Alice Gregory is a highly respected expert on sleep throughout development. She has been researching sleep for almost two decades and has published more than 100 articles on this and associated topics. She completed her undergraduate studies at the University of Oxford, her PhD at the Institute of Psychiatry, King’s College London, and is currently a Professor at Goldsmiths, University of London.
In this extract Alice Gregory, author of ‘Nodding Off’ and sleep expert, talks about sleep safety for babies.
While suffering the challenges of night waking, parents of young infants can be tormented further by the way their children’s sleep changes from one night to the next. Night-tonight variation can make the weather look like a paragon of stability. When a parent joyously declares that their young infant has started ‘sleeping through the night’, we have to wonder whether it will last. One night of uninterrupted sleep doesn’t mean that disturbed nights are a thing of the past, just as a ray of sunshine in March doesn’t forecast a glorious summer.
Anything that can cause pain or discomfort can affect infant sleep. This translates to potentially problematic sleep for any child who has an upset stomach, headache, slight cold, earache, or arm ache from an injection, plus any kid with a wonky nappy, a Babygro that was washed with (or perhaps without) fabric conditioner, or who is placed in a room that’s a little too hot or cold for their liking. Thinking about it in that way, it seems a miracle that babies ever sleep.
A baby who sleeps through the night may be a parents’ dream, but if that baby is newly born this could be worrying. Certainly, small infants need to wake up: their bellies are tiny and without waking for milk they could become weak and dehydrated. Even older infants and children do not need to sleep for excessively long periods and doing so may at times suggest that there is a problem. Guidelines on how long people of different ages should sleep wisely incorporate the idea that one child’s need may differ from that of another.
Before considering the techniques available to help with children’s sleep – safety needs to be at the forefront of our minds. Any Brit of my generation will remember with horror the cot death of four-month-old Sebastian, the son of the UK TV presenter Anne Diamond. There is something about a TV presenter that makes us feel that they are part of the family. We share our breakfasts with these people – they are in our bedrooms and living rooms first thing in the morning and the public sorrow was immense.
As reported by the BBC, following this tragedy, a grieving mother found the strength to promote safe sleeping practices in infants. The campaign was called ‘Back to Sleep’. It highlighted the importance of laying a baby on its back to sleep. Countless deaths were prevented as a result of this campaign. The statistics speak to that: in the UK, more than 1,500 cases of sudden infant death syndrome (SIDS) were reported to have occurred in 1989, just two years before the death of Sebastian; this had reduced to 214 cases in 2015.
Guidelines about SIDS are constantly reviewed in line with best evidence and so change over time. Recent guidelines include, among other recommendations, making sure that infants are placed on their back for every sleep and letting infants sleep only on firm surfaces – such as appropriate mattresses in cribs that have been safety approved. It’s also been suggested that infants should sleep in their own space (such as their own crib), but in the same room as a caregiver. It’s important that an infant does not overheat as they sleep, and soft objects such as toys and loose bedding, pillows and bumper pads should be avoided and kept well away from infants during the night.
Advertisers need to catch up on the importance of promoting safety and stop portraying unsafe sleep environments, such as bumper pads and loose bedding, when marketing infant cribs. Much as it might look cute to show a baby dreaming among a sea of soft toys, this isn’t a scenario that should be encouraged in case of accidental suffocation. It simply isn’t worth the risk.
In an attempt to help keep babies safe, hospital staff in certain parts of the world are now sending new parents home with a cardboard box. This idea originated in Finland in the 1930s when the government provided parents with a box full of all of the bits and bobs needed for the arrival of their new baby. The boxes had the added benefit of providing a decent location for the babies to sleep too. Sleeping in boxes perhaps conjures up images of the inadvisable practice of allowing babies to sleep in dresser drawers in years gone by.
Although schemes similar to that in Finland have since been adopted in Scotland, Argentina and New Jersey, not everyone is happy with this initiative. Sceptics point out that any apparent benefits of this scheme may be coincidental and reflect general improvements in healthcare. Charities have also raised questions about safety testing and argue that Moses baskets and cots are the best place for a baby to sleep.
Alice Gregory is the author of Nodding Off (published by Bloomsbury Sigma, £16.99) – Buy now on Amazon