Nursery Safety: A refresher course

03/29/2008 at 02:00 PM ET

Update: See our additional safety tips in the extended post.

Originally posted March 28th: The recent controversy over the safety measures (or lack thereof, according to Parents magazine) employed by new moms Brooke Burke and Jennifer Lopez in their baby nurseries has been dismissed by many of our readers as a gross overreaction.  Still, others insist its a matter of serious concern.  No matter where you fall on the safety scale there are some basic, universally accepted rules for minimizing danger to baby while in their nursery — the room they’re likely to spend most of their time in as infants.  We at CBB thought it might be a good time to refresh ourselves on just what those rules are.

Click Continue Reading for the safety recommendations. 

SmokealertFirstand foremost make sure you have a working smoke detector in or justoutside your nursery, as well in or just outside of all sleeping roomsin your home, and on every floor, including the basement.   
Jpma_logo
Whilea new crib is almost always best, putting baby to sleep in a used cribis fine — so long as it was made after 2000, is in excellent shape,has not been the subject of a recall and comes with the Juvenile Products Manufacturing Association (JPMA)certification seal. Outdated models have slats that are too far apart,which makes it possible for a baby’s limbs to become stuck; a safe cribshould have slats that are no more than 2.4" apart.

Large_velboasleepsackblue_2While it doesn’t pack the prettiest punch, a fitted sheet should really be the only thing in the crib besides your baby.  Bumpers, stuffed animals, pillows and blankets look warm and cozy, and can really help pull your nursery look together — but they represent a major suffocation hazard.  Instead, stack the stuffed animals on a shelf and hang the quilt on a wall (both away from baby’s reach, of course) so that you retain the aesthetic appeal of these items without sacrificing safety in the process. And to keep baby warm at night, dress him in a wearable blanket or swaddler like those from Halo or Bonkie Baby. Also, it’s crucial to remember that infants should be put to bed lying on their backs to prevent SIDS. (This is the opposite of what they told our parents so don’t be surprised if your mother tells you not to do it.)

Tinylovefarmyard_a01The crib mattress should fit snugly with no more than two fingers width between its edge and the side of the crib.  Mobiles are fine so long as your baby is immobile, herself.  Once she’s able to get onto her hands and knees, usually around the age of 4- or 5-months, the mobile becomes a strangulation hazard and should be removed from the crib.  Make sure baby’s crib is not within reach of a window, curtains, blinds or outlets and — on a related note — use outlet plugs both in the nursery and throughout your home.

Antitipstrap Anchor all large pieces of furniture — including dressers, bookshelves and armoires — to the wall.  You’d be amazed at how quickly a crawling baby can figure out how to open a drawer and climb inside; If not bolted into the wall, that dresser can topple over in an instant, causing serious injuries or death to the baby trapped beneath.  If you’d like to use a changing table, look for one with elevated sides that will help prevent your baby from falling.  Use the safety strap, and try to always keep one hand on your baby while you’re reaching for diapering supplies.  For obvious reasons, those supplies should be kept within your arm’s reach — but not within baby’s!

CoolmisthumidifierTo ease nasal congestion during a cold, use a cool-mist humidifier.  While its true that a cool-mist humidifier can become a breeding ground for mold and bacteria, it isn’t an issue if you maintain a regular cleaning schedule of the tank and related parts.  A steam vaporizer — while better from a mold/bacteria standpoint — poses a significant burn risk to baby, and is thus widely considered the less-safe option.   


Here are some additional safety guidelines, as inspired by questions from readers, with information from First Candle, a wonderful national nonprofithealth organization uniting parents, caregivers and researchersnationwide with government, business and community service groups toadvance infant health and survival. (The name First Candle comes from the first birthday candle on a child’s cake.) We will post more information as questions are asked.

SIDS (Sudden Infant Death Syndrome)

