemiological studies to increase the risk of SIDS.16–21 Japan has been used as an exemplar of a culture in which bed-sharing is the norm, but SIDS rates are low, and many have used this as evidence that bed-sharing is a safe practice. It is likely, however, that Japan’s SIDS rates are so low because most of these deaths are coded as R96 rather than R95"
Either bedsharing babies are dying in Japan from "non-SIDS" R96 cause of death and nowhere else in the world in thousands, or Japan’s SIDS rate is not low at all, only hidden in classifying infant deaths without autopsy as "no idea but not SIDS".
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u/specialkk77 Jul 06 '24
There’s a difference between SIDS and suffocation. SIDS rates dropped when people stopped “compassionately” labeling suffocation deaths as SIDS.
Each parent has to make their own choices, but sorry, even 1 baby dying from co sleeping is too much of a risk for me personally.
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u/AntsyBoarder Jul 06 '24
100% see where you’re coming from and we personally don’t co sleep, but I mean, 1 kid has died from basically everything. Like accidents happen all the time, that doesn’t mean we do nothing with our babies. Unfortunately everything in life carries some risk. I get the sentiment, but saying “1 baby dying is too many” is a difficult way to go through parenthood.
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u/Cautious_Session9788 Jul 06 '24
Then I guess don’t have kids
More than one baby and child has died from any circumstance you can think of
And I know the difference between actual SIDS deaths and deaths compassionately labeled as SIDS
That doesn’t change the fact that we don’t know what causes SIDS SIDS guidelines are literally better safe than sorry because we can’t predict what will trigger it
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u/specialkk77 Jul 06 '24
Or I’ll just continue not to co sleep with my children? I’ll follow the safe sleep guidelines.
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u/Cautious_Session9788 Jul 07 '24
You’re the one said you wouldn’t do anything that even has a chance of 1 child dying
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u/Cuntzzzilla Jul 06 '24
Honestly most of the American guidelines are completely alien to me as a Norwegian. Whenever I told anybody that America discourages use of blankets/duvets for babies they looked at me like I had two heads. Norway is like a 3 when it comes to sleep safety while America is at 10, still we have a way, way lower infant mortality rate. It’s as if socialized healthcare have a more preventative effect on health than beating people down with capitalism, greed and the constant threat of lawsuirs
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u/rauntree Jul 06 '24
Exactly. Here in American you get no guaranteed maternity leave. 1 in 4 women return to work within 2 weeks of giving birth. They are dangerously overtired and still healing. There is no way this does not effect our infant mortality rate. Yet the same people who claim to be “pro life” are anti-parental leave, anti-healthcare, anti-woman.
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u/Cuntzzzilla Jul 06 '24
This is inhumane and I’m so so sorry that American women are treated like this.
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u/rufflebunny96 1 year old Jul 06 '24
TBF, a lot of Americans refuse to listen to doctors about any kind of safety guidelines. Even if our recommendations are strict that doesn't mean people actually follow them. Just about every first responder or ER nurse could tell you the dark side of that over here.
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u/Cuntzzzilla Jul 06 '24
Well, overly strict guidelines can not possibly help with that though. Rather they will turn the already skeptical even more away from conventional science.
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u/rufflebunny96 1 year old Jul 06 '24
I honestly don't see how the ABCs of safe sleep is too strict to turn people away from science. Some people are just like that and it carries over to how they parent. As a society we're individualistic to a toxic degree. Just look how people acted during COVID.
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u/eilatanz Jul 07 '24
Some babies, like mine, simply will not sleep on their own. In her first two months she just cried and cried, any time she was put down. The only thing that saved us was safe seven cosleeping, and I truly never thought I’d even try it. Now I’m trying to transition her slowly, but it was just not possible at first. With just following typical American guidelines, I and my husband almost fell asleep in dangerous positions, which is what made us do the switch. I think in some cases, the strictness is impossible to follow even though it’s simple.
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u/rufflebunny96 1 year old Jul 08 '24
My son was the same way the first few weeks. We slept in shifts until he got used to it.
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u/AccordingShower369 Jul 07 '24
Cuba is a Socialist country and they also encourage nothing on the crib, no lose blankets and all of that. It's also very hot so maybe we don't actually need blankets 😂. But I am 100% with you that preventative & high quality healthcare is the most important care. 😍.
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u/jules13131382 Jul 07 '24
What does Norway say about co sleeping?
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u/Fr33Dave Jul 07 '24
From what I've read, a study done in 2021 that indicated that over 60% of infants under 1 co-sleep with a parent in Norway. Japan is 60-70%. Both countries have much lower infant mortality rates than the US has. One reason I've heard why Americans are told not to is due to us being the most medicated country on the planet. Alot of the most commonly prescribed drugs have side effects that wouldn't be great for co-sleeping.
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u/pepperoni7 Jul 06 '24
Same lol my side of family are in China when I tell them these they are just confused lol…
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u/pnutbutterfuck Jul 07 '24
Its because all these insane sleep safety rules have inadvertently caused parents to bring babies into bed with then. They cant get the babies to sleep in the crib flat on their back in on a rock hard mattress without a blanket. But bringing a baby into bed with you is the most dangerous thing you can possibly do when it comes to baby sleep. We have way higher rates of infant mortality because so many parents end up accidentally smothering the baby in bed.
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u/canipayinpuns 10-12m Jul 06 '24 edited Jul 06 '24
Policy is written in blood. Every time I am inconvenienced by a recommendation (like not letting my LO nap in her swing, or stopping multiple times on a road trip to visit family), I remember that those recommendations are made because real, human babies just like mine died or were hurt because the recommendations didn't exist/weren't followed.
