Q: In today’s blog post, we’re talking with Harper Morton, a safe sleep expert. Harper, tell us about yourself…
A: Hi! My name is Harper Morton. I’m a mum of one, a kindergarten educator and born and raised in Victoria, Australia. I spend my free time drinking tea, baking, appreciating the beautiful Australian native wildlife, and researching baby and toddler safety, notably safe sleeping habits. I love connecting with people all over the world who advocate for the safety of children.
Q: Why is it that you are so passionate about safe sleep?
A: Here in Australia, we have no organisation that provides up-to-date evidence-based guidelines for safe sleep. Many of the recommendations are from over 20 years ago, and continue to not be updated. I strongly believe that every child has a right to a safe environment and survival, as per the United Nation Convention on the Rights of the Child. In the early days of becoming a mother, I was up all night, every night, anxious about SIDS. When I learned that it’s possible to dramatically reduce the risk of SIDS (by up to 99%), my anxiety lowered.
Looking at social media, childcare providers, and baby sleep products on the market, it’s quite terrifying that safe sleep is not normalised in society. Unintentional suffocation is the leading cause of death in infants; this can be reduced by following the ABC’s of safe sleep. Young children have no say in their safety, it’s up to the adult to provide a safe start to life. I believe every child has a right to a healthy, happy, and safe childhood.
Q: When you are educating parents on the importance of safe sleep, what is your main message that you’d like to get across?
A: The message I would like to convey to parents, family members, guardians, and childcare providers, is that we, as adults and caregivers, have the power to provide the safest possible environment for the children we are caring for. We have the power to significantly decrease the amount of preventable sleep-related deaths in infancy and toddlerhood.
I want everyone to know it’s okay to not know the answer, it’s okay to have been doing something wrong in the past, but when we know better, we do better. Almost every case of SIDS or sleep-related death has a risk factor involved, this means that most of these cases were preventable by following safe sleep guidelines. Safe sleep can be hard when you have a not-so-great sleeper (I’ve been there, I understand), but the risk of death is high when safe sleep is not followed. If you have a partner, family, friends, anyone, ask for help when you need to get some sleep for yourself. Practice safe sleep like their life depends on it, because it does.
Q: Give us the basics. What should every parent know about safe sleep for their infant?
A: The leading researchers in SIDS and safe sleep recommend following the ABC’s of safe sleep: alone, on their back, in a crib, bassinet or play yard. An infant should be placed in a sleep space without any other children or adults, with no blankets, soft toys, sleep positioners, bumpers or baby nests. Until the age of one, they should be placed on their back to sleep- not on their side or stomach. The way the trachea and the oesophagus are positioned means that even if the baby is to spit up, laying on their back is still safest. If they roll to a different position on their own, then it is safe for them to stay there, granted they are not swaddled. Lastly, the sleep space must meet current safety standards, meaning it must be a crib, bassinet or play yard; no rockers, bouncers, baby seats, nests (such as the Dockatot), swings, couches, sofas, armchairs, or adult mattresses. Supervision does not make unsafe sleep safe, as many causes of sleep-related death are silent and just look like a sleeping baby. Importantly, sleep is sleep, unsafe is unsafe, it doesn’t matter if it’s overnight sleep or just a short daytime nap. Suffocation, positional asphyxiation, strangulation, carbon dioxide rebreathing, and entrapment does not discriminate between night and day.
Q: Are there baby products that you love for safe sleep? And I’m sure there are plenty that you hate – give us the good, the bad, the ugly!
A: Sleeping bags! Sleeping bags or sacks are a wonderful, safe alternative to blankets. They keep baby warm during cold nights. Ones with TOG ratings I give extra love to- they often come with guides as to what to wear, and make it really easy to know how to keep baby at a comfortable temperature without overheating. The Fisher Price Baby Dome is amazing for the newborn stage. It’s portable, meets current bassinet safety standards, and is perfect for when they fall asleep all the time everywhere. There are too many unsafe sleep products on the market to name them all- but some really popular items dangerously marketed as safe are mesh bumpers and baby nests. Mesh bumpers are still unsafe, despite being marketed as “breathable”. Babies can, and have been strangled by mesh bumpers. Baby nests are just another soft sleeping surface that cause carbon dioxide rebreathing and suffocation, but again, unfortunately, often marketed as a safe sleep space.
