Is Back or Tummy Sleeping Better for Baby?

We all know that placing baby to sleep on their back has resulted in a decrease in the number of SIDS cases.  However, is it "better" for baby to sleep on their tummy or their back?   The answer may surprise you.


Yes, we all know that it is "safer" for baby to sleep on their back, but is it actually "better" for baby?  Every parent lives with the specter of the sudden, inexplicable death of a healthy baby during the infant's first year. In 1992, after reviewing British and Australian research on SIDS, the American Academy of Pediatrics recommended that parents put babies to bed exclusively on their backs in their first year.  In 1994, the National Institute of Child Health and Human Development followed that recommendation with a far-reaching federally financed Back to Sleep public education campaign.  At the time, 70 percent of infants in the United States were sleeping on their stomachs. By 2002, that figure had plummeted to 11.3 percent.  On Oct. 10, 2005, the American Academy of Pedicatrics issued an advisory re-emphasizing the correlation between "nonprone" sleeping and a lower rate of SIDS.  The academy also advised parents to breast-feed, to avoid placing their infants on their sides to sleep, to use pacifiers and to place baby in a crib alone.  Still, most pediatricians concede that when babies are placed on their stomachs, they tend to sleep better, they are less apt to startle and they often sleep through the night sooner.



Stomach sleeping makes sense in a lot of ways. For one, babies often sleep better that way. When a baby is on his back, a reflex causes his limbs to fly up in a disorganized fashion. This is fine for an awake baby, but a lot harder for a baby trying to shut down and go to sleep. Babies are affected by this in varying degrees, but some are constantly awakened by smacking themselves in the face, or just by the abrupt movement of their bodies. On the stomach, the baby's body is tucked away and the view of the world is limited, making it easier for the baby to shut down and tune out. There is also research that shows stomach-sleeping babies are quicker to reach milestones such as crawling and rolling (as these milestones require a lot of practice time on the belly).

A 2002 study in the journal Pediatrics, found that preterm infants in intensive-care nurseries were frequently placed on their stomachs.  When the nurses from some of these nurseries where questioned,  the nurses said "Babies sleep better this way."  When asked why they instruct parents to place baby on their back as part of their discharge instructions, the nurses responded with, We have to tell parents to that that."

Not only do many infants sleep better on their stomachs, they are much less likely to develop plagiocephaly, a deformation of the skull that leaves infants with flattened heads.  Dr. Jeffrey H. Wisoff, an associate professor of neurosurgery and pediatrics at New York University Medical Center, said that since the Back to Sleep campaign began, the head condition had "become an epidemic."  Dr. Wisoff, although he does not dispute the evidence linking supine sleeping to the lower SIDS rates, said that a decade ago he saw only a handful of plagiocephaly cases a year.  "Now we see up to a dozen kids with asymmetric heads a week,"

Baby Sleep Facts You Want To Know.

Did you know?........  feeding your baby cereal will not help them sleep through
the night.  In fact, feeding baby cereal too soon may actually be harmful
to baby since it decreases their absorption of iron.

Did you know?........   slow than very rapid breathing in newborns, known as
periodic breathing, is common. A newborn baby may also normally stop breathing completely for 5 to 10 seconds, particularly while sleeping.  This pattern, periodic breathing, will eventually evolve into a more mature breathing within the first few months.

Did you know?........  Did you know that a bluish tinge to baby's hands a feet while sleeping

does NOT mean baby's hands and feet are cold. Newborns have poor thermo
regulation to their distal extremities,(hands and feet) which causes the
blood vessels in the surface skin to constrict (even when hands and feet
are not cold) causing the bluish tinge.

Does your baby really need a "firm" crib mattress?

