The old phrase ‘never wake a sleeping baby’ is a myth – and a potentially unsafe one, particularly when it comes to babies on inclined surfaces such as a car seat or capsule. Inclined surfaces are not considered safe sleep surfaces, as they may cause airway obstruction and increase the risk of Sudden Unexpected Death in Infancy (SUDI).
Car seats should only be used for travel purposes. Infants should be removed as promptly as possible to continue their sleep on a firm, flat surface free of loose or soft items.
Research findings: dangers of sleeping in car seats inside and outside of the car
Research released in the American medical journal, Pediatrics (2019), revealed that allowing babies to sleep in car seats and capsules in contexts other than standard travel increases the risk of SUDI.
Analysing 2004–2014 US National Center for Fatality Review and Prevention data, researchers found that of 11,779 infant sleep-related deaths during this period, 348 occurred in sitting devices. Furthermore, 62.9% of those inclined cases occurred in a car seat, with less than 10% of those car seats being used as directed.
Leaving babies to sleep in a parked car presents an additional overheating risk due to how quickly temperatures can rise. However, the study revealed risks also extend to improper use outside of the vehicle, with more than half (51.6%) of deaths occurring in car seats taking place at the infant’s home.
Dangers of ‘chin to chest’ position when sleeping on inclined surfaces
A firm, flat surface is a much safer sleeping environment than an inclined position, such as a car seat. This is because leaving babies in a curved position for a long period of time, as is the case in a car seat, means their neck is flexed forward. This posture places them in a ‘chin to chest’ position, which can block their airway and increase the risk of SUDI.
Even when supervised, it may not be easy to detect if a baby is experiencing respiratory distress. Therefore, it is not recommended to leave infants in this position for sleep even when they are being actively watched. Additionally, falling out of the car seat may present another safety concern.
How to keep your sleeping infant safe when travelling
Infants may need to spend prolonged periods of time in a car when travelling long distances. In this instance, it is recommended to take frequent breaks where infants are taken out of their car seat at regular intervals.
Upon arriving at a destination, infants should be removed promptly from their car seat – even if it means waking them up – and returned to a firm, flat surface free of loose or soft items to safely continue their sleep.
For Safe Sleeping and Safer Pregnancy information call 1300 998 698 (business hours) or visit our online advice hub.
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