The role of fathers in preventing sudden unexpected death in infancy (SUDI)

By Stephanie Cowan

New fathers, listen up! This article is about you and your role in protecting your baby from sudden unexpected death. Your baby needs you to be up to date in your knowledge, and strong in your decisions. Every year about sixty New Zealand babies die suddenly and unexpectedly in their sleep. Sadly, most of these deaths are preventable.

Throughout human history, fathers have been the protectors or guardians of their families. This role is a defining one for men, especially in modern times. A father who protects his children ensures their deep-rooted security, confidence and trust. It is no longer hungry lions and tigers that your babies need protecting from. The dangers now are harder to see. The lions and tigers of today lurk in the places where babies grow and the places where they sleep.

Protection as they grow
Babies need a smokefree place to grow. They need this in pregnancy and throughout their childhood. Protecting your child from smoke effects is the single biggest thing you can do for their health. Smoking slows blood flow, this damages the placenta, babies get less food and oxygen and their growth and development are stunted. Food and oxygen are essential to life. Like a seedling growing in the dark, it is harder for babies to survive and thrive if they have to struggle with smoke. Smoking in pregnancy makes all the other SUDI risks greater, especially bed sharing.

We live in a time when being smokefree is the cool choice and help is all around for people who are not. We have Quitline services, almost free patches and other quit aids. These take the struggle out of quitting and are far safer than smoking, especially in pregnancy. A protective father will do what it takes to be smokefree himself. He will do what it takes to ensure his baby is smokefree in pregnancy and do what it takes to provide a smokefree home and life for his child.

Protection as they sleep
Babies need protection as they sleep, for every sleep, wherever they sleep. For many SUDI babies, something about the sleeping setup changed ‘that night’.

Babies need to lie in a safe position when they sleep. They need to sleep on their backs. They need to be stretched out on their backs and not propped on pillows or chairs or anything soft. Babies have strong reflexes to protect their airways and life-support systems that remind them to breath. These work best when they sleep on the back.

The back is the only safe position for sleep. Side sleepers can roll to the front, and front sleepers have the greatest SUDI risk of all. Babies may sleep longer on the side or front, some may even settle better on the side or front, but no baby is safe in these positions when they sleep. A protective father will ensure his baby always sleeps on the back.

Babies also need a clear face when they sleep. Of course they will start their sleep with a clear face, but will it stay clear throughout their sleep? A protective father will make sure of this. He will do a ‘safety check’ each time his baby goes to bed and check for hazards. “What might change during this sleep?” he will ask himself. Babies can and do roll into people and against and between things. Bedding, pillows or toys might cover their faces. They might slip under bedding, fall into pillows, get wedged into gaps, or become face down on a soft surface. All these situations are dangerous for babies. Pillows and V-pillows are especially so.

Babies need their parents close by even when they sleep. They may snuffle and grunt and keep you awake at first, but ‘in the same room as you’ is the safest place. Why this is so, is not yet clear, however, ‘closeness to parents’ is important to survival for all mammals. It is certainly what your baby expects. Just how close is safe, is under the research spotlight. The evidence is loud and clear that, for some babies and in some situations, sharing your bed is too close for safety. Babies with weakened arousal responses (due to smoking in pregnancy, low birth weight, being premature, bottle-fed or unwell) are much safer sleeping in the same room as their parents, but not the same bed.

The SUDI risk increases for babies when bed sharing with others and:
* either parent has been drinking, taking drugs, smoking or extremely tired
* the sleeping place is makeshift such as couches, armchairs, beanbags or cushions
* there are other children in the bed, or pillows, a duvet or soft mattress

A protective father will avoid bed sharing in these situations but ensure his baby sleeps close by.

More often than not, health information and services are directed at mothers, leaving some fathers wondering where they fit in. Men could be forgiven for thinking their role as new fathers is more as back-up for their partners; the one who gets the meals, does the chores, goes to work. New babies need more than this from their fathers. They need them to be their protectors, starting in pregnancy, and especially when they sleep.

Stephanie Cowan
Director,
Change for our Children
www.changeforourchildren.co.nz