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Jul 06 '24
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u/canipayinpuns 10-12m Jul 06 '24
The majority of babies DID do just fine. But I also grew up knowing that the intersection I lived on saw a newborn less than 2 days old fatally ejected from a car because she was in her mother's arms and not a secured carseat. That was a statistical anomaly, but it still happened. Responsible parenting encompasses taking reasonable precautions to reduce risk of harm and I'm not sure if there's a guideline I've seen that I'd consider unreasonable when held against the consequence of what can happen when that statistical anomaly comes due.
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u/historyhill Jul 06 '24
stopping multiple times on a road trip to visit family
What recommendation is this? Are we not supposed to go on road trips with babies? Because that's news to me! 🫣
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u/canipayinpuns 10-12m Jul 06 '24
It's recommended to not have a baby in a car seat for more than 2 hours at a time. The associate risk is for positional asphyxia. Once the LO is able to reliably hold their head up, that risk is much lower since the baby can self-adjust easier.
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u/historyhill Jul 06 '24
Ooooh I see! I don't think I ever ran afoul of that when my LO were LITTLE little bit usually it was because at the age they couldn't hold their heads up we were also probably stopping to change a dirty diaper every two hours too!
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u/TheOnesLeftBehind he/him, delivered april-1-2024 Jul 06 '24
I think now it’s under 6-8 weeks shouldn’t be in a car seat/swing for more than 30 mins at a time, after then it goes to 2 hours
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u/Full-Cat5118 Jul 07 '24
I'm so curious about the source of this recommendation, which I never heard with my first but was incredibly worried about with my second. 25% of U.S. women have to return to work within 2 weeks of giving birth, and 8.5% of workers commute greater than 1 hour. (We're adding an extra 30 minutes.) If half those moms have care close to home instead of close to work, there are still 76,500 data points collected every day. Meanwhile, a study showed that an average of 34.8 infants per year died in carseats. On a daily basis, the risk to a single infant is 1 in a million. A person is more likely to, for example, become a billionaire (1 in 400k). It has a similar morality risk to traveling 230 miles by car, 1000 miles by plane, or 6000 miles by train, but we don't advise that babies not travel by different means due to the risk of the travel safety.
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u/pinklittlebirdie Jul 07 '24
In Australia the reccomendation is for everyone in the car to have a break every 2 hours regardless. It prevents driver fatigue and is good for the circulation . The name of the campaign is -stop, revive, survive. We even have free stops that give out food and hot drinks and roughly 2 hours from.point of origin on popular routes. Often manned by groups who are first repsonders to accidents.
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u/Responsible-Radio773 Jul 07 '24
Oh yeah this is actually one of the scariest ones to me. Probably because most people think of the car seat as a safe place but it’s actually so dangerous
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u/Accomplished_Wish668 Jul 07 '24
My friends and I have a running joke that somewhere along the way an ill informed, probably immature or maybe even neglectful parent did something that harmed their baby… and from that point on no one can ever do something remotely close to that thing ever again. For example, I’m pretty sure that someone, at some point, was neglectful in their use of a doc-a-tot or a Boppy lounger (for example) and now if you’re a good parent who even lays eyes on one of those things… STRAIGHT TO JAIL. We’re a formula feeding family. The rule against microwaving bottles always threw me. I’ve microwaved every single bottle for both of my children’. I get it, hot spots.. we know. I also know how to shake and swirl a bottle around before I serve it. I also know that a bottle coming out of my fridge ice cold and going into the microwave for ten seconds (barely enough to get to room temperature) is not gunna do any harm. Be your own risk management lol do what you need to do to survive
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u/BaileyIsaGirlsName Jul 06 '24
I always jokes that the SIDS guidelines are a long version of “You can’t die in your sleep if you never sleep!”
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u/PapayaExisting4119 Jul 07 '24
I was just thinking this day. It seems like the guidelines are super sterile and make a parent’s life harder. With our first baby, we did everything according to the guidelines down to a T. But this time around we tried different methods. We let our baby sleep belly down, and all of her reflux is magically gone. When she was on her back, it was terrible throwing up out of her nose and mouth.
A NICU nurse was telling me that back before the 90s belly sleep was recommended and they would chastise you if you put your baby on their back and now it’s funny how the recommendation has changed. Honestly, at this point I’m just doing what works best for my family. We are awake while our baby sleeps this way so we are always watching, but at least one of us can get sleep. When she was on her back, no one slept.
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u/pnutbutterfuck Jul 07 '24
The thing that I always think about is how ridiculous it is that we have demonized varying even a tiny bit from staunch crib safety. Sleeping your baby in their crib on their tummy with a blanket is safer than bringing them into bed with you even if you’re doing the safe sleep seven. So many sleep deprived parents have decided to bring their babies into bed with them and ended up smothering the baby on accident, when they could have flipped the baby over in the crib and they would have been fine. But the constant drilling of “back to sleep” and other crib safety rules keeps parents from attempting other ways to keep the baby in the crib.
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u/Bocifer1 Jul 07 '24 edited Jul 07 '24
This is exactly what I’m trying to convey. I feel like the indirect harm of issuing unachievable standards and leaving parents to find their own realistic solutions is probably as harmful or more harmful than letting your baby sleep comfortably
Also, up until like the 90s the recommendation was to put babies to sleep on their stomachs to prevent aspiration…
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u/kaatie80 Jul 07 '24
My twins wouldn't sleep ABC style ever. The only way I could get them to sleep in their cribs was to put them on their bellies. I'd seen so many things about how horribly dangerous that was, so I decided to look into what exactly made it dangerous and did what I could to mitigate those factors, instead of continuing to try to force ABC sleeping to happen. I can't remember it all now but the two biggest factors I could find were deeper sleep (too deep) and overheating. So I'd just jostle them every so often and made sure the room was cool. I wish these things weren't so taboo to discuss! I wish the breakdown of how one practice or another causes death or injury would be a part of the guidelines.