The American Academy of Pediatrics (AAP) recommends placing baby to sleep on their back on a firm crib mattress.  However, there is not a lot of information shared telling new parents why a firm crib mattress is recommended.  I have posted polls, read forum responses, solicited responses from sales folks at baby stores, and have even asked new parents why they think the AAP recommends a firm crib mattress.  The two most often received responses are;  "It's better for babies' growth and development," and "It helps prevent babies from rolling over since babies sleep better on their back."  "

The idea that a firm surface is better for a baby's growth and development is inaccurate.  If we think about it logically, a human's fastest rate of growth is from conception to birth.  During that 9 month period, baby is actually is a soft pouch of liquid.  The second fastest rate of growth for humans is from birth to 12 months.  During this first year of life is when baby's bones are very malleable.  Sleeping on a firm, hard surface is actually not good for baby's growth and development.  In fact, since the inception of the "back-to-sleep" campaign, there has been a significant increase in the number of babies with skull deformities.  The bones that make up your baby's skull are designed to move around so that the head can pass through a tight space when baby is born; the plates of the skull are pliable.  In fact, the skull bones look like big pieces of a puzzle that fit together, but are not firmly attached.  As the head grows, it changes shape.  While children and adults have relatively fixed shaped heads, babies do not.  The speed at which the skull changes shape in the first 12 months of life is remarkable.  When babies are laid down to sleep in the same position over and over again on a firm surface, specific spots on the skull receive more pressure just from the weight of the head on that area causing deformities.  

I have also heard the response that a firm crib mattress helps prevent babies from rolling over since babies sleep better on their back.  A firm sleep surface actually makes it easier for a baby to roll since less strength is required.  Also, even SIDS experts confirm that babies do sleep longer and more soundly on their tummies.  Moreover, most pediatricians concede that when babies are placed on their stomachs, they tend to sleep better, they are less apt to startle, and they often sleep trough the night sooner.  In fact, according to Dr. Jane Williams, early childhood specialist and director of child development programs for GymbaROO, "babies should be spending more time on their tummies than lying or being propped in 'containers' such as car seats, infant seats, swings, and high chairs."  


The reason the AAP recommends a firm crib mattress for baby.....and actually they recommend a firm crib mattress with a tight fitting sheet....is to prevent baby from rebreathing Carbon Dioxide.  Rather than breathing clear, fresh air, baby "rebreathes" their exhaled air.  Since a baby cannot raise their head for the first 3 to 4 months of life, sleeping on a firm crib mattress with a tight fitting sheet makes it less likely that a baby's exhaled carbon dioxide will trap in the folds of a loose fitting sheet or the soft pockets of a soft mattress.  Some babies will react to this "distressed situation" and cough, cry or otherwise get themselves out of the stressful situation.  However, some babies brains do not communicate that there is a problem or they are in a "distressed situation," and they continue to sleep through the problem and rebreathe their exhaled air (CO2) which can be fatal.  The same holds true for overheating; the brain does not respond to a deadly rise in body temperature.  However, there is no way for any of us, including medical professionals, to know which babies do and do not have the brain communication function that reacts to these "distressed situations."  This helps explain why some babies can sleep on their tummy on a conventionally designed crib mattress and be safe and others cannot.    According to medical experts, until we can identify the babies that are unable to get themselves out of these distressed situations, it is important to prevent every sleeping baby from "rebreathing."   This is why you want to keep blankets, stuffed toys, pillow like bumper pads, loose fitting sheets, and all other soft objects out of your babies crib.


Since the Heaven Sent Breathable Crib Mattress  does not allow CO2 to trap, and does not use any crib sheets, it has gained the endorsement and recommendation of Henry Ford Hospital; Wyandott, as well as many Pediatricians, and infant sleep disorder specialists.  


The Heaven Sent Breathable Crib Mattress is a scientifically proven safer crib mattress than the AAPs recommended firm crib mattress with a tight fitting sheet... It's the ideal crib mattress for tummy sleepers.

