Helping Babies Sleep Safely

by Richard H. Middleton, Jr. & Leah S. Guerry

Doctors are still uncertain about the cause of Sudden Infant Death Syndrome (SIDS), but some companies are coming out with products marketed to reduce the incidence of this worldwide problem.

SIDS, also sometimes called "crib death," refers to the sudden death of an infant less than one year old whose death is unexplained, even after a complete post-death examination of the child and scene of the baby's death, and analysis of family medical history and any symptoms the baby had prior to death.

Since 1992, the American Academy of Pediatrics (AAP) has recommended that all healthy infants be positioned on their backs for sleep. The academy based its recommendation on reports that revealed babies who sleep on their stomachs have a higher chance of dying of SIDS. According to the AAP, incidence of stomach-sleeping decreased from 75 percent in 1992 to 25 percent in 1995.

Placing babies on their backs for sleeping is an important step for parents and care givers to take to help reduce the risk of SIDS. Some companies are taking that recommendation -- plus others like providing firm baby bedding and good ventilation around the baby -- into new marketing territory.

Some companies now make foam wedges to prop babies into a side-sleeping position. Others make mattresses and crib pads designed with special material or other mechanisms to increase air flow around a baby's face.

One maker of a baby-positioning product includes on its Web site information about the AAP's recommendation for back sleeping and a note to parents about SIDS. The company does warn that its product will not eliminate SIDS and that parents should consult their pedia- trician about their baby's sleep position. Another company, which is overseas, boasts of its product track-record: No reported cases of SIDS involving its company's mattress covers or special sheets. This particular company says its products protect babies from toxic gases generated from various elements.

Some medical experts, like those at the National Institute of Child Health and Human Development at the National Institutes of Health (NIH), have not yet come out with an opinion on the use of certain products like "wedges" to help prop babies into sleeping position because safety and efficacy studies have not been done. The AAP takes a similar stance. Its Task Force on Infant Sleep Position and SIDS does not recommend products that help keep babies off their stomachs while sleeping.

A recent St. Louis University School of Medicine study of eight different baby sleep products marketed to reduce the risk of SIDS recently found that only one of the products achieved what it claimed -- prevent exhaled air (carbon dioxide) from being trapped near a baby's face. The product, the Halo Sleep System, is a $200 mattress with a built-in fan that propels air toward the baby.

Dr. James Kemp, an associate professor of pediatrics at St. Louis University School of Medicine, who led the study, first examined all the products and then made recommendations to manufacturers as to how their products could be improved. Originally, none of the eight products did what manufacturers claimed. The maker of the Halo Sleep System was the only one whose product improved. A spokesperson for the medical school says the engineer of the Halo Sleep System lost a child to SIDS.

In the study, doctors concluded, "Standard, firm bedding and most items said to prevent re-breathing, do little to reduce, or may worsen, [carbon dioxide] trapping; most cannot be recommended for infants who might turn their face down; and industry standards for re-breathing based on biomechanical models should be developed." The medical school's spokesperson says the doctors have sent their recommendations to the U.S. Consumer Product Safety Commission (CPSC) for comment.

Ken Giles, a spokesperson for the CPSC, says the commission started an investigation "weeks ago" to see if products that claim to prevent SIDS are risky.

"Our investigation is not from the truth-in-advertising point of view. That's something the Federal Trade Commission would do. Our investigation is from a safety standpoint," says Giles.

The CPSC is not releasing any details of its investigation at this time. Giles says, "It could be months before we know anything."

The following list is a reminder of CPSC recommendations for a safe baby sleeping environment:

Place baby on his/her back on a firm, tight-fitting mattress in a crib that meets current safety standards.
Remove all pillows, quilts, comforters, sheepskins, stuffed toys and other soft products from the crib.Consider using a sleeper as an alternative to blankets, with no other covering.
If you use a blanket, place baby with its feet at the foot of the crib. Tuck a thin blanket around the crib mattress only as far as the baby's chest.
Make sure the baby's head remains uncovered during sleep.
Do not place the baby on a waterbed, sofa, soft mattress, pillow or any other soft surface to sleep.
Do not place the baby in an adult bed

Richard H. Middleton, Jr., president of the Association of Trial Lawyers of America, is a partner in the Savannah, GA, law firm of Middleton, Mathis, Adams & Tate, P.C.

Leah S. Guerry is the executive director of the Louisiana Trial Lawyers Association

Reprinted with permission of Louisiana Trial Lawyers Association, P. O. Box 4289, Baton Rouge; (225) 383-5554 or (800) 354-6267.