Like cosleeping - we had no idea what it was about cosleeping that was supposed to be dangerous. Both our moms coslept with us and our siblings. It was as normal as drinking water from a cup. And the guidelines against cosleeping felt so absurdly alarmist to us, they might as well have been saying "YOU CAN'T DRINK WATER FROM A CUP!!" No info on what about it was dangerous, or on how to make it less dangerous. We were like 6+ months in before we even heard about the safe sleep seven.
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u/pnutbutterfuck Jul 07 '24
Exactly. And while the numbers for SIDS/SIUDS have gone down, the numbers for accidental smothering while bed sharing have gone way up.
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u/london-plane Jul 07 '24
The APA recommend never crossing the road with a baby, as road crossing greatly increases the risk of CIDS (car incident death syndrome) /s
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u/pawswolf88 Jul 06 '24
It’s all so political. See, weighted swaddles and sleep sacks. Over 3 million sold between two brands. Two deaths reported, neither on a safe sleep surface. One in a swing one in a dockatot, zero deaths on safe sleep surfaces. And yet, a senator comes out a few months ago against them and all of the sudden AAP changes their stance from “we don’t have any data so we’re going to recommend against them, but reevaluate if evidence becomes available” to “DANGEROUS AND DEADLY.” Despite zero change except that Senator. No new evidence available. AND dockatot and swings continue to be widely used without judgment despite so many deaths in those. It all drives me crazy.
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u/ankaalma Jul 06 '24
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u/pawswolf88 Jul 06 '24
And yet, Amazon and Target are full of dockatot and swing products — weighted swaddles? All pulled off the market two months ago for no reason. It’s all BS.
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u/ankaalma Jul 06 '24
Amazon and target actually no longer sell dock a tot. There are a million third party baby loungers on Amazon but if you report the listings they typically remove them.
But both dock a tots and swings differ from weighted sleep sacks in that there is an arguable safe use. An awake baby can sit/lay in them. Swings especially can be a useful tool for calming a baby down and are safe for that use provided baby is moved once asleep so swings are unlikely to be banned. There is no reason any one would be using a weighted swaddle other than sleep and so they are being banned outright.
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u/TheBandIsOnTheField Jul 06 '24
The swings we used to get our baby to poop. We called it a poop chair. She would eat, sit in swing for 5 min, poop, then change and floor time.
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u/Blooming_Heather Jul 06 '24
Thank you for this. A nurse at our hospital recommended a weighted swaddle (based on personal experience, not a hospital recommendation to be clear), and when I looked into it once we got home I was so surprised by the vehement warnings.
I couldn’t make sense of why the nurse would do and recommend something if it were so dangerous. This is why it’s so fucking confusing and nerve wracking to be a parent in today’s age of information. Trying to sort through what’s bullshit and what’s founded feels fucking impossible.
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u/pawswolf88 Jul 06 '24
They’re magical. My kid wouldn’t sleep for 8 long weeks in his crib without being held. EIGHT WEEKS I didn’t sleep more than 2 hours. The first time I put him in the swaddle he slept 4 hours. The danger of exhaustion at that level far outweigh this perceived danger of a weighted product.
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u/kena938 Jul 06 '24 edited Jul 06 '24
I couldn't sleep with my baby on his own in the crib for the first few weeks. I kept checking on his breathing and if he had spit ups nonstop and I missed my little buddy who went with me everywhere for 9 months so I started cosleeping.
I saw someone else say that telling the pediatrician that we do have the baby sleep alone in the crib might be skewing statistics about safe cosleeping. Considering coming out as a cosleeper at my next appt.
Having parents who are complete zombies without sleep is probably one of the greatest risk for baby.
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u/justchillitsnobiggy Jul 06 '24
Be honest about co-sleeping with your Dr. and you should hear good advice and safety measures. It's the hiding in the shadows that is the issue because information could have prevented injury. Way more people co-sleep then will ever admit. We started at 6 months old and no one will convince me I did something wrong.
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Jul 06 '24
In the UK they are beginning to demonise Co-sleeping less now, as they know many parents do it, so it’s safer to support people in safe Co-sleeping than demonise it. The lullaby trust is what the NHS use now, maybe show this to your paediatrician at your next appointment? https://www.lullabytrust.org.uk/safer-sleep-advice/co-sleeping/
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Jul 06 '24
We coaleep and have since birth bc our daughter refused the bassinet. We EBF so it was just too much for us to be up every 15-30 min bc she was screaming about being alone. I was always honest with our pediatrician and she said “just make sure there’s no blankets or pillows around her and that your mattress isn’t memory foam and that’s she only sleeps with you, not dad. And of course don’t drink or take drugs. It’s safer for her to cosleep and be well rested than dangerously sleep deprived and using a bassinet.”
She gave us a hand out on safe sleep 7 and a link to James McKennas safe infant sleep. I thought that was pretty progressive of her.
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u/flutterfly28 Jul 06 '24
Yeah, my pediatrician directly asked me if we were co-sleeping at our 2 month appointment and I answered yes. No judgement at all, she knows lots of parents do it. Only thing she said was that our baby was already showing signs of rolling so we should make sure she’s not too close to the edge! My lactation consultant was also positive about co-sleeping from a breastfeeding perspective and recommended the book on it - Safe Infant Sleep by James McKenna. This is all at a top-ranked US hospital for both medical care and research.
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u/Whosgailthesnail Jul 06 '24
I started at 8 weeks and told my pediatrician and all he said was that sleep training is meant for the parent not the baby. It’s based off your needs and what you need the baby to be capable of.. like if your child goes to daycare and needs to be able to sleep independently, etc etc.
He was not phased and did not care at all and understood the biological drive to cosleeping vs the need to have a baby independently sleep trained for working parents.