The Facts and Myths about Sudden Infant Death (SIDS)

What you really need to know about Sudden Infant Death Syndrome (SIDS)

Myth I, "Supine sleeping has greatly reduced the incidence of SIDS since 1992." FALSE. SIDS deaths in the U.S. decreased from 4,895 in 1992 to 2,247 in 2004. But, during a similar time period, 1989 to 2004, SIDS being listed as the cause of death for sudden infant death (SID) decreased from 80% to 55%.  According to Dr. John Kattwinkel, chairman of the Center for Disease Control (CDC) Special Task Force on SIDS "A lot of us are concerned that the rate (of SIDS) isn't decreasing significantly, but that a lot of it is just code shift. In fact, a resent recommendation published in the Forensic Science, Medicine, and Pathology Journal outlining new guidelines for SIDS classification resulted in a large percentage (69%) of original SIDS diagnosis being classified as positional asphyxiation. The report concludes that SIDS has been mislabeled....when the new recommended classification scheme is used; these deaths are not coded as SIDS, and indicated asphyxia as the potential contributor to, or as the specific cause of death, that appears to exist in a large percentage of cases originally designated as SIDS using older classification schemes. When certifiers use a classification system that focuses upon potential asphyxia in determining the cause of death the incidence of SIDS dramatically decreases.

Myth 2, "There is a regulated, standard, routine procedure for determining an infant death as SIDS. FALSE. Deaths that are determined to be SIDS deaths are as variable as the doctor or coroner determining the cause of death. There is currently no law regulating the national standards for investigation only voluntary recommendations. The Scripps review of 40,000 infant deaths going back to 1992 revealed that the quality of infant death investigations, the level of training for coroners, and the amount of oversight and review vary enormously across the country. In many cases, professional bias.” both for and against a diagnosis of SIDS” trumps medical evidence. President Obama and the CDC are only just (as of this year, 2009) beginning to make legislation to standardize these investigations.

Myth 3, "Supine sleeping, prevents SIDS." FALSE.  No one thing prevents SIDS. It is a mysterious occurrence that the medical world only has theories about. It seems to be an environmental incident, closely related to the infant's home environment, environmental exposures, pre and antenatal care, among other factors.

Myth 4, "Because I know that supine sleeping prevents SIDS, it must be safe to place my baby to sleep this way." Not entirely false, not entirely true.  There are several current completed and working studies that indicate that supine sleeping may be dangerous. We do know that back sleeping decreases the baby’s comfort level with tummy time, and minimizes the baby’s sensory input to the oral motor region. Variety is normal, and sleeping in one position decreases “normal” variety for developing infants. Other side effects of the back sleeping position include increased rates of shoulder retraction, positional plagiocephaly (flattened back of the head) and positional torticollis . A research study on children with plagiocephaly found that 26% had mild to severe psychomotor delay. This study also showed that 10% of infants with plagiocephaly had mild to severe mental development delay. Because of the delays caused by back sleep, some medical professionals have suggested that the "normal" ages at which children had previously attained developmental milestones should be pushed back. This would enable medical professionals to consider children who previously were considered developmentally delayed as "normal" (Stevens P, "The Flip Side of Back to Sleep", The O&P Edge.)

Additional studies have reported that the following negative conditions are associated with the back sleep position: increase in sleep apnea, decrease in sleep duration, strabismus, social skills delays, and temporomandibular jaw difficulties . Other studies have reported that the prone position prevents subluxation of the hips, increases psychomotor development, prevents scoliosis, lessens the risk of gastroesophageal reflux, decreases infant screaming periods, causes less fatigue in infants, and increases the relief of infant colic. In addition, prior to the Back to Sleep campaign, many babies self-treated their own torticollis by turning their heads from one side to the other while sleeping in the prone position (Graham J, Gomez M, Halberg A, Earl D, Kreuzman J, Cui J, Guo X. Management of Deformational Plagiocephaly: Repositioning Versus Orthotic Therapy. The Journal of Pediatrics. 2005;10.016:258-22).

Dr. Rafael Pelayo from Stanford University and a number of other pediatric sleep researchers in the U.S. have stated that they believe that the American Academy of Pediatrics' recommendations regarding co-sleeping and pacifier use may have unintended consequences. They have stated that the SIDS prevention strategy of the American Academy of Pediatrics which keeps infants at a low arousal threshold and reduces the time in quiet sleep may be unhealthy for children. They state that slow wave sleep is the most restorative form of sleep and limiting this sleep in the first 12 months of life may have unintended consequences to both the sleep and the infant.