  • The current research about SIDS (formerly known as crib death) points to two leading causes: re-breathing carbon dioxide and overheating. Most recommendations revolve around providing a safe sleep area for baby.
  • A recent breakthrough in SIDS research has discovered that there is a population of babies that are born with a defect in their brainstem where serotonin is used and recycled. Serotonin controls all of the baby’s major bodily functions such as heart rate, breathing, arousal, temperature and blood pressure. SIDS victims do not have enough serotonin receptors to carry important messages to the brain. In other words, in situations where an alarm would normally sound in the baby’s brain to help them respond to a challenge, no alarm is sent and the baby sleeps through the challenge and can die – suddenly and unexpectedly.
  • Re-breathing carbon dioxide happens when you breathe exhaled air (which is very low in oxygen) instead of fresh air. When babies sleep on their stomachs, they are re-breathing the low oxygen air that builds up around their heads and faces.
  • This is why it’s so important to put baby to sleep on their back. Since the "back to sleep" campaign launched in 1994, SIDS rates have been reduced by more than 50 percent (the                      equivalent of sparing the lives of more than 3,500 babies each year.)
  • Despite this progress, SIDS remains the number one cause of death for infants from one month to one year of age – still claiming the lives of approximately 2,000 babies each year (7 babies each day.)  Recent studies have shown the risk of SIDS to be double for African-American infants and two and one-half times greater for Native Americans. A disproportionate one-fifth of all SIDS deaths occur in childcare settings.
  • The reason it’s important to remove all sof
    t items from baby’s sleeping area like pillows, blankets, comforters, soft or pillow-like bumpers, stuffed animals is because they can block the flow of fresh air. That and they can literally block the baby’s airways.
  • Overheating is caused by too much warm clothing or too warm a room. Dress your baby in the same warmth of clothing you are wearing, then remove an item.

Additional Sleep Safety Tips

  • According to First Candle, the ideal place for a baby 0-6 months to sleep is in a safe sleep area covered only by a sheet next to the parents’ bed like in a co-sleeper, play yard, bassinet or crib. If your baby sleeps in another room not in hearing distance, use a baby monitor.
  • If you are going to share a bed with your child, be sure to take precautions (click here to see what they are). Regarding SIDS and co-sleeping, Dr. Sears says, "I believe that in most cases SIDS is a sleep disorder, primarily a disorderof arousal and breathing control during sleep.  All the elements of naturalmothering, especially breastfeeding and sharing sleep, benefit the infant’sbreathing control and increase the mutual awareness between mother and infant sothat their arousability is increased and the risk of SIDS decreased." It’s interesting to point out that cultures where parents co-sleep with their babies have the lowest SIDS rates.
  • Babies under 6 months should not be put to sleep on their stomachs unless instructed to by your doctor. By the time baby is able to roll over into a different position consistently, they are in a much safer zone and at less risk for SIDS. The American Academy of Pediatrics says that it is not a good idea to put babies to sleep on their side because there’s too much risk that they’ll roll over onto their stomach. Just make sure there’s nothing that could make it hard for them to breath.
  • The advantage of having baby in the same room as the parents is that they are easily alerted to abnormal breathing or other signals of distress, thatmay be missed if the baby were in a separate room.
  • Offering a pacifier at naptime and bedtime is believed to decrease the chance of SIDS, say the AAP and First Candle.
  • More sleep tips at AskDrSears.com.

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Showing 25 comments

Nicole on

The one thing that I never really got was no blankets and things – because you always see babies with blankets on TV. But I totally get that it causes a hazard – when is it okay to start putting blankets and stuffed animals in? (I don’t have kids yet, but it makes me very curious).

Jessica on

That’s a good question and i am also myself curious on that. When is it safe to cover a child with a blanket in a crib?

Amy on

I recently started putting a blanket in my daughter’s crib and she is almost 2 years old. She still doesn’t get the concept of covering up, so it is really pointless. We have just always dressed her very warmly to sleep so it was never an issue. My opinion was that when she could stand up in her crib, roll over, sit up, pull things off herself, etc I figured she could handle it. I’m not sure what the standard recommendation is though.

Kris on

I don’t remember what the recommended age is for using a blanket but we just avoided them until our kids were in big kid beds (over 2 years old). They moved around so much they never would have stayed covered anyway. We opted to just put an extra layer of pj”s on them and they slept just fine that way.

Thanks CBB for putting this out there. It’s always nice to have safety reminders easily accessible.

Noe on

Could it possibly be that they sup up the nursery’s for the visit? I mean can we give these ladies some credit?

Amelia on

Awesome! Thanks so much for the tips!