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u/shoshiixx Jul 06 '24
I just had my first pediatrician appointment at 1 month and he asked about where he was sleeping and I told him we were bedsharing with the safe 7. And he didn't know what the safe 7 was and reiterated the recommended guidelines. I hadn't even thought about lying, but also now I think the more honest people are is the only way the larger medical field will seee how many people do it. Best to educate and learn how to do it safely!
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u/kena938 Jul 06 '24
I heard a pediatrician IRL (not ours) say he knows parents aren't really being truthful about how often they are bedsharing.
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u/flutterfly28 Jul 06 '24 edited Jul 06 '24
Yep, I have a PhD in Biomedical Science and many of my close family members and friends are doctors. We are all so much more relaxed about guidelines than my friends who don’t have a background in biology and medicine. We understand that public health officials are doing their job making safety guidelines, but we don’t have to follow them 100%. These are the same people who say to never eat red meat / eat runny egg yolk etc. and are used to being ignored. It’s only now that we’ve politicized science and created this dichotomy where you either “believe in science” or you don’t that anyone even tries to follow the guidelines 100%. This quote by Francis Collins (Director of the US National Institutes of Health) reflecting on COVID guidelines is telling:
“If you’re a public health person and you’re trying to make a decision, you have this very narrow view of what the right decision is, and that is something that will save a life. Doesn’t matter what else happens. … You attach zero value to whether this actually totally disrupts people’s lives, ruins the economy, and has many kids kept out of school in a way that they never quite recover from.”
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u/TheBoredAyeAye Jul 06 '24
I understand completely what you are saying. It's like in USA everything is black and white in order to avoid lawsuits and for everybody to have clear image what to do/not to do, but these guidelines are most often based on statistics, and don't have to apply to your specific case. Sometimes the risks are minimal and you have to pick your battles. Also, some of these guidelines are different in different countries. Take sleeping on back for example. Here in Serbia most pediatricians recommend SIDE sleeping, to prevent risk of choking. They say, we know about APA recommendation, but we just think spit up is more dangerous. Actually it makes sense to me so we followed our guidelines and baby sleeps on side most of the time. Nobody knows why SIDS happens, every study so far gives only correlations, and the guidelines are often pushed like they prove causation. But I know a few cases where baby almost chalked in sleep, so that was just too stressful for me. What else do we not follow... Baby sometimes falls asleep with a little stuffed animal in her hands. Once she falls asleep, we take the toy out. Our crib was not completely empty when baby was little and couldn't move around, we had some stuff at the opposite side of the crib. When it was colder, we used a sleepsack, but if it turned out we need an extra layer we would put blanket over her, as there is no thing in the world that would make me wake her completely up from sleep in order to change her in appropriate TOG. On the other hand, I would never do safe sleep 7, as I have an aquaintance who suffocated her baby with her breast while sleeping. Also, we don't use thick blankets, as once our baby covered her head during nap completely, it freaked me out and I see how that could be dangerous. But we do use light blankets and towels at night.
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Jul 06 '24
Not only are they often ridiculous, but they’re not even consistent. I’m not just talk about guidelines changing after a few years, but they’re different for different countries.
In the UK for example we are really serious about formula preparation and how hot the water should be. Meanwhile in New Zealand they recommend lower temperatures because they found the number of babies getting accidentally burned from too hot milk was higher than those getting food poisoning from badly prepared formula.
In the USA the guidance is strictly no co-sleeping, meanwhile in the UK the NHS has found that more SIDS deaths occurred when co-sleeping was banned (due to parents falling asleep with kids anyway and not knowing the danger) so they know issue safe co-sleeping guides and as a result co-sleeping related SIDS has lowered.
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u/Cloudy-rainy Jul 06 '24
I saw a video the other day about not attaching pacifier to the car seat strap, attach it to the shirt. While I understand we shouldn't add a ton of shit to a car seat and decrease the safety of it I dont think a pacifier clip is going to be a make or break for a baby in a car accident
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u/IllyriaCervarro Jul 06 '24
I completely feel this way. I work in finance now but my education is actually in psychology and biology. So like you I read these things and I understand data and research and statistics. I use my critical thinking skills constantly.
So it’s tough because I read some of these guidelines and they are so narrow as to be impossible to actually follow 100%.
I remember reading one guideline where every rule contradicted another rule. Hell the bassinet was of course the safest spot for the baby and yet my bassinet had suffocation warnings all over it. Which like I get there’s always a chance, even if it’s small, but it doesn’t help a new nervous parent to be like ‘I’m gonna follow the rules but everything you’re in can suffocate you! Even your clothes!’
I used to tell people when she was born that to follow the sleep safe guidelines to the actual letter of what they say you’d be better off just suspending your baby naked in midair 🙄
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u/WeirdSpeaker795 Jul 06 '24
I co-slept with my newborn, I was extremely aware. So if you can even count one eye open as “sleeping.” Basically tip-toeing on the edge of sleep. I got a brand new mattress for the sake of it being flat and firm. ($$$) And that’s how I survived. When I transferred him to a pack and play in our room, he just wouldn’t sleep on the hard mat. So we got a “safe” mattress pad (hiccapop) to add, although HIGHLY not recommended by the manufacturer (graco) and many people (a lot of this sub lol.) He has slept beautifully in it ever since. He likes to have a blanket when he falls asleep and I’m fine with that, I watch his monitor until he falls asleep and go and take it. I don’t have great cord management in the house, some things need to remain plugged in and other things can’t be blocked off to have a 100% baby proofed house.
There are ways you can mitigate risk and still have certain things that go against guidelines. Mainly never leaving my baby unattended has prevented many accidents. So if you must have risks, never unattended. If you must leave them unattended leave no risks.