Since 1998 there have been several studies published which report that infants placed to sleep in the supine position lag in motor skills, social skills, and cognitive ability development when compared to infants who sleep in the prone position. In a 1998 article entitled “Effects of Sleep Position on Infant Motor Development” by Davis, Moon, Sachs, and Ottolini, the authors state We found that sleep position significantly impacts early motor development. The prone (stomach) sleeping infants in this study slept an average of 225.2 hours (8.3%) more in their first 6 months of life than the supine (back) sleeping infants.

Back-sleeping significantly reduces the amount of slow wave sleep that infants engage in and it is theorized that infants that have the brain-stem defect are at increased risk of being unable to arouse from SWS (also called deep sleep) and therefore have an increased risk of SIDS due to their decreased ability to arouse from SWS (Kattwinkel J, Hauck F.R., Moon R.Y., Malloy M and Willinger M Infant Death Syndrome: In Reply, Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden\Pediatrics 2006;117;994-996). (Basically they're saying that if the infant has this defect, then they are at risk. Healthy infants are not apparently at risk for not arousing from SWS, and prenatal factors are what affect the development of the brainstem). SWS is vitally important to development and growth, and studies indicate that supine-positioned infants are being deprived of it, thereby aiding in cognitive and psychomotor delay.

The purpose of this post is the advocacy that “sleep should be safe in any position.” There is a lot of scientific data proving that air permeable sleep surfaces “significantly” reduce the risk of positional asphyxiation. The message that simply putting your baby to sleep on their back will save their lives is ludicrous. SIDS will happen......the true meaning of SIDS is an unexplained death. Positional asphyxiation and suffocation (which most of these deaths are labeled as SIDS) can, however, be prevented.

Always place baby in crib alone.

Chicago is First to Ban the Sale of Bumper Pads

Chicago is the First City in the Country to ban the Sale of Bumper Pads
and the State of Maryland Wants to do the Same.


Early October, Chicago became the first city in the country to ban the sale of crib bumper pads due to concern that the popular products pose a suffocation risk to babies.


The City Council approved the ordinance in response to an investigation conducted by the Chicago Tribune, which found federal regulators have received reports of babies suffocating for years but have failed to warn parents or investigate all deaths.


Chicago officials introduced the ordinance to send a message to federal regulators and other municipalities that bumper pads are not safe. The state of Maryland is considering a similar proposal to ban the sale of bumper pads, and the federal agency responsible for regulating consumer products — the Consumer Product Safety Commission (CPSC) — said last year that it is investigating the issue in response to the Chicago Tribune articles.

In March, the Chicago Tribune reported that federal officials have investigated at least a dozen deaths where bumpers appeared to play a role. In those fatalities, the safety agency said bumpers were not clearly the culprit because other items were also in the crib. But in reviewing the agency's own records, the Chicago Tribune found that in many of those cases, babies who died had their faces pressed into bumper pads. Further, the Chicago Tribune found numerous cases in which the safety agency did not investigate a child's death even though the agency had reports on file suggesting bumper pads played roles in the fatalities. The Chicago Tribune looked into some these cases and found that medical examiners and coroners said bumper pads were involved in the suffocations.


In 2006, a five-month-old baby in Michigan was found with her face pressed against the bumper pad. The baby's skin was blue. A medical examiner found that the baby had suffocated and federal regulators received a death certificate stating that she had been trapped against padding in the corner of her crib. Regulators, however, did not investigate the case.


It's unclear exactly how many babies have died from suffocating against bumpers. Medical examiners and coroners aren't required to report deaths to the CPSC.


Bumper pads were originally thought to protect baby from falling through the slats, or becoming entangled in the crib rails. However, regulation enacted in the 1970’s mandates that slats on cribs be spaced close enough that babies wouldn’t fall through or get caught.