In addition to the above questions, when is it safe to start letting the baby sleep on their stomach?

tink1217 on

I would love to know how all of us survived years ago when babies were put to sleep on their tummies, with blankets, and in cribs with bumpers. I totally get it about the safety issues now. I really do. I just wonder how all of us survived before all this started coming out and being considered what is safe?? That being said…if I have another child I will follow guidelines to be on the safer side of things.

lizzielui on

Tink1217: Actually, all of us didn’t survive. There have been thousands of crib deaths, from various causes, over the years. Sometimes, they have been unexplained or sometimes they have been chalked up to just a baby being sick and dying, but it happens. We just hear about the stories more now because communication among the masses is much better. However, my paternal bore 11 children, three of which died in the crib before their first birthday. Back then babies were put to bed on their stomachs, with blankets and toys, and in cribs that had no type of bumpers so anything could have happened. When I was was two years old (back in the 70s) my infant cousin suffocated from a heavy blanket that was left in her crib to keep her warm. Somehow, she moved so much throughout the night that the blanket went over her airways and she died. When they found her the next day her face was scrunched up underneath the blanket just above her nose. So yes, the dangers have been around for many many years.

Lauren on

Personally it makes me so horribly upset how negative people are about baby safety. When my daughter was born everyone from family and friends to tv magazines books and more talk about SIDS like crazy! I had PPD very badly and the fact that everyone and their mother decided to tell me that if I used a blanket on my daughter she would suffocate or if I didnt put a hat on her she would get sick. She is alright and I did everything I could to keep her that way. I just think that new mothers are sensitive enough and that the constant criticism is nothing but a nuisance. Not saying safety isnt important just saying that everyone needs to take into consideration the emotions of new parents and not bring up possible death of babies like they do.

Elizabeth on

Oh give me a break. As far as the blankets and pillows in the cribs, I’m willing to bet almost anything that these nurseries were set up for the photo shoot, and that these ladies aren’t stupid, nor do they lack the resources to find out what it takes to properly baby proof a room. As said above, give them some credit. These babies aren’t even moving around enough at this point for half of the safety issues that were pointed out to even matter. Let’s just assume they’ll take care of what they need to as they go. Goody two shoes blogs make me sick.

Stephanie on

Ugh, Tink, it annoys me to no end when people say something like “well how did we all survive…” We DIDN’T all survive! The safety measures have improved over the years precisely because we know what caused some babies to die “back then.” My mother-in-law loves to tell the story of how she put my husband in a plastic bucket in the car when he was a baby and he was “just fine.” Uhhh, well were ya ever in a car accident?? No, thank God, they were not…and that’s what carseats are for – just in CASE we get in an accident, right? Otherwise, sure it’d be fine to ride down the road with your infant in your arms, but the reason for a carseat is obviously because you cannot take that chance. I’m all for taking all the well-researched safety measures I can to protect my child, as I’m sure most people are.

I have to say that I agree with Parents magazine though, that JLo nursery is not practical or safe and seems like a huge waste of energy for a frilly photo shoot :( I mean I guess I thought it was pretty in a museum-quality kind of way, but I sure didn’t want it for myself in any way. As a mom of a toddler, I know how frustrating it can be to try and wrangle him in a non-childproof space!

Thanks CBB for the safety reminders, my husband and I are constantly continuing to baby-proof our new home as our 1 year old finds something new everyday!

cc on

crib sleeping for a newborn infant is a hazard! babies die of SIDS because they dont have an adult to regulate their own heartbeat by. we have evolved as a species to be close to our young and protect them through the night. Co-sleeping is the healthiest thing to do. this is why babies have attachment issues when they grow up. if your baby sleeps with you, you can always know if they are safe. adults can naturally monitor the child in bed even when they are sleeping. i did it and my son is one now, and he is the happiest, healthiest most friendly kid i know. he doesnt suck his thumb or have any attitude problems.

jessica on

Having a baby sleep in bed with its parents sounds wonderful, but please remember it will not work for everyone. In some cases it would be very dangerous. I am a very heavy sleeper- NOTHING wakes me up. I do not have children yet, but I would never consider putting my baby in bed with me. One of two things would happen- I would never sleep out of anxiety, or the baby would be seriously hurt.

finnaryn on

To cc… While I co-slept with all three of my children, and will do so with any future children, it is not recommended for everyone and very specific rules need to be followed for it to be safe. Please visit Dr. William Sears website for more information: http://www.askdrsears.com/html/7/T071000.asp

That said, there were times when my children would sleep in a bassinet or crib either for naps, or if I was sick and overly tired, therefore not able to safely co-sleep. I did not introduce blankets until they were over 18 months old. I believe they need to be old enough to pull the blanket off of themselves, even if it is tangled.

As for sleeping on their stomach, as my kids tend to do, our doc said that once a baby is able to roll over on their own, both from stomach to back and back to stomach, then they should be fine. You still shouldn’t put them to sleep on their stomach, but you don’t have to worry if they turn over in the night.