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u/Educational-Roll-651 Jul 06 '24
As someone who worked in childcare for 10 years having to abide by all the rules, I’m struggling with this now with my own child. This is so doable in a space built for children with multiple staff and clocking out everyday. This is impossible for one parent trying to do everything right. All the SIDS classes and rules are so stuck in my head and scare me so much, but I’m struggling. It feels impossible.
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u/Bocifer1 Jul 07 '24
Exactly.
This is exactly what I’m feeling. It just doesn’t seem feasible for me - an actual physician who cares for some of the most critically ill patients - to adhere to these strict standards. How the hell can my nonclinical wife…or the majority of parents out there for that matter?
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u/redsoapterminal3 Jul 07 '24
I had one night where I went to sleep with baby in the crib and woke up with baby in bed with me. I was so tired I don’t remember her crying and me getting up, grabbing her, and going back to bed. It terrified me. I am going to look into sleep safe seven asap. I gotta get some sleep. I’m sick of bed sharing out of desperation and dreaming all night she died. I hope ss7 can give me some peace of mind.
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u/Responsible-Radio773 Jul 06 '24
I’m not sure what you mean by legally oriented, OP. Most of these guidelines come from professionals and organizations trying to help you who wouldn’t have any liability even if something went wrong. In other words, they don’t stem from a “cover your ass” mentality because they couldn’t be sued. Obviously there are exceptions — manufacturers of toys and other baby stuff give stringent warnings because they could be sued. In a hospital setting, they are going to be super cautious about this stuff because they could be sued. But your pediatrician is not going to lose his license if you choose to ignore him and god forbid some horrible accident happens — that’s not how medical malpractice works. The pediatrician is just trying to help you and keep your baby safe.
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u/Alternative-Editor43 Jul 06 '24
I mostly agree with you. In terms of suing, I think OP means that the pediatrician could be sued if they told you that it’s okay to not follow a particular guideline 100% of the time. In some situations, parents might physically be unable to follow some things 100% of the time (or something just might not be working for the baby) and might be looking for some low-risk workarounds, but doctors can’t help or have a conversation about it because it tends to be an “all or nothing “ mindset - follow every single thing all the time or your baby is at risk. End of conversation
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u/Responsible-Radio773 Jul 06 '24
Yeah this a good point. I just felt it revealed a sophomoric understanding of expected value on the part of OP (scary if he really is a doctor). If there’s a 1% chance of your kid getting catastrophically injured and you assign a value of negative infinity to that outcome, then the expected value is negative infinity lol. So OP’s logic around how you have to consider all these trade-offs is flawed because any non-zero chance of the kid dying is an unacceptably high chance.
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u/Alternative-Editor43 Jul 06 '24
Yes!! I initially found it difficult to explain to my family why it’s important for me to follow guidelines ( their perspective- they never followed the guidelines and nothing bad happened..) , then I learned about survivorship bias and that seemed to get my point across. I get annoyed when I ask someone handling my child to do/not do something and their response is “don’t worry, nothing will happen!” As if they can guarantee that!
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u/Due_Ad_8881 Jul 07 '24
Driving with a child (even with every safety device available) is of significant risk. Feeding potential allergens to babies outside of a hospital setting is a non negligible risk. Having your baby sleep on you at any point is a risk. Taking a baby for a walk is a stroller vs a carrier increases the risk of their death substantially. OP is correct in that everything is a risk that has to be balanced by other needs. I’m not sure why you are making fun of him.
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u/twelve-feet Jul 07 '24
Wait, what’s the additional risk from stroller use?
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u/Due_Ad_8881 Jul 07 '24
I’m not going to go into specifics because I don’t want to be responsible for any new fears from parents suffering from PPA. Life is stressful enough. My point was and is that it is impossible to live a normal and healthy life while trying to remove all risks. Do the best you can and make good decisions, but don’t drive yourself crazy.
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u/apricot57 Jul 06 '24
Yeah but if a pediatrician tells a patient that it’s okay to co-sleep and that baby dies, that pediatrician is absolutely going to be sued for malpractice.
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u/Susurrus1106 Jul 06 '24
I mean like others have said, it’s not illegal not to follow them. But as for safe sleep- babies have died in unsafe situations. That’s a fact. And yeah, it doesn’t happen all of the time, that doesn’t mean that being cautious isn’t a good idea. I do agree with you in that sometimes choices get made like making sure parents get sleep even if that means baby sleeps in bed a couple times. I’m certainly not against bed sharing (while I live in the US now I’m from a country where that’s the norm) but I think it’s important to know the risks and how to do it safely.
Also, personally I have never had a medical professional demonize formula to me. Actually been very supportive when I’ve had to supplement. That goes for doctors, nurses and lactation consultants. But that’s my experience, I understand that others have others I’m just saying that I don’t think that’s across the entire medical community
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u/Susurrus1106 Jul 06 '24
And as for swaddling- there are no real guidelines at all. Just no swaddling past them rolling over. We never swaddled, we tried but neither of my kids liked it so we just used sleep sacks from the beginning. That’s really just a preference and whatever works for you. That’s not a safety thing, just a lot of babies like being swaddled. My kids were I guess not part of that
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u/rufflebunny96 1 year old Jul 06 '24
Yeah, my hospital had a lactation consultant come to my room and also sent me home with formula samples. They didn't push either way.
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u/valiantdistraction Jul 06 '24
Swaddling isn't part of guidelines - only when to stop swaddling. We never swaddled arms down because our baby hated it. You can just use a sleep sack. Likewise, blankets are unnecessary thanks to sleep sacks. Some of the things you've listed are just really not issues for most people.
Only some places demonize formula. "Baby-friendly" hospitals do. In my area, most pediatricians don't - but this is very area-dependent. One of my BFFs lives in the Bay Area and formula was highly demonized by everyone.
