Safe to Spit Up: Car Seats and Other Elevating Dangers for Babies

 In April 2015, an Oklahoma family lost their two-month-old son, Shepherd Dodd, because he suffocated when his in-home child care provider left him napping in a car seat. It's making the national news and social media rounds now because Shepherd's story is getting the attention of state legislators on the serious issue of safe sleep standards.

What is safe?
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According to Dr. Erich K. Batra, as quoted in the The Journal of Pediatrics April 2015 article
"Cribs Are for Sleeping, Car Seats Are for Traveling: Danger in Using Sitting and Carrying Devices for Sleeping Infants," “Infants and young children should not be left unsupervised when using a sitting or carrying device due to the risk of suffocation and death.” The keyword here is unsupervised.

This article also sources seven main tips as outlined below:

• Do not leave children unsupervised (awake or asleep)
• Never leave children in a car seat with unbuckled or partially buckled straps
• Car seats should never be placed on a soft or unstable surface
• Infants in bouncers, strollers, and swings may be able to maneuver into positions that could compromise their airway; straps on these devices may not prevent infants from getting into hazardous situations
• Ensure that infants cannot twist their heads into soft bedding or slump forward in a seat; restraints should be used according to manufacturer’s instructions
• Slings are particularly hazardous because of their design and the ease with which an infant’s airway can be collapsed. If used, the infant’s face should be “visible and kissable” at all times
• Do not place more than one infant together in a swing meant for one infant.
  
  

These may seem like common sense tips, but it truly takes an extraordinary vigilance. For new parents, or those without reliable gut instincts, child care sources, support systems, or more realistically - haven't slept in days, weeks, months - these can be some trying times. 

And what about reflux babies? 

Two words: ELEVATION and SLEEP. They do not work together, and even worse, can cause mounting risks. 

A very common remedy to help alleviate reflux: elevating and or inclining your babies position after feedings (such as baby wearing) and for sleep and resting (such as using a crib wedge mattress or other solution). Mix in uber-stressed-out, ultra-sleep-deprived parents and/or caregivers, and hazardous situations can present themselves. As seen on various searches online, what works for some parents doesn't follow these guidelines, even if conducted under strict supervision.

In my home state of Ohio, the Department of Health, early in 2015, launched a "safe sleep" campaign to address one facet of high infant mortality rates, ranking fourth in the country (3 each week in the state). In their messaging, the concern of back sleeping and choking was broached, including links to a diagram on the National Institutes of Child Health and Development Safe to Sleep and SIDs prevention page. 

In short, in my opinion, the situation of safe sleep is 100x more amplified for parents and caregivers dealing with reflux, silent reflux, colic and other common infant issues. It's a huge challenge creating a safe sleep environment for a baby that spits up in their sleep, or can't seem to sleep at all. It's goes beyond the crib and creating a safe physical, mental and emotional space for the whole family. Many families don't have the means to purchase a wedge or specialized reflux device or solution. 

I can only offer two more words: AWARENESS and SUPPORT. That is my plea to everyone out there in these situations for themselves, and the friends, family members and even just acquaintances in your world. Parenting is tough, and scary, and requires vigilance - and in these early months - it can take more than you have to give. I hope we can continue to spread the word and build the support systems needed.

Article links:

Parents prompt legislative study after baby dies while sleeping in car seat - Fox23.com

Cribs Are for Sleeping, Car Seats Are for Traveling: Danger in Using Sitting and Carrying Devices for Sleeping Infants - jpeds.com

Ohio's Infant Safe Sleep Campaign - Ohio Dept. of Health

Frequently Asked Questions for Safe Sleep - National Institutes of Child Health and Development

Parents Whose Baby Died Warn: Don't Let Babies Sleep in Car Seats: Parenting.com

CarSeatLady.com Cold Weather Tips