Traveling With Baby

At one time, visiting our parents was as simple as making sure the lights and oven were off and hopping in the car for a three hour drive. Now that we have a baby, that same trip can take up to six hours between getting all of the baby’s gear loaded (he has more stuff than we do!) and stopping to feed him when he cries. Traveling is a big deal when there is so much to be responsible for; it’s a wonder we are able to make it anywhere on time.

Our latest trick is to wait until the baby goes down for the night then load him into the car seat and take off. This technique means we can drive straight through without stopping for bottles and the baby wakes up at grandma’s house so there is a smaller period of adjustment. It can be very tiring to arrive at our destination so late, but the benefits seem to outweigh the drawbacks.

I was concerned about the advisability of letting the baby sleep in his car seat for such long periods of time. Doctors warn against letting babies sleep in car seats citing increased risk of SIDS but the problem factors seem to be unrelated to the child sleeping in the car:

• The airway can become blocked if the head is flexed forward
• When the head is flexed forward, the jaw contacts the chest, obstructing the breathing pattern
• This can happen when the restraint is not used and the child has poor control of their head – normally they are younger than 6 months of age
• The particular cases being warned about involved children being placed in car seats to sleep rather than during use as safety devices in vehicles

Car seats here in Canada are designed for babies to sleep in comfortably even when being transferred from the indoors to a car and back. Being able to load the baby without waking him up is convenient for parents and healthier for the baby. When used properly car seats reduce injury by 90 to 95 percent.

Back to traveling – is it safe to keep the baby in the car seat for those long trips? The answer is yes, provided breaks are taken when the baby is awake so he can be released from the car seat and allowed to stretch. An 8-hour non-stop trip in a seated position places a lot of stress on the baby’s developing spine so it is important to move him from time to time.

Baby Sleeps on His Back

We can’t stress enough the importance of placing newborns to sleep on their backs. Research has shown that babies who are placed on their backs to nap are less likely to succumb to SIDS.

The ‘Back to Sleep’ campaign is a new phenomenon. While the jury is out on exactly why sleeping on the back is better, the number of SIDS-related deaths in the USA has dropped from 5,000 to 3,000 annually since back-sleeping parents has been recommended to parents.

Some babies – especially newborns – are soothed when placed on their stomachs. If you do need to place you baby on their stomach, supervise them the entire time. Place them on their back when they are to sleep.

In regards to choking and vomiting, babies are hard-wired to spit up and placing them on their back does not increase their risk of choking.

Sharing the Bed with Baby

The issue of co-sleeping with baby is one that doesn’t come up in our household. For us, it just isn’t something we would be comfortable with. When he comes home with us the little one will sleep in our room in his own bassinet until he’s old enough to go into his own crib.

Other parents decide that the best place for baby is in bed with them. Parents worldwide share their adult beds with their infants and find the practice increases their closeness to their child, makes feeding easier, and helps sync their sleep patterns with the baby’s.

Experts Say No

In North America, the practice is generally frowned upon by those “in the know”. The reasons given by the likes of the U.S. Consumer Product Safety Commission (CPSC) and the American Academy of Paediatrics (AAP) include:

Bed-sharing increases the risk of SIDS when one or both adults is a smoker

Bed-sharing increases the risk of suffocation because the baby can become wedged between the mattress and headboard/nightstand

Bed-sharing increases the risk of suffocation because the adult can roll onto the baby during sleep

· Co-sleeping increases the risk of strangulation when the baby is placed in a bed containing a headboard with bars or gaps wide enough for part of their body to become entangled

Experts Say Maybe

Interestingly, I was able to find a report from the AAP that suggests research data neither condemns nor endorses bed-sharing. You need a subscription to view the full report, but you can find a link to it below.

In short, research data indicates there are risks associated with bed sharing, while conflicting research indicates the practice is safe.

Does Common Sense Say Yes?

Let’s consider the issue from a practical standpoint. The number of babies born in North America over the last 10 years is in the millions. The number of babies who are known to have died as a result of bed-sharing is in the hundreds. Just looking at the numbers, I wouldn’t be inclined to see this issue as a danger to my child, particularly given the positive developmental opportunities that exist here.

However, if even one baby were to be hurt, I know that I wouldn’t want it to be mine so regardless of the numbers and arguments, every parent has to decide what they feel is best. But I offer this list of preventative measures to help keep baby safe:

1. Don’t smoke. The health advantages of quitting notwithstanding, I won’t go on about the risk to the child or repeat the ‘quit now message’ we’ve heard so much it lost all meaning. Just don’t smoke – if you do smoke, don’t co-sleep.
2. Always place baby on her back.
3. Never co-sleep in a waterbed.
4. Make sure your headboard (and footboard, if you have one) is of solid construction and doesn’t feature holes for baby to become stuck in.
5. Make sure your bed frame is tight and secure, and there are no spaces large enough for baby to fall into. The two-finger rule that applies to car seat installation applies here.
6. Never sleep next to your child if you have consumed any kind of drug, including cold medicine and alcohol. Your body will not be as intuitively aware of the baby’s presence in your sleep and you risk smothering your child.
7. Keep pillows and soft blankets away from baby as these pose a choking hazard.
8. Get your doctor on-board with your plan. Even if your pediatrician is against bed sharing, s/he may be comfortable enough to give the green-light if you can convince him that your setup is sound.

A Middle Ground – Side sleepers

I would suggest the use of side sleeper (sometimes known as “Co Sleeper”) beds as the middle ground for parents who are considering co-sleeping with their infants but are concerned about the possible risks. These products are essentially a bassinet with three rails that attach to the side of the adult bed. Babies and parents gain the benefits that come from bonding and sharing a sleeping space, while also enjoying the protection of personal sleep environments that are tailored to their softness requirements.

Arm’s Reach (http://www.armsreach.com/) is one company that specializes in the construction of co-sleepers, Baby Bunk is another (http://www.babybunk.com/).

Useful/Source Links:

http://aapgrandrounds.aappublications.org/cgi/content/extract/8/4/46

http://www.armsreach.com/

http://www.babybunk.com/