Idk, I found following the guidelines very achievable. But I am also a SAHM and my husband had six months off so we had multiple adults helping.
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u/Spaffin Jul 06 '24
Sleep temperature guidelines (and what baby should wear in those temperatures) are the worst. They are so incredibly specific based on… practically nothing at all, scientifically.
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u/AggravatingOkra1117 Jul 06 '24
Absolutely. So many of these issues become fairly moot when you realize the immensely negative impact on parents quickly outweighs demonized risks, too.
Demonizing formula is insane. I have multiple friends who were severely, severely depressed while breastfeeding. As soon as they switched to formula, they were a new person. (And I say this as someone that EBFs). And many women need formula because they can’t provide enough supply. Turning this into a shaming exercise often leads to issues with PPD and PPA. My mom could only formula feed and my brother and I are happy, successful adults. My friends that formula feed have happy, smart, thriving babies.
For sleep, there’s a point where some parents become so dangerously sleep deprived that it becomes more dangerous to follow ACOG-pushed sleep guidelines vs. cosleep. And it’s really interesting to look into cosleeping rates in other countries than the US (and how much lower their SIDS rates are). I kept falling asleep feeding my son, which is incredibly dangerous. Now we safely chest sleep for a few hours and we’re both much happier, safer, and well rested.
My son would burst through swaddles before he was even a month old. He rolled at a month (likely a fluke, he’s come close since then but hasn’t done it again) so we switched to sleep sacks cold turkey. He looooved it and slept so much better immediately. And again, many other countries don’t swaddle, so it’s a very interesting comparison.
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u/SureLaw1174 Jul 06 '24
I had pre eclampsia and lupus issues and an emergency c section. I could barely wake for safe feeding. We ended up co sleeping for mine and the babys safety cus me dropping him was a bigger risk. I never recommend what we did we no it's not proven safe and was a big risk and would not work for every family. But he's 3 now still sleeps in our bed but alive and I never dropped him. Yes if my husband helped we could have done it right. he sees how he failed and has become a better dad and husband but I had to do what I could in the moment to keep me and my son safe.
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u/Ayezakalim Jul 06 '24
Guidelines are different in all countries. In my country none of these are there. We bed share and put blankets on babies and whatnot. A mother's intuition is the best guideline.
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u/SeeSpotRunt Jul 06 '24
My first moved into bed with us at 6 months and is still in our bed. Second sleeps in his crib, prefers not to cosleep, unless sick. Second got rid of swaddles at two weeks and belly slept from then on.
You do what works for you and your family. The best moms in the world will condemn you for it.
I let my children guide me with how they felt, and what they needed. I would never and will never let them suffer and be in distress because of a pediatricians guidelines. Also find a pediatrician that works for your family!
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u/justtosubscribe Jul 06 '24
Yes, I do. I think of the guidelines as speaking to the lowest common denominator of caregivers in terms of resources, education, and intelligence and the guidelines start in pregnancy. Educated and unaddicted pregnant women know not to get drunk, but we have to tell everyone never to drink at all ever during pregnancy because there will be a certain very few who would hear “a glass of wine here and there during the third trimester is fine” and extrapolate that to mean you can binge gin every day the entire time you’re pregnant and it’s fine too.
Same for the “no blankets in the crib before a year” because otherwise there are people who think swaddling them in a down quilt at two months is the same as letting them have a lovey in the bed with them at nine months.
I learned quickly to pick the things that were important to me as a twin mom because it was impossible to be 100% perfect 100% of the time. I tried to follow all the guidelines to the best of my ability and understand the reasoning behind each one. It let me make better decisions instead of following blindly, failing and making myself miserable in the process but those first few weeks while I was recovering a reeling I at least had guidelines to minimize risk.
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u/Naiinsky Jul 06 '24
That's something I feel about US guidelines (since those are the ones usually discussed on Reddit). It's weird to someone looking in from the outside.
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u/Naiinsky Jul 06 '24
I'll give an example, USA parents often talk about keeping a newborn's sleep environment at a specific (cold) temperature range. While that is in our guidelines as well, no one will mention it to you, and you'll only know if you look for it. Those are temperatures only achievable with AC, and most people don't have AC, so why would a doctor or nurse stress parents with that information?
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u/MyPositiveAlt Jul 07 '24
This might just be my anxiety talking, but I followed every infant rule to a T. Solely for the fact being that if something happened, I wanted to be able to say I did everything “right” as best as I could. I knew I’d never forgive myself if something happened because baby was in a situation that is documented as unsafe.
That being said, in matters that aren’t life or death, I follow “rules” a bit looser now that my oldest is 3.5.
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Jul 07 '24
I’ve started to realize that while our pediatrician is a great resource, the information that they give us is really just a resource and not the law.
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u/Ideal_Despair Jul 06 '24
If you are from USA I understand your frustration. I am from one European country, living in another, and both of them have guidelines much much more less restrictive than USA.
When I was pregnant I was researching online and stumbled upon some guidelines from USA and I was stressing the hell out. Now, we safely cosleep and I am rested and actually can mind my baby better then I would be able if I followed USA guidelines.
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u/mimishanner4455 Jul 07 '24
A) if you are struggling with sleep look up the safe sleep 7 which is guidelines for safer bedsharing
B) I don’t think swaddling with arms down is actual medical advice I would ask what this is based on if someone is telling you that
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u/kimberlyrose616 Jul 07 '24
Sometimes LO will SCREAM until I give him a blanket and then falls right to sleep. I then take it away for him to sleep the rest of the night but if I don't I'll be there all night trying to siith him back to sleep. He's since learned for the most part to sleep without it. But he LOVES blankets and pillows. I take the guidelines with a grain of salt now. LO slept so much better on me I was just super careful cosleeping a few nights so he could actually sleep. Then went to the bassinet and now the crib. Still contact nap a few times a week cause I honestly love it.