These products that were originally introduced as a “safety” devise for cribs became more of a “fashion” statement in cribs with many manufacturers focusing on bumper pad as the main focal point of the crib. Since bumper pads are considered a high risk hazard in the crib, parents are faced with finding other alternatives in crib mattresses and accessories to bring a look of style to their nurseries.  Many stores in the Chicago area are selling the Heaven Sent Breathable Crib Mattress not only for its safety features, but for its sylish looks.  According to Mark Lazar, of Lazar's Juvenile Furniture, "If parents want a stylish crib, without the added cost and potential hazard of bumper pads, sheets, or pads, this (Heaven Sent Breathable Crib Mattress) mattress is the ticket.  Forget the fact that this crib mattress is safe; it's very attractive in a crib." 

There are Safe Alternatives to the Toxins in Conventional Crib Mattresses

by Cameron Garriepy, an expert in baby products...

Parents face so many difficult decisions as they await the arrival of their child. Many choices come down to personal preference, but some weigh more heavily because the child's health, safety and development are potentially affected.


Choosing a crib mattress is one such decision. From simple physical factors such as a mattress's firmness and ease of care, to more complex matters of chemical off-gassing and environmental impact, finding safe alternatives to conventional crib mattresses can be challenging and confusing.


Conventional crib mattresses are made in one of two ways: innerspring coils or high density foam.


A coiled crib mattress, much like its adult counterpart, contains springs layered between padding. The padding and filler material can include volatile organic compounds, or VOC's. Some of these compounds, such as formaldehyde, are classified as carcinogens, and many can have short- and long-term effects on your baby's health. In addition, the vinyl cover which makes a conventional crib mattress waterproof is made of vinyl, specifically polyvinyl chloride, or PVC, a rigid plastic which must be treated with chemicals called phthalates to give it flexibility.


A high density foam crib mattress lacks the vinyl and fillers of a coil mattress, but VOC's can still be present from anti-flammability treatments.


Regardless of its construction, a traditional mattress can create a dangerous sleep environment. The vinyl covers on coil mattresses and the high density foam of a standard foam crib mattress do not regulate your baby's sleep temperature. Core temperature is believed by some to be a contributing factor in SIDS (Sudden Infant Death Syndrome) deaths.


Moisture, dust mites, and bacteria can flourish, which may lead to serious health complications later in childhood, such as allergies and asthma. Even in an organic foam or coil sleep surface, moisture in the bedding can create a habitable environment for bacteria.


All mattresses, including those for cribs, sold in the US must meet flammability standards, but the government does not regulate how mattresses are rendered anti-flammable. Some common chemicals use to treat crib mattresses are chlorinate, antimony, dimethyl sulfate, crystaline silica and boric acid, a poisonous pesticide.


Fortunately, there are safe alternatives to the toxins in conventional crib mattresses.


When searching for your baby's crib mattress, there are some factors to consider:

• A sleep surface which wicks moisture away from baby, drawing moisture out of the sleep surface reduces the chances for harmful microorganisms to reproduce. A washable sleep surface prevents dust mites and further reduces bacteria.
• A breathable/air permable crib mattress material helps to stabilize your baby's core temperature, which, in addition to giving your baby a more comfortable and restful sleep, may possibly reduce their chances of SIDS.
• The physical construction of the mattress can also impact its safety. Searching out a sleep surface which will support your baby through their toddler years without breaking down, splitting or tearing justifies what can seem like a large investment.

Babies, toddlers and preschoolers spend much of their hours in sleep, sleep which is crucial to their health as well as intellectual and social development. Providing a safe and healthy sleeping space goes far in ensuring a parent's peace of mind when baby comes home and for years to come.

This article was written by Cameron Garriepy, an expert in the

Baby Products category at www.yoexpert.com

The Facts About Baby Sleep Product Testing, Endoresements, and Certification.

There are a lot of organizations that offer some type of "seal" of approval.  We have all seen them, and even rely on them when making decisions on what is best for our baby. 

