Simple bath-time safety measures from Pediatrician Dr. Jennifer Shu

It’s hard to miss the fact that babies are slippery when wet, much less ignore the occasional evening news story about an infant or child being unintentionally scalded or drowning unattended in mere inches of water. The good news is that most childhood injuries in general are preventable, and those related to bathing are no exception. Here are a few simple but extremely important bath-time safety measures that will keep you and your baby from getting in over your heads.

• It’s a matter of degree. The ideal bath water temperature is thought to be somewhere between 95°F and 100°F, while water warmer than 105°F is considered to be too hot and cooler than 90°F, too cold. In contrast, many water heaters are installed at 140°F to 150°F. At 140°F, it only takes 3 seconds for a child to get a third-degree burn. Pay a quick visit to your water heater and make sure that the upper temperature limit is set no higher than 120°F—a temperature at which you should be able to hold your hand under a running stream of hot water without getting burned.

• Fill ‘er up first. Run the bath water first. Turn off the water, and then put your baby in it. Having water flowing directly into the tub when your baby is already in it is an unnecessary risk because the temperature of running water can be inconsistent and hot water controls can be bumped.

• Know what your baby’s getting into. Make it a habit to always test your baby’s bath water on your own skin (preferably on a more sensitive area such as your wrist or elbow) before putting your baby in it. That way you’ll be sure to know exactly what you’re both getting into.

• Please give your undivided attention. Regardless of how much or how little water you have in your newborn’s bath tub, you’ll need to offer him at least one hand of support at all times and ideally keep two eyes focused on the task at hand.

About Dr. Jennifer Shu
Jennifer Shu, MD, is a pediatrician, author and mother in Atlanta. Her passion is educating parents on all topics relating to children. Dr. Shu is editor-in-chief of the American Academy of Pediatrics’ (AAP) Baby & Child Health and co-author of the award-winning books Heading Home with Your Newborn and Food Fights, both published by the AAP.

An enthusiastic and experienced writer and public speaker, Dr. Shu is a medical expert on CNNHealth.com, a member of the Parents magazine Board of Advisors and an editorial advisor for the AAP’s Healthy Children doctor’s office publication. She has been featured as a guest expert on CNN, NBC Nightly News, Headline News, MSNBC and Discovery Health, as well as in Newsweek, US News & World Report, USA Today, US Weekly, and numerous parenting magazines, newspapers and medical publications.

Dr. Shu received her bachelor’s degree at the University of Virginia and her medical degree from the Medical College of Virginia. Dr. Shu completed her pediatric training and chief residency at the University of California in San Francisco. She has been a leader within the medical profession as a past national chairperson of the young physicians sections for both the American Medical Association (AMA) and the AAP.

Baby Sleeps Safe is committed to keeping babies safe and giving parents the most up-to-date information on SIDS prevention.  Please see the following article:

Fan in baby’s room may help prevent SIDS

By Liz Szabo, USA TODAY 10-6-08

Fans may reduce the risk of SIDS, or sudden infant death syndrome, a new study shows.

Babies who slept in a room with a fan were 72% less likely to die from SIDS, according to a study released today from Archives of Pediatrics & Adolescent Medicine. The study included interviews with the mothers of 185 infants who died from SIDS and the mothers of 312 other babies.

Fans offered even more protection to babies sleeping in warm rooms, where temperatures were over 69 degrees, according to the study. Although opening a window also appeared to reduce the risk of SIDS, authors say this finding could have been due to chance.

Although doctors don’t know exactly why fans seem to help, it’s possible that fans improve air circulation, preventing infants from rebreathing exhaled carbon dioxide, which can pool up in the gap between a baby’s face and the mattress, says author De-Kun Li, a reproductive and perinatal epidemiologist with Kaiser Permanente’s research division.

Because a baby’s neck muscles are weak, they may not be able to turn their heads to find fresh air, Li says.

That’s why the American Academy of Pediatrics recommends that babies sleep on their backs. Deaths from SIDS have fallen by half since 1992, to a rate of about 0.5 deaths for every 1,000 live births. Pacifiers also seem to protect babies, Li says, perhaps because the handles prevent a child’s face from becoming pressed against the mattress.

Marian Willinger of the National Institutes of Health says that the new study, while intriguing, needs to be followed up by additional research. Putting babies to sleep on their backs is still the most important thing parents or caregivers can do to prevent SIDS, she says.

A study published Monday in Pediatrics, however, show that 26% of mothers of 3-month-olds don’t follow that advice. One-third of mothers shared a bed with their 3-month-old, another practice that may increase the risk of SIDS.

Parents who are young, with low incomes or low education are least likely to follow safe sleeping guidelines, the study says.

Daycare providers are even less likely to put infants on their backs, according to a second study in Pediatrics. About 20% of SIDS deaths occur when someone other than a parent is in charge.