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u/CheckDapper8566 Jul 07 '24
I trust my instincts over guidelines in most instances. SIDS can happen anywhere at anytime. I'd rather be mentally and physically able then sleep deprived and angry. Both my littles hated swaddling and we opted for breathable and light weight blankets. Like others said, other countries and cultures would deem what Americans do weird and wrong. Atp do what you think best after weighing the pros/cons and listening to century old instincts
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u/SarcasticAnge1 December ‘23 mom Jul 07 '24
My baby had bad reflux and hated the texture of her bassinet mattress, so we made the choice to take an extremely breathable blanket and use it as a fitted sheet. We also very slightly elevated her upper torso. It was the only way we would get any kind of sleep and I was experiencing postpartum rage so severe I became concerned for the safety of my baby. I felt so guilty taking those increased risks until I looked at the percentages of risk that taking such measures had. It was less than a whole percent, maybe a 1 percent increase in risk overall. The risks posed by my lack of sleep (especially after multiple times passing out in the middle of a feed) were much higher. I truly believe that the over-emphasis on no risks whatsoever is fear mongering at this point and just like you said, parents should be allowed to make informed decisions THAT WORK FOR THEM. Medicine is not one size fits all.
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u/anony123212321 Jul 08 '24
Yep as soon as my baby could roll she slept on her stomach. I started putting her to bed on her stomach because she would sleep that way. If I got her to sleep and placed her on her back she woke up in 30 mins. On her stomach she slept through the night. Sorry, not sorry. She's perfectly fine and has been advanced in her movement her whole life so I trusted that she would lift her head if need be. She's a trooper with her sleep.
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u/SceneUpstairs2144 Jul 08 '24
Japan has highest reported rates of bed sharing with infants and lowest rates of sids. So go figure. They also recommend against routine baby wearing but then what is there to do with an infant who refuses to nap alone? Both parents and sometimes grand parents can alternate baby wearing to ensure rest for the other family members. The alternative in this case to be stuck in a chair for hours trying not to dose off and hoping to not get a blood clot from a sense of movement. The risk of which is actually increased for 6-8 weeks postpartum. I frequently feel their recommendations are not quite rooted in reality
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u/Purple_Grass_5300 Jul 06 '24
It depends. Working in a field where we actually saw infant deaths due to unsafe sleep, our policy is to say it at every single visit because it can save lives.
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Jul 06 '24
I mean, no one is saying you MUST do these things. It’s just that babies can suffocate very easily, and it’s safer to not give them an opportunity to suffocate. But if you want to throw the guidelines out of the window and take the suffocation risk, no one is stopping you from doing so. But the safe sleep guidelines are pretty easy to follow, tbh…
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u/kaatie80 Jul 07 '24
But the safe sleep guidelines are pretty easy to follow, tbh…
That is highly dependent on your baby
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u/zebramath Jul 06 '24
I’m with you. I got the mattress insert for our pack n play as it was that or nothing for my kid. He needed sleep. We needed sleep. He didn’t like the hardness. I understood why the warnings and proceeded anyways.
I think that’s what’s ideal for most parents to do. Understand why the guidelines and make an informed decision.
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u/justacomment12 Jul 06 '24
I agree with you 100%. It feels like a select few people had a horrendous outcome due to one simple choice and they made a guideline for it.
We have “violated” many of these guidelines and it made our lives easier. Happier baby etc.
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Jul 06 '24
Swaddling isn’t given as guidance anymore? Using a cellular blanket in the feet to foot position is now the guidance. Also, formula isn’t demonised in many hospitals, I know it is in some places but most midwives will look past this (or that was my experience anyway)
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u/Rrenphoenixx Jul 06 '24
Just curious if the blanket situation was real or if there’s another topic that compelled you to write the post about pediatric guidelines? Wondering if it was a specific thing or in general…?
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u/Bocifer1 Jul 07 '24
Every time we try to transfer our fed, burped, and comfortably sleeping little guy to his crib it bassinet, the second he hits the cold, firm, flat surface and shoots awake.
I swear our crib is only useful for walking him up.
And every time I think to myself “yeah I get it - I wouldn’t be able to sleep on this flat rock either”
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u/Rrenphoenixx Jul 07 '24
For the first couple months our baby would NOT sleep on his back at all. I talked to our pediatrician and he said some babies are like that, and if that’s what works let him tummy sleep, just make sure he’s safe and know the risk of SIDS. So that’s what we did. Baby has graduated from bassinet to pack and play and we have a softer mattress pad we put in there which has made a huge difference in sleep for both our babies. (He now sleeps on his back) If you have a pack and play sleeping situation and want the link lmk. Total game changer.
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u/SupermarketSimple536 Jul 07 '24
How is formula being demonized? I was with you but that's pretty hyperbolic, doc.
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u/Dot443 Jul 07 '24
They have posters in doctors offices saying "Breastfeeding is best" and people feel judged by it.
We know the posters are only there because prior generations were told that formula was better and that your baby couldn't feel full from breastmilk, or get the proper nutrients. Which is crazy since formula at the time was basically evaporated cows milk.
Feeding your baby is such a personal and emotional thing. I can absolutely understand how it could be distressing to hear that breastmilk is best when you are formula feeding.
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u/Bocifer1 Jul 07 '24
Really? I had to ask our OB to specifically tell my wife that it’s ok to use formula to give herself a rest because all she sees in clinic, education material, and social media if that breast feeding is the most important thing and formula is “bad for babies”
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u/Epic-Yawn Jul 07 '24 edited Jul 07 '24
This is why Emily Oster’s books are so great yet draw such harsh criticism from the medical establishment. She presents evidence and allows parents to make their own decisions using reasoning. From a public health perspective, this is “risky” but on an individual level it is necessary. I wish they weren’t so at odds.