The Juvenile Products Manufacturing Association (JPMA) is one organization that is widely recognized by both manufacturers and consumers as a leader in the standardization of testing and compliance criteria for more than 2,000 products in 20 categories. 

Since its inception in 1976, the JPMA Certification Program continues to grow and play an important role in the juvenile products industry. ASTM International (formerly The American Society for Testing & Materials) develops and publishes the standards that products must meet in order to JPMA Certified.  The JPMA Certification Seal on a product tells consumers this product has been verified as conforming to the requirements established by ASTM, through independent laboratory testing and follow-up on-site inspection of the manufacturer's production line.  Manufacturers must pay a fee for this certification and must enlist JPMA recommended product testing labs to conduct standardized testing of their product. One such testing Lab is Intertek.  The JPMA currently certifies cribs, but contrary to popular belief, does NOT certify or test crib mattresses.  Unfortunately, you will not find a single crib mattress that bears the coveted JPMA’s seal of approval.

The Consumer Product’s Safety Commission (CPSC) is another very well respected organization in mandating safety standards for all types of baby products.  But even The CPSC has more to say on cribs than crib mattresses.   The CPSC does require a full size crib mattress to be 27 ¼ inches by 51 5/8 inches and not be any thicker than 6 inches.  

The CPSC has also been very beneficial in banning the use of some Phthalates found in crib mattresses.  It is in this vinyl waterproof covering that phthalates are found. Vinyl is a plasticized form of PVC. By itself, PVC is toxic enough; it’s widely considered to be one of the most environmentally unfriendly plastics in use today. However, PVC is a hard plastic, made soft and pliable for the surface of a crib mattress by adding hazardous plasticizers called phthalates. Vinyl, and hence phthalates, have also been used as the waterproof membrane in most crib mattress pads.  Phthalates are known to affect a child’s developing endocrine (hormonal) system, which may cause asthma, allergies and even cancer.  As of Feb. 10, 2009, the Consumer Product Safety Improvement Act (CPSIA) has banned three varieties of phthalates (DEHP, DBP, and BBP) for use in baby and children’s mattresses and other baby products. The other three phthalates in the CPSC ban (DINP, DIDP, and DnOP) are only illegal for teethers and other objects expected to be placed into a child’s mouth, so they still may be present in vinyl crib mattresses. Another phthalate chemical known to cause cancer (DnHP) has not yet been banned at all.

The CPSC also mandates flammability standards for crib mattresses.  All crib mattress manufacturers must now comply with the strict CPSC 16 CFR Part 1633 Standard for Flammability (Open Flame).  The CPSC changed its flammability standards to the Open Flame test when it was discovered that crib mattresses, during a fire, were engulfing in flame.  The reason being is that foam is a petroleum based product and when in contact with an open flame, will ignite and burn rapidly.  However, it has forced many mattress manufacturers to result to putting boric acid in their mattresses in order to comply with the CPCS flammability standards.  Organic mattresses use the same boric acid in order to make their mattresses water resistant. 

>First Candle is another well respected seal when looking for safe baby sleep products.  However, the organization charges company a hefty fee to bear their symbol.  In fact, the higher the fee an organization is willing to pay, the higher level of endorsement the company receives.  When a product is submitted to First Candle, unlike the JPMA, no testing is done.  There is NO conforming to the requirements established by ASTM, or any other product testing organization.  The product is simply evaluated by a panel of undisclosed professionals; none of whom are product or safety engineers.  The First Candle Organization does a wonderful job of spreading the word on Baby Sleep Safety as well as bereavement counseling and research.  I realize product endorsements are a way for the organization to make money for their many charitable causes.  However, their “seal of approval” and product endorsements are not backed by product testing

There are many other organizations that offer manufacturers a way to “buy” their seals.  Most of these organizations solicit manufacturers to pay a hefty fee to have their products doled out, for free, to a handful of consumers; all of various education levels, and have their products evaluated by end users.  These end users are mostly moms.  Again, NO conforming to the requirements established by ASTM, or any other product testing organization.