In a study of 1,993 infants, only 51% of babies were put to sleep on their backs at the beginning of the study, in which researchers measured the effect of educating childcare providers about SIDS. The program provided modest improvement. Observers noted that 62% of babies were put on their backs at childcare centers that received the training, compared to 57% of babies at centers that didn’t receive the training.

Childcare providers are more likely to put babies on their backs if daycare centers have a written policy about safe sleeping, the study says. About half of states require childcare centers to put babies on their backs to sleep.

Study author Rachel Moon, a leading SIDS expert at Children’s National Medical Center in Washington, says parents should talk to their childcare providers. “In our observations, parents go in and talk to the childcare provider about what creams to use for diaper rash much more than they talk about sleep position,” Moon says.

Top 10 Safe Sleep Habits from Pediatrician Dr. Jennifer Shu

Since the 1990s, the risk of Sudden Infant Death Syndrome (SIDS) has gone down, most likely due to the practice of putting babies on their backs to sleep. Also called crib death, SIDS is one of the main causes of death in infants, striking more than 4,500 babies each year. SIDS peaks in infants ages 2 to 4 months and is highest during the winter months.

To aim for the safest sleep environment possible, here are the top 10 tips that I recommend to my patients:
1. Back to sleep. Put baby on her back every time she goes to sleep. Older advice to put baby on her side or tummy while sleeping is no longer recommended, as tummy sleeping has been linked with SIDS and babies placed on one side may roll onto the tummy. The safest place for baby to sleep is in a bassinet, cradle or crib that meets current safety standards. Crib slats should be no more than 2 3/8” wide and the mattress should fit snugly within the crib.

2. Spread the word. About 1 out of every 5 SIDS deaths occurs while under the care of someone other than a baby’s parent so make sure caregivers such as relatives, babysitters and childcare providers also know to put baby on her back to sleep. There is a much higher risk of SIDS in babies who normally sleep on their back but are then placed faced down to sleep.

3. Tummy to play. Give your baby some tummy time on a firm surface such as a carpeted floor while she’s awake and being supervised. Upper body strength can be helpful if baby accidentally rolls onto her tummy at night.

4. Breastfeed your baby. In addition to the many health and nutritional benefits of breastfeeding, nursing can reduce the risk of SIDS as well.

5. Keep loose objects out of the crib. If you choose to use a blanket, tuck it around the mattress or use it to swaddle baby, keeping her face and head uncovered.

6. Keep soft, fluffy objects out of the crib. Pillows should not be used for babies under one year. Also, remove thick crib bumpers and comforters, which may smother baby’s face.

7. Avoid overheating. Keep the room at a temperature that’s comfortable for an adult and dress baby lightly (such as in 1 or 2 layers of clothing).

8. Keep your home smoke-free. Chemicals from tobacco smoke may put babies at risk for SIDS. Encourage smokers in the household to quit if possible. Otherwise, smoke outside and then wash hands and change out of any clothing that may come in contact with baby upon coming back in.

9. Use a pacifier. Consider offering baby a pacifier when she falls asleep, although it is not necessary to replace it if it falls out during the night. If breastfeeding, it is a good idea to wait until baby is nursing well (usually around 1 month) before offering a pacifier.

10. Use a fan. One recent study showed that running a ceiling fan can keep a room ventilated and reduce the chance of SIDS.
About Dr. Jennifer Shu
Jennifer Shu, MD, is a pediatrician, author and mother in Atlanta. Her passion is educating parents on all topics relating to children. Dr. Shu is editor-in-chief of the American Academy of Pediatrics’ (AAP) Baby & Child Health and co-author of the award-winning books Heading Home with Your Newborn and Food Fights, both published by the AAP.

An enthusiastic and experienced writer and public speaker, Dr. Shu is a medical expert on CNNHealth.com, a member of the Parents magazine Board of Advisors and an editorial advisor for the AAP’s Healthy Children doctor’s office publication. She has been featured as a guest expert on CNN, NBC Nightly News, Headline News, MSNBC and Discovery Health, as well as in Newsweek, US News & World Report, USA Today, US Weekly, and numerous parenting magazines, newspapers and medical publications.

Dr. Shu received her bachelor’s degree at the University of Virginia and her medical degree from the Medical College of Virginia. Dr. Shu completed her pediatric training and chief residency at the University of California in San Francisco. She has been a leader within the medical profession as a past national chairperson of the young physicians sections for both the American Medical Association (AMA) and the AAP.

Introducing the Baby Sleeps Safe blog! This blog will host articles by child development and early childhood education experts as well as provide updates about relevant news stories highlighting infant safety tips.

We welcome constructive dialogue and look forward to receiving input from parents, grandparents and child safety activists. Together, we can make a difference in the lives of our precious little ones.