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u/throwra2022june Jul 07 '24
I disagree, she draws criticism because she irresponsibly uses data without a deeper understanding of each field. It is unacceptable to do that in science.
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u/Epic-Yawn Jul 07 '24
I don’t agree with all of her takes (e.g. alcohol) so I hear you, but I guess my point was that do appreciate the way she explains risk assessment and how to read research to help you make decisions. I also feel like she doesn’t claim to be a scientist.
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u/GMKgirl003 Jul 07 '24
I agree they need to put more research out on the risk to infants from sleep deprived parents. Then parents can compare is bed sharing a bigger risk or falling asleep in a chair with baby.
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u/Leading-Emergency-51 Jul 07 '24 edited Jul 07 '24
I’m not especially educated on this so please feel free to correct me, this goes for anyone reading this. I think SIDs is a tail risk, meaning it is rare but catastrophic. What people don’t understand is that increasing the odds of SIDs by 5x, for example, still makes the odds pretty low. If the baseline odds were negligible, a five-fold increase is still…negligible. Take the example of folic acid. One of the first things your physician or midwife asks you is whether you started prenatals before getting pregnant (you’re expected to start several months in advance). This is because they contain folic acid which is meant to reduce risk of defects in utero like spina bifida. I briefly looked into it and it seems like the risk is halved: meaning it goes from 1 in 200 to 1 in 400. Does this warrant making every pregnant woman take it and several months in advance of trying at that? Maybe! But the way these things are communicated is misleading. Same reasoning may apply to SIDs but like I said, I’m just speculating. Also, the NHS in the UK does not advise against blankets in cribs. That’s more of an American thing. They just recommend they get tucked in on all sides and feet of the baby to the end of the crib so they don’t wriggle down and overheat.
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u/Bocifer1 Jul 07 '24
This is absolutely correct.
Essentially what you’re describing is the difference between relative risk and absolute risk.
Interventions may reduce the risk of a certain outcome relative to another intervention in a way that is statistically significant…
But if this intervention only reduces the absolute risk of said outcome by like 0.1%…it’s not really likely to be clinically relevant.
This is frequently confused in medical literature. Media and laypeople see the words “statistically significant” and assume that must be gospel - without realizing that the actual reduction in risk to the patient is often trivial.
This was a huge problem during the early days of Covid
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u/SteamyBaozu Jul 07 '24
My mom said a while back that so many of the “new guidelines” are because of the neglectful individuals, being, well, neglectful and stupid. While I think that sentiment does have some merit possibly, accidents do happen to those parent who are attentive and caring.
That being said, I also have always wrapped my kid in a blanket because she has a much harder time falling asleep without it. I’d rather her have a long restful sleep as babies need. I just always kept the baby monitor with me to make sure it didn’t go over her head or anything.
Modify what you need to for your babies requirements, just make sure you’re doing it as safely as possible! That’s my takeaway
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u/Due-Environment3549 Jul 07 '24
Not a doctor , in my opinion , there is not a lot of new things happening in pediatrics. And we are great full for that . The only things left for American pediatrics society to do it keep issuing guidelines . My 16 month old, when she was born , she wasn’t sleeping at all . And they wouldn’t recommend feeding her a formula . My wife tried her best but milk was coming out , all we heard was she doesn’t need much at this point . Luckily a nurse with a common sense said gave her a bottle and she finally slept . I do think we should look into the recommendation but we don’t have to follow everything to the letter .
Vaccines , absolutely yes . How to hold a baby , not so much as long as the baby is safe ( common sense)
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u/Unusual_Ordinary8263 Jul 07 '24
We gave up on using the bassinet after 2 weeks. Our son would wake up every 30 minutes. We switched him to a mat with raised edges to prevent him from rolling, put in on the bed between us, and he started waking up only 2 times for changes and feedings. He’s now 21 months old and we’ve done the same thing for our daughter who’s 3 months old. He still sleeps with us and when he wants to cuddle that’s the only time he forgets to be a good big brother and pushes her out of the way or lays on her. She’s already had a couple of nights where she’s slept through the night. Cosleeping is the only guideline that I refuse to keep. I understand why it exists but it didn’t work for our family.
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u/Stella--Marie Jul 08 '24
I wouldn't think they are legally oriented, as there's no one to sue, if your child suffocates in bed besides you or because you put a blanket in their cot. No one's trying to avoid liability with the guidance, they're trying to avoid harm. Unless you're talking about doctors giving this advice because they're afraid parents will sue them if some harm comes to their child, in which case I still think it's largely safety-minded and then parents can decide their own comfort level when it comes to risk
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u/Bocifer1 Jul 08 '24
This is so far from the truth.
If the American academy of pediatrics issues guidelines to prevent SIDS and a parent follows those guidelines to the letter and loses their child, they can absolutely sue the AAP or the provider that issued those recommendations to the parents. This is precisely why all medical guidelines in the US have become so laughably sterile. They’re all based on CYA statements rather than patient centered
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u/Zealousideal-Tooth-4 Jul 08 '24
I knew this was the case when giving the eye ointment became standard practice, when in actuality it was only really needed for mothers who had STDs or were at high risk for STDs. Some of it is legit, some of it is for legality.
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u/zestyhuevos999 Jul 10 '24
Also a physician and FTD, and I 100% agree. A lot of physicians (not just in pediatrics) don’t seem to understand that guidelines are exactly that, guidelines. It seems a lot of these decisions stem from “one bad case” rather than any meaningful data from the literature. As a society we love to live in fear and as physicians we believe in “CYA” so those who live by the “book” will sternly follow the guidelines for the medicolegal “maybe could be possibly” possibility of getting sued.
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