When it comes to your baby’s safety, make sure products have been tested by independent testing labs that specialize in the testing and safety standards of juvenile products.   

Breathable Can be a Misleading Term....The Importance of Checking For Air Permeability in Baby's Sleep Products.

There are many fabrics that we consider as breathable.  It’s not uncommon to hear someone refer to their Cotton shirt as breathable.  I have even heard of crib mattresses that are encased in plastic being referred to as breathable because they have a few grommets in the sides that allow air to escape.  I am sure by now many of you have even seen crib sheets, mattress protectors, and even densely filled crib mattresses touting their claims of being "Breathable." 


When we refer to the word breathable, an adjective, according to the dictionary definition,

1. (of air) fit to be breathed

2. (Clothing, Personal Arts & Crafts / Textiles) (of a material) allowing air to pass through so that perspiration can evaporate.

So are some product's claims misleading when they refers to them as breathable?  I guess it depends on which definition of breathable they are referring to.  In our cotton shirt example, it would be considered breathable by definition 2.  The cotton shirt will certainly let air pass through so that perspiration can evaporate.   But when we hear of Breathable Crib Bumpers, which we have all embraced as a safer alternative to conventional padded crib bumpers, we realize they are breathable according to definition 1 above.  So what sets them apart from a cotton shirt's definition of breathable?  It is their level of Air Permeability as well as their breathability.

By definition, Air Permeability is a measurement of the ease with which air is able to travel through a porous or solid material. The industry standard test for measuring Air Permeability in fabric is the  Active Standard ASTM D737.  This worldwide defacto standard for air permeability testing is based on the Frazier Differential Pressure Air Permeability Tester.

Air permeability is an important factor in the performance of such textile materials as gas filters, fabrics for air bags, clothing, mosquito netting, parachutes, sails, tentage, and vacuum cleaners. In filtration, for example, efficiency is directly related to air permeability. The standard measurement of airflow is determined by how much cubic feet (CFM) of air pass a point in one minute. The higher numbers, the more air permeable…..or the more air being moved through the fabric.

So please don't be mislead with products claiming to be breathable.  Breathable labels do not always mean an individual can inhale and exhale through them. For a truly Breathable product, you want to make sure it has a high ASTM D737 rating as well as a high CFM rate.  Don’t be afraid to request the test results from companies claiming to have “Breathable” baby products. 

The Secure Beginnings Heaven Sent Breathable Crib Mattress has an ASTM D737 test rate of over 330 (referred to as blue sample in test results) and a CFM rate of 168 versus a standard crib ASTM D737 test rate of .19  and a CFM rate of .10  (referred to as white sample in test results)  CLICK HERE TO SEE FULL REPORT

CO2 Rebreathing Study of Breathable Crib Mattress

Is Sudden Infant Death (SIDS) Still a Concern When Choosing a Crib Mattress?

We all know that the "back to sleep" campaign introduced in the US in April, of 1992 has decreased the incidences of SIDS by over 50%. In June of 1992, the Task Force on Infant Positioning and SIDS, reaffirmed that a baby should be placed on their back on a firm crib mattress when placed in a crib. They further recommended that soft surfaces or objects that might trap exhaled air (CO2) should not be in an infant's sleeping environment, particularly under a sleeping infant to prevent an infant from rebreathing CO2 (Carbon Dioxide). The 1994 statement was issued jointly by the American Academy of Pediatrics (AAP) and several governmental agencies and SIDS organizations and marked the initiation of a national campaign to encourage parents and caregivers to place healthy infants on their backs when putting them down to sleep. 

However, despite the "Back to Sleep" campaign, it seems that there is still over 4,500 sudden unexpected infant deaths each year.  In fact, SIDS is still a leading cause of death from infants aged 0 months – 1 year in developed countries, despite a significant decline in its prevalence, according the American Academy of Pediatrics.  More over, there is continued reluctance among many caregivers to place infants supine for sleep. Reasons for this reluctance include concerns about choking and aspiration, sleep disruption, or the adverse developmental effects attributed to back sleeping.   

