Positional Asphyxia - I Never Knew

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

[nannyde]

Nice post

When you know better you do better.

Now you know.

[Cat Herder]

Thank you for this post.

[laundrymom]

Thank you.

[Heidi]

I also never knew this until I learned it here.

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

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

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

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

[Unregistered]

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

[Cat Herder]

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

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

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

check out www.firstcandle.org/

www.heart.org for infant cpr

[Meyou]

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

Here are two questions though....

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

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

[Cat Herder]

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

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

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

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

[Solandia]

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

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

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

[Meyou]

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

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

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

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

[MarinaVanessa]

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

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

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

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

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

[Meyou]

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

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

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

[tweedledeedum]

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

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

[harperluu]

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

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