SLEEPING SAFELY IN A CRIB

NEW YORK TIMES COLUMN: FAMILIES TODAY:
SLEEPING SAFELY IN A CRIB
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. With the new precautions for SIDS in the crib, how do I help my infant learn to comfort himself? We follow the current thinking to keep a crib uncluttered with pillows and blankets.

In your books you suggest a “lovey” or a blanket for transition time. My son hasn’t yet found such an attachment.

We’ve gotten him to sleep in his crib at night, but he resists bedtime and is inconsolable at nap time. Instead, I continue to lie next to him on our bed, which isn’t safe if I leave the room.

A. The Back to Sleep campaign, sponsored by the National Institute of Child Health and Human Development, nichd.nih.gov/sids, has reduced the incidence of SIDS (Sudden Infant Death Syndrome), also known as “crib death.”

We should all stick with the campaign. Back to Sleep recommends placing babies on their backs to sleep. But we are still learning about the impact of altering infants’ spontaneous sleep positions and of giving up traditional ways to help them stay asleep.

Many parents find that their infants have trouble settling into a restful state when placed on their backs to sleep. In this position, babies can’t easily curl up into the more familiar fetal position or get their hands to their mouths to suck and soothe. Swaddling can help babies settle down to sleep. Swaddling’s pressure may feel like the womb’s support.

We agree with you that infants must learn to console and comfort themselves. The ability to experience distress, and to overcome it, is developed early and lasts a lifetime. The ability starts with a parent or other caregiver’s soothing a baby, who gradually learns to imitate and then internalize it.

Infants discover how to comfort themselves – sucking a thumb or finger, or stroking their cheeks or a blanket’s soft satin border. You can introduce your baby to his thumb, or to a small stuffed animal or a piece of soft cloth – be sure that there’s no possibility it could obstruct his nose or mouth.

Hold the object close while you lie with your baby so he connects the comforting feeling of your skin, warmth, breath and heartbeat with something small and safe that may even take on your familiar smell. Try a soft piece of one of your own old shirts. Other ways to make a crib more welcoming: Record yourself singing your baby’s favorite lullaby and play it softly as he goes to sleep. Or try a CD of lullabies by others.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton heads the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.