Posted tagged ‘infant sleep’

Infant recliners kill babies

June 9, 2014

The Pediatric Insider

© 2014 Roy Benaroch, MD

Last time I objected to an infant recliner, I got all sorts of colorful comments*. I was even accused of having a “personal vendetta” against one of them, because I said that they’re not appropriate or safe to use as routine sleepers for babies. Of course, most of the time, having your baby sleep semi-upright in a cushy sling will probably work out fine. Most of the time. Until it doesn’t.

The “Nap Nanny”, sold between 2009 and 2012, was one of those baby recliner-things. It was sold as a way to help babies sleep. Predictably, what happened happened: babies died. Six of them became entrapped or otherwise suffocated in the “Nap Nappy,” or in another version called the “Nap Nanny Chill.” It was recalled last year, but they’re still out there and in use. Another baby just died in it.

We know the safest way for babies to be put down to sleep is flat on their backs, on a firm surface. Not semi-upright, or in a sling-shaped thing. Once babies can roll over on their own, they should be allowed to do so, without straps or other devices to hold them in place. I don’t know how all of the babies died in the Nap Nanny, but the most recent case I linked to seems to have involved entanglement in the straps.

Using a recliner or car seat or similar device as a routine sleep positioner is a mistake. It will probably work fine, most of the time—very much like driving with your child in your lap instead of a car seat. Or not getting vaccines on time. Those decisions, most of the time, will work out fine. Until they don’t.

*Most of the comments objecting to my last article on sleep positioning were from families with babies had specific medical diagnoses, and were told to use a reclined position for sleeping by their docs. I’m not addressing babies with special situations or diagnoses here—I’m talking about ordinary, healthy babies.


When white noise is too noisy: Don’t crank that machine to eleven

March 10, 2014

The Pediatric Insider

© 2014 Roy Benaroch, MD

I like white noise to help babies sleep. It seems to mask other sounds, and when used routinely becomes a nice sleep-cue for newborns, infants, and older kids. White noise machines, or “generators”, are routinely sold at baby stores, and there’s (of course) even an app that will make your phone create that static-like, whooshing or raining noise.

Yup. An app. That makes your phone sound like a 1970’s clock radio tuned between stations. I knew I shouldn’t have let my mom throw that away.

Anyway: as with all things in life (except coffee), there can be too much of a good thing. So says a new study from Pediatrics, “Infant Sleep Machines and Hazardous Sound Pressure Levels”. Researchers from Canada tested 14 ordinary white noise generators that are marketed to parents as sleep helpers to see how loud they could be when cranked up to maximum volume. They re-created a crib sleeping environment, and tested sound levels with the devices right at the crib rail, or on a table next to the crib, or across the room.

Now, there really isn’t a single standard for white noise, but for hospital nursery equipment an accepted noise threshold is to keep volume under 50 dB (decibels) for one hour’s exposure. In real life, potential damage to hearing depends both on the intensity (volume) of the sound, its frequency, and its duration; other factors like ear shape and the overall health of the baby are probably important, too. But the 50 dB threshold is probably a fair approximation of a volume that shouldn’t be exceeded, at least not for more than an hour or so. 50 dB is about what the volume of a shower sound like when you’re standing in the bathroom—a little louder than ordinary speech, but you could talk over it by speaking up a bit.

What the researchers found was that all of the devices exceeded 50 dB when turned up to maximum, as measured right nearby (as if the device was in or right near the crib.) Most of them exceeded 50 dB even when placed six feet away. Again, though, these were all tested at maximum output, with the dial turned up to 10 (or, perhaps, 11). The loudest of the devices came in at 93 dB, about as loud as a hand drill. For comparison, a rock concert is about 115 dB.

This study didn’t measure the effects of this level of noise on actual babies, and in fact there really isn’t any good data about just how loud/how long white noise needs to be to affect hearing development. Still, the study shows that these things can get pretty loud, and that may not be a good thing.

However, neither is a screaming, restless baby. Those get pretty loud, too—much louder than 50 dB. Mom and dad’s hearing (and sanity) are important, too.

The authors of the paper call on manufacturers to label their products informing parents of the danger of loud noise, and of limiting the devices’ sound output.

Let me also recommend some common sense: when you use these things, don’t turn them up to maximum and let them run all night. You can safely use a white noise machine reasonably, turned up half-way, or something like that. If it is hard to speak over the noise it’s making, it’s probably too loud. Junior might sleep better with some white noise, but I don’t think he’s quite ready for Crazy Train.