Pediatric nurse discusses passage of new safe sleep law, what it means for babies

The Safe Sleep for Babies Act of 2021 became law on May 16, officially banning the use of certain sleep products deemed hazardous to a child. This was welcome news to Ann Lambert, an associate clinical professor in Auburn’s College of Nursing, who has been a strong advocate for safe sleep practices throughout her more than 35-year career. A pediatric nurse practitioner since 2000, Lambert explains what the law means for preventing infant deaths.

Lambert has degrees from Auburn University, Auburn University at Montgomery and the University of South Alabama, as well as a post-master’s certification as a pediatric nurse practitioner from the University of Alabama at Birmingham. Lambert joined the Auburn faculty in 2013. She primarily teaches maternity and pediatric nursing content.

As an educator, practicing nurse and advocate for safe sleep practices, what are your thoughts on this legislation?

As a nurse, this is a great victory that has been in progress for many years. The legislation specifically bans the manufacture and sale of crib bumpers and inclined sleepers. We know these products are unsafe. Bumper pads and inclined sleepers have resulted in more than 200 preventable infant deaths. Use of these items increases the risk of suffocation and sleep-related infant deaths. For example, if a baby’s face is resting against a bumper pad, it can easily result in death. No family should ever have to live through this tragedy. This law will save lives.

(The law defines “inclined sleeper for infants” as a product with an inclined sleep surface greater than 10 degrees that is intended, marketed or designed to provide sleeping accommodations for an infant up to one year old. It defines “crib bumper” as any material that is intended to cover the sides of a crib to prevent injury to any crib occupant from impacts against the side of a crib or to prevent partial or complete access to any openings in the sides of a crib to prevent a crib occupant from getting any part of the body entrapped in any opening.)

As a member of the National Association of Pediatric Nurse Practitioners, we have supported this specific legislation and have been active in writing letters of support and making calls and visits to congress. This is just one strategy; however, everyone can be an advocate for infant safe sleep and other child health policies. Let your voice be heard, educate your family and friends about infant safe sleep.

Based on your expertise, the current practice for safe sleep is a baby on its back with nothing else in the crib. Why is that the safest?

Research shows several factors put babies at risk for sudden infant death syndrome, or SIDS, and other sleep-related causes of infant death, such as sleeping on their stomachs, on soft surfaces or on/under loose bedding. We know that following the ABCs of safe sleep—Alone, Back, Crib—reduce the risks of infant death.

Alone: Think of this as “nothing but baby,” not even toys or stuffed animals. Nothing that could be a choking hazard or cause suffocation. The baby will not be lonely; it will be safe. 
Back: Sleeping on their back is the safest position. People worry about a baby choking while on its back, but babies are not more likely to choke when sleeping on their backs.
Crib: A crib, bassinette, portable crib or play yard with a firm mattress and tightly fitted sheet is the safest.

These recommendations reduce the risk of SIDS and death or injury from suffocation, entrapment and strangulation.

It wasn’t too long ago that the best position was on a baby’s stomach and then its side. What changed?

You are exactly right. We were following the best advice we had at that time. If babies sleep on their stomach or side and/or a soft surface, they are at a very high risk for SIDS. Since then, we have learned the back sleep position is the safest for all babies until they are 1 year old.

How do you teach safe sleep practices in the College of Nursing?

As a nurse educator, I am actively teaching our students in the classroom about preventing SIDS and other sleep-related causes of infant death. Students also participate in a simulation exercise to teach caregivers about risk prevention and infant safe sleep practices. This gives them an opportunity to address difficult conversations in a lab setting, with live actors, before they encounter the situation in practice. As an outreach focus, students are actively involved in teaching daycare staff, parents, grandparents and teenagers about safe sleep. We have been able to collect data from these educational interventions and publish our results about increasing knowledge and awareness about SIDS and other sleep-related causes of infant death.