Jessica on

^ Do you mean for baby to sleep in bed with you? Or for the crib (moses basket) to be next to the adult.

Aelys on

I think what everyone has to keep in mind is that “safety rules” are different from one country/continent to another.
As a baby, I was put to sleep on my tummy, then a decade later doctors started saying infants should be put to bed lying on their backs, and now they say babies should be put to bed lying on their side, and every time the reason was to prevent SIDS.
When I was a babysitter, parents would tell me to put their kids to bed lying on their backs, and the babies would always turn in their sleep and you’d find them on their tummies and curled up (you know, the cute nappy-in-the-air position), and after a while the pediatrician would say that it’s because it’s the position they were in in their mother’s tummy and they felt reassured sleeping in that position and baby should be put to sleep on their tummies or side.
I guess in the end it’s up to each parent and their baby.

Dana on

cc–My daughters slept in their nurseries and in their cribs until they were old enough to move into a “big girl” bed. They are both very well-adjusted, happy children who never sucked their thumbs or used pacifiers. We get comments all the time on how well-behaved and polite they are when we take them out in public (they are that way at home, too). While I am not knocking co-sleeping, I think that your son’s achievements should be attributed to you as a mother, and not necessarily the sleeping arrangement.

There are many factors that lead to SIDS, some of which are still unknown. By eliminating as many as you can (smoking in the house, back to sleep, animals and blankets in the crib, sleeping by windows) you can reduce the risk to your baby.

And I agree with some other posters about the celebrity nurseries–I think that much of the hazards are merely being set-up for photo shoots. I remember Brooke Burke responding to the controversy over her nursery hazards saying that normally the mattresses are of the approved height and the draperies are tied back and out of reach. Pretty pictures sell more copies than safety-conscious pictures.

Kait on

Whoa, cc. There are a lot of gross misconceptions in your post. I don’t mind when people have different opinions, but I do mind when they haven’t done enough research into the real issue. Crib Sleeping is not “dangerous” for newborns if the conditions are right. Co-Sleeping can be just as dangerous (if not more) if it is done incorrectly. SIDS is not a case of an infant’s heart stopping, it’s their breathing that is the problem. Babies do not need to regulate their heartbeats by an adults. Babies have naturally fast pulse rates (ranging well over 100 BPM), while adults pulse rate should be under 100 BPM.
The sad fact of the matter is, a parent can do everything ‘right’ and their child can still die of SIDS. Science doesn’t know why, but they are getting closer to an answer.

Children do not develop “attitude” problems (which, can a 1 year old really have a bad attitude??) from a lack of co-sleeping, they develop behavior problems from inconsistent or bad parenting. Also, thumb sucking in a child that young is not a sign of anything other than that a child had learned a self soothing technique. It’s GOOD for babies and kids to have a self soothing technique because mom and dad can’t always make it better. They need to have some control over if they can make themselves feel better.

PSB on

cc

I think cosleeping is great, but it doesn’t work for everybody. I also have a happy, healthy toddler, who never sucked his thumb (though I don’t really understand how this relates to where they sleep), and we did just fine with the baby in a bassinet in our room for the first few months, and then in his own crib with a video monitor (no bumpers or toys, and with a Halo sleep sack – which is the best invention EVER!).

I personally was always worried about my pillows or blanket suffocating the baby. I couldn’t sleep very soundly whenever we tried to cosleep, because of the worry. I know lots of cultures cosleep, and I’m not knocking it, but I think to suggest that it’s the best way to get a happy baby, is kind of ridiculous.

All babies and all parents are different and have different needs. Even at two years old, my son still cannot sleep comfortably in bed with us – he prefers the containment of a crib, I guess.

As far as JLo’s nursery is concerned, I think a lot of new moms probably make this decorating mistake, but they learn when they talk to other moms they know. Maybe (like others have suggested) the nursery was done up just for the shoot. I think it’s likely. I also agree with Tink and others that there has been a huge decline in auto deaths and cribs deaths since new safety rules have been put into place. I really can’t imagine why anybody would argue AGAINST progress when it comes to safety. Would you choose to not learn the Heimlich Maneuver because people 50 years ago didn’t worry about choking babies? Weird.

Jillian on

CBB- In the updated post under SIDS, fourth bullet down, should it say “to put baby to sleep on its back” not “its stomach”? I may be reading it wrong…

Thanks for the information… From someone who is looking to start a family soon and has no nieces or nephews to relate the experience to, any safety information is greatly appreciated…

Though I don’t think the People magazine cover is the place to do it, it would be nice to have something to give us inspiration for building a high style yet safe environment for our little ones.

Sara on

Is the first sentence from this excerpt of this CBB entry a typo?

“This is why it’s so important to put baby to sleep on their stomach. Since the “back to sleep” campaign launched in 1994, SIDS rates have been reduced by more than 50 percent (the equivalent of sparing the lives of more than 3,500 babies each year.)”

Sarah’s note: Yes, I believe Danielle updated it this morning and there was that mistake and some problems with spacing, but I corrected it so it should show up soon!

Noelle on

I’m Dutch and over here duvets, pillows and bumpers are never used. So I’m a little surprised every time I see a photo of a nursery in America where they are used.

Over here blankets are used and not just sheets. I never knew why a duvet wasn’t allowed in a crib until I held one in front of my mouth and tried to breath. Almost impossible.

I also didn’t know so many babies died of SIDS in America. Over here it’s much less… In 2002 the number was 22 and that could be less. It’s hard to tell whether a baby has died of SIDS or deliberate suffocation.

jen on

Give me a break. I saw the photos in the article and they are so over done. No one keeps their babies cribs piled high to the 9′s with blankets and toys. They did that for the magazine. Everything is so put together for show. Dont freak out saying that their room is dangerous. You cant judge from seeing a picture perfect picture. I doubt their room looks like that for any other reason other than for show.

amandamay on

just my 2 cents – i co-slept with my son (now 5 yrs) until he was 2 years old (no crib or bassinet). i didn’t have one of those “co-sleep” pads or any special “devices” you see being sold (apparently to keep you from rolling over on the baby..?) i suppose to me those kind of negate the purpose of co-sleeping. i’ve always thought it weird that as a culture americans put their babies in a completely different room and close the door. on a biological/instinctual level, i wanted my baby as close to me as possible (kind of how a mother animal would keep her babies near her to protect them) my son was a persnickity baby (very fussy, high maintenance, high energy) and he would calm down so much when place on my chest or cuddled against me in bed (heartbeat to heartbeat) and he would fall asleep more quickly when i would breathe in rhythm with him. anyway, i know co-sleeping isn’t for everyone, but to me it seems the most natural thing in the world. it seems far more strange to take a baby and shut it away in a different room. i wish people weren’t so afraid of co-sleeping – i never once felt like i’d accidentally roll over on my son or suffocate him etc. your body just somehow “knows” where your baby is (you know how mothers tend to say you never fully sleep once you have a baby – you always have one ear listening and one eye open) It’s just interesting how different cultures treat babies.

katiedid on

Here are the facts. Every year over 2000 babies die from SIDS, and in addition, at least the same amount from suffocation, whether it be in a crib with blankets, comforters and bumpers, or in a parent’s bed. SInce the Back to Sleep Campaign in 1194, SIDS deaths have been reduced by at least 40%; recent SIDS research, which links SIDS to a seratonin deficiency in the brainstem, still can’t be diagnosed in babies, which means that for EVERY BABY, following Safe sleep practices is IMPERATIVE. No loose blankets, no comforters, no stuffed animals, and lose the bumpers too. Babies should be in the crib, on their backs, with only a wearable blanket over regular sleepwear, but not bundled so much that they will overheat. The debate about co-sleeping rages on, and each family must make informed decisions that are right for them, but statistics show that babies ARE dying in their parent’s beds. In Massachusetts last year, 38 babies died in their parent’s beds.
Take a guess at how many babies under the age of 1 died in car crashes last year? it was less than 100. Just think how many babies would be alive today if safe sleep practices were mandated the way that car seats are. That isn’t practical or possible, unless all of the baby bedding companies are put out of business, but we all can spread the word about following safe sleep guidelines to our family and friends. And another thing…. ditch the sleep positioners. The AAP and the CPSC do NOT approve of them, and babies have suffocated using them. When your baby is ready to roll over on his/her own, that’s fine. if they can roll, they can also scoot down and suffocate on a positioner. you don’t need it. Just keep the fluffy bedding out of the crib til they are at least 1; and at that, some babies could suffocate because they don’t have the motor skills to get a blanket off of their face. Your best bet is using a wearable blanket. Some companies like Halo SleepSack make them all the way up to toddler sizes.

I hope I have answered some of the questions raised in this forum, without angering the co-sleeping parents out there. it’s all about SAFETY and COMMON SENSE. and doing whatever we can to keep our babies safe and alive!!!

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