In a statement released by First Candle SIDS Alliance,  in addition to the obvious hazards of the adult bed (suffocation, overlay, wedging and falls) there are two more “invisible” challenges in the sleep environment that can trigger a SIDS death in a vulnerable baby. Rebreathing carbon dioxide (exhaled air) and overheating.   Rebreathing can be caused by tummy sleeping and soft bedding or other items in a baby’s sleep area that traps the carbon dioxide around the baby’s face. Rather than breathing clear, fresh air, they “rebreathe” the exhaled air. A normal, healthy baby would react to these challenges and cough, cry or otherwise get themselves out of the stressful situation. To a baby predisposed to SIDS, their brain does not tell them there is a problem and they continue to sleep through the problem - which in turn can trigger them to die suddenly and unexpectedly. The same holds true for overheating - the baby’s brain does not respond to the rise in temperature.  This theory helps explain why some babies can sleep on their tummy and live and others can’t; why some babies can bed share and live and others can’t, etc. It is the hope of the SIDS Alliance that the next research breakthrough will be a way to identify these vulnerable babies so parents can exert extra care in getting them through the critical first months of life when the SIDS risk is the highest.

The leading hypothesis that explains significant risk factors for SIDS in the sleeping environment is the rebreathing hypothesis.  According to this hypothesis, based on a 1998 case comparison study of 206 SIDS deaths in the United States, Scheers et al.  Arch Pediatr Adolesc Med 1998; 152:540-547, babies sleeping in an environment which is characterized by limited dispersion of exhaled gas, such as the prone position, soft bedding, and with facial covering, causes rebreathing of exhaled  air and can bring about hypercarbia, hypoxemia and death.  In a mechanical model of an infant rebreathing it has been reported that air turbulence or circulation can reduce CO2 inhalation.

According to an independent testing lab using the mechanical model, representing an average 4 month old infant, on the Heaven Sent Breathable Crib Mattress there was a significant decrease in the amount of CO2 present on the crib mattress when compared to a conventional firm crib mattress with a sheet.  For test and comparison purposes a bean bag chair and a long haired sheepskin surface were tested as well.  The test was conducted in a controlled environment emulating a normal household temperature and humidity level; the run time of the test was 1 hour.  The test was repeated several times for each sleep surface and had a standard deviation of +/- .05.  A mixture of 76% N2, 17% O2, 78% N2, 2% AR and 5.0% CO2.  A conservative model of 25 breaths per minute was used (the normal breathe per minute of an average 6 month old is 30 breaths per minute.)  Once the model/machine was turned off, a measure was taken for each of the 4 surfaces mentioned to see how much of the (5%) CO2 was retained on each surface over a 10 minute period (600 seconds).

The testing data/results along with visual images were also sent to Dr. William W. Fox, Division of Neonatology, Children’s Hospital of Philadelphia, and Dr. Thomas H. Shaffer, Department of Biomedical Research, Alfred I. duPont Hospital for Children for expert medical opinion to confirm the level of hazard for carbon dioxide rebreathing.

Given the results of the carbon dioxide evaluation and the expert medical consultation, the Secure Beginnings Crib Mattress poses a significantly lower hazard for carbon dioxide rebreathing than the tested firm crib mattress with a cotton sheet. While the firm crib mattress represents a known low hazard item and is recommended by the American Academy of Pediatrics to reduce the risk of SIDS, inconclusive causes of SIDS cases have occurred on firm crib mattresses. The Secure Beginnings Mattress demonstrates a significant decrease in carbon dioxide retention compared to the firm crib mattress and presents a significantly lower hazard level than the firm crib mattress.

Given the results of the carbon dioxide evaluation and the expert medical consultation, the Secure Beginnings Crib Mattress poses a significantly lower hazard for carbon dioxide rebreathing than the tested firm crib mattress with a cotton sheet.   CLICK