Few things are more exhausting than a new baby. Increased infant crying, perhaps a few older children to care for, and trying to get back to work after a few short weeks all result in very, very tired caregivers.

October is Safe Sleep Awareness month. There has been a great deal of information shared this month around what a safe sleep crib looks like. And although it can sound a bit boring, ensuring cribs are free of objects which could lead to suffocation is worth the mental shift from “cute” to “safe”. Talking with all the family and friends who come in contact with baby about safe sleep practices is important to ensure even good-willed intentions do not lead to tragedy.

Adding Substance Use to the Mix

Imagine the last time you were beyond tired. Maybe you found yourself dozing off driving to or from work. Maybe you fell asleep watching a movie you actually wanted to see. Or maybe that last zoom call was just too long to handle. Sometimes our bodies take over even when we have every intention to stay awake.

Now take a moment and imagine adding substances that can lead to additional depression of the body’s ability to function, like alcohol, marijuana, some over the counter and prescription medications, and illicit substances. When contemplating the use of substances with a newborn in the home (separate from breastfeeding risks and substance use) it is important to be extra vigilant in ensuring your baby has a safe place to sleep.

Caregiving of an infant is exhausting. Falling asleep when feeding a baby on a couch or in bed is not uncommon for a tired caregiver. The impacts and side effects of many common substances increases the risk of positional overlay, which is when a caregiver accidentally rolls over on a baby in bed or on a couch or large chair, suffocating the infant. If you are thinking right now you would totally wake up if you rolled over on a baby, remember the times noted above. You didn’t mean to fall asleep, but you did. And if a caregiver is exhausted, and impacted by substance use, whether they were feeding the baby, or in bed with a baby and an additional caregiver, the risk of positional overlay or entrapment increases. And sleeping on a couch with a baby increases the risk even more, especially when substances are involved.

Increasing Safety in Sleeping Environments

According to the American Academy of Pediatrics (AAP), there are several ways to increase safety in sleeping environments, including:

• Until their first birthday, babies should sleep on their backs for all sleep times—for naps and at night. 
• Use a firm sleep surface. 
• Room share—keep baby’s sleep area in the same room where you sleep for the first 6 months or, ideally, for the first year. 
• Only bring your baby into your bed to feed or comfort.
• Never place your baby to sleep on a couch, sofa, or armchair.
• Bed-sharing is not recommended for any babies. However, certain situations make bed-sharing even more dangerous. Therefore, you should not bed share with your baby if:
  • Your baby is younger than 4 months old.
  • Your baby was born prematurely or with low birth weight.
  • You or any other person in the bed is a smoker (even if you do not smoke in bed).
  • The mother of the baby smoked during pregnancy.
  • You have taken any medicines or drugs that might make it harder for you to wake up.
  • You drank any alcohol.
  • You are not the baby’s parent.
  • The surface is soft, such as a waterbed, old mattress, sofa, couch, or armchair.
  • There is soft bedding like pillows or blankets on the bed.
• Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation out of the baby’s sleep area. 
• It is fine to swaddle your baby. 
• Try giving a pacifier at nap time and bedtime. 

For more detailed descriptions of the above information, visit A Parent’s Guide to Safe Sleep.

You Are Not Alone

Being a caregiver for a newborn is exhausting. If you are a parent or caregiver reading this, know you are not alone and that feeling exhausted is normal. It will pass. You will find a new pattern and chances to catch up on sleep over the next few years. Following safe sleep practices now, including limiting substance use, and creating and using safe sleep environments, can reduce the risk of SUIDS and the risks of positional overlay. Reach out to parent groups, family or your community for support. Raising children is beyond hard!

For more information on resources to help provide safe sleep environments, call 1-800-CHILDREN, 2-1-1, or your local health department. For more information on finding support from other parents, visit CircleOfParentsCO.org.