Q: I know that some recommend that parents stop swaddling at 8 weeks. In my experience, babies this young are not rolling and the Moro reflex is still quite strong. I personally think this recommendation often leads parents to make other unsafe sleep decisions. Do you have thoughts on this?
A: This recommendation comes from the leading researcher into SIDS and safe sleep, Dr. Rachel Moon. Moon has stated “we see deaths from babies who are swaddled and end up on their stomachs by 2-2½ months, I get really nervous when babies are swaddled past the age of 8 weeks.” The Task Force on SIDS sees first hand countless infant deaths. It’s just not worth the risk. What I found helps, and have heard works for many others too, is once baby is asleep, holding their arms down with our hands for 5-15 minutes until they’re in a deeper sleep.
Q: There are lots of people out there that speak of this “Safe Seven”. Can you tell us what you think of the safe seven? Is it really safe enough?
A: The “safe seven” comes from Dr James McKenna; an anthropologist, he is an expert in human behaviour, not safety and health. McKenna chooses to ignore all data from the National Child Death Review case report system database since 2004- that’s a lot of important information. Even when the “safe seven” is followed, there are still three major risk factors involved; adult overlay, the adult mattress, and entrapment by bed framing and walls. Babies have died from being overlayed by their parents or suffocating on their mother’s breast. Babies have died from suffocation and carbon dioxide rebreathing from an adult mattress. These risks are not present when following the ABCs of safe sleep. Often the argument is that the parent is a “light sleeper” and is “aware” of their own, and their child’s movements. No one in their deepest stage of sleep, is in a light enough sleep to know their child is silently suffocating, asphyxiating from the softness of the adult mattress, or rebreathing carbon dioxide. These causes of death don’t require any sound or movement to happen when in an unsafe environment. No adult mattress meets current crib mattress safety standards. Crib mattresses go through testing to ensure they are safe for a baby to sleep on, adult mattresses do not.
I’ve also joined social media groups where the “safe seven” is promoted, in hopes of risk minimisation for bed sharing. I spent months in the groups. In that time, not once did I see a single image where the “safe seven” was actually being followed. All it takes is for a pillow to move down, an adult or infant to roll, or a blanket to come up, for a fatality to occur.
Q: Since you prioritize safe sleep, I’m curious your opinion on sleep training. Do you promote the benefits of teaching babies to fall asleep and back to sleep independently?
A: Yes I do, as long as the family is comfortable with the method of sleep training. Numerous studies have stated the absolute importance of having an adequate amount of sleep for babies, children and adults. Studies have also shown that developing healthy sleep habits early in life has positive long-term effects. I also think it’s okay to not want to sleep train and all babies respond differently to different methods of developing healthy sleep habits. It’s also important to keep in mind that there are so many different methods of sleep training! There are options to choose from to suit your family and your level of comfort.
Q: There’s so much NOISE on the topic of safe sleep. Why should we take your advice over others? How is a parent to know who to listen to?
A: My advice comes directly from the leading researchers in SIDS and safe sleep. The information I share is not my “opinion”, it’s all based on science, evidence and fact. It’s important to acknowledge how lucky we are to live in a society that has access to modern medicine and research. The research that has been conducted over the last century has meant an incredibly dramatic decline in mortality rates for children. When we listen to the leading researchers, we are being given the fantastic opportunity to do better for ourselves and for our children.
It’s also important to be careful with what research we are looking at. A lot of the research cited on social media does not actually give us a good insight into the topic, whether it be a study done on a very small amount of participants, cherry-picked data, or one I’ve recently seen was a study about rats (yes, rats!)- although these studies are important when looking at the big picture, we can’t rely on them singularly for our information. The AAP and the Task Force on SIDS are the most up to date and current sources of information- which is why I get my information from them.
Q: If parents want to learn more, where can they find solid evidence based information on the importance of safe sleep?
A: The AAP (the American Association of Pediatrics) is the definitive authority on paediatric health, safety and care. The Task Force on Sudden Infant Death Syndrome are the leading researchers into safe sleep, and their up-to-date research and publications provide reliable and credible evidence for parents and caregivers.
Q: If parents would like to connect with you directly, where can they find you?
A: I am most active on my Instagram page, but can also be contacted through my website. My messages and email are always open to questions, assistance and finding ways to keep your baby safe while they sleep. Truly, all I care about is that your baby is safe, so never hesitate to reach out.
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