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Wednesday, 24 October, 2001, 23:20 GMT 00:20 UK
Q&A: Cot Death
Seven babies die from cot death every week in the UK.

Catherine York, an advisor on a 24-hour helpline run by the Foundation for the Study of Infant Deaths, answers some of the most frequently asked questions.

The Helpline number is 0870 787 0554

Is it okay to take my baby on an aeroplane?

There is no evidence that flying is unsafe for babies, if they are healthy.

If you fly with your baby on either long or short flights, you should follow these guidelines:

  • place your baby on the back to sleep
  • keep your baby cool
  • sit away from the smoking area on the plane and in the airport terminal
  • make sure your baby takes appropriate feeds and doesn't become dehydrated.

If you have specific questions about your baby, for example if your baby is unwell or has a cold, speak to your doctor before travelling.

Can I use a duvet, quilt or pillow for my baby?

If your baby is under one year, do not use any soft bedding, such as duvets, quilts or pillows, as they are associated with an increased risk of cot death.

Instead, use one or more layers of light blankets.

Don't use electric blankets or hot water bottles. If you use a Moses basket, it should only have a thin lining.

What kind of mattress should I use?

It doesn't matter what kind of mattress you use, or whether it is new, as long as it is firm, not soft, doesn't sag and shows no sign of deterioration. Keep it well aired and clean.

Mattresses with a PVC surface or a removable washable cover are easiest to keep clean.

Ventilated mattresses (with holes) are not necessary.

Place your baby with their feet to the foot of the cot.

Never sleep your baby on a pillow, cushion, bean bag or water bed or sleep together with your baby on a sofa.

Where should I put my baby's cot?

Do not place the cot next to a radiator, heater or fire, or in direct sunlight as this poses a risk of the baby getting too hot.

Recent research shows that having your baby's cot in your bedroom with you for the first six months reduces the risk of cot death.

However, the research does not tell us why.

If your bedroom is too small for the cot as well as your bed, put the baby in the nearest room, with the doors open.

Should I breastfeed my baby?

Yes, if possible. While breastfeeding may not protect against cot death, it is the natural and best way to feed your baby and increases resistance to infections.

Can my baby share my bed?

It's lovely to have your baby in your bed with you for a cuddle or a feed, but put them back in their cot before you go to sleep.

The safest place for a baby to sleep is in a separate cot by the side of the parents' bed.

There is a proven risk in bedsharing if you or your partner smoke, have recently drunk alcohol, take drugs or are extremely tired.

Should my baby be immunised?

Yes - recent research shows that immunisation significantly reduces the risk of cot death.

Can I use a sheepskin for my baby?

Research has shown that sheepskins are not a risk factor if your baby sleeps on their back.

Sheepskins are a risk factor as soon as your baby starts trying to roll over onto their front.

Then take the sheepskin away.

My baby won't settle on the back. What shall I do?

Babies settle easier on their backs if they have been placed to sleep that way from the beginning.

If your baby won't settle, keep trying. It may help if you give them a cuddle, sit them in a car seat or sitter to get them used to back sleeping.

My baby keeps rolling onto her front. What should I do?

Babies who sleep on their backs are safer and healthier.

Should your baby vomit they are not more likely to choke if on their back.

If you find your baby has rolled onto their tummy, turn them onto their back again and tuck them in, but don't feel you have to get up all night to check.

Babies will at some point learn to roll onto their front. When the baby can roll from back to front and back again, on their own, then leave them to find their own position.

At the start of any sleep time, put them on their back.

Is it safe for my baby to play on their front?

Yes, and not only is it safe for your baby to play on their front but it is to be encouraged so that their muscles develop properly.

Do movement (breathing) monitors prevent cot death?

Despite their widespread use there is no research evidence that monitors, also known as apnoea or breathing monitors, prevent cot death.

Babies can and do die whilst on a monitor.

They are designed to sound an alarm after 20 seconds if they can't detect a baby's breathing movement.

They may use sensor pads attached to the tummy or housed in an elastic belt which fits over the baby's clothing.

Others use a pressure pad under the baby or an ultrasound beam. They do not monitor air flow and therefore cannot detect an obstruction in the airway until breathing movements cease.

Can I use a cot bumper for my baby?

In the past, there had been concerns that bumpers may make babies too hot, increasing the risk of cot death.

However, recent research has shown that they have neither adverse nor beneficial effects.

Consequently, FSID and the Department of Health neither promote nor discourage the use of bumpers.

Is it OK to swaddle my baby?

There is no research evidence on swaddling.

Different people swaddle in different ways, using different weight materials.

It is therefore difficult to give definitive advice, except to advise if people swaddle their baby it is sensible to use thin materials, be sure to keep your baby's head uncovered, take care what other bedding and clothing you use (recognise that swaddling is instead of a blanket), and make sure that the baby is not too warm by feeling if the tummy is hot to the touch or the baby is sweating.

Do dummies reduce the risk of cot death?

The evidence in this area is complicated.

Research suggests that, for babies under a year old, those who always use a dummy and babies who never use a dummy may be at lower risk of cot death than babies who usually use a dummy but failed to do so during their last sleep.

In other words, if your baby is using a dummy regularly, this use should continue.

On the current evidence, researchers do not recommend dummies to reduce the risk of cot death.

Can my baby use a sleeping bag/sac?

If you wish to use a sleeping bag for your baby make sure it's designed for regular use at night (i.e. not one designed for camping).

It should be with arm holes but sleeveless, without a hood, and it should be an appropriate size to prevent your baby from sliding down into the bag.

To make sure your baby doesn't become too hot choose a lightweight bag.

Although togs cannot be measured precisely and there is no research on sleeping bag tog values and cot death, it is sensible to choose a sleeping bag with a low tog rating, no more than 2.5.

But check if your baby is too hot by feeling if their tummy is hot to the touch, or if they are sweating.

Remember that what the baby needs will vary greatly according to the temperature of the room.

If it is very warm, they may need no more than a vest and a nappy underneath or it may be necessary to use only light bedding, such as a thin blanket or sheet, or no additional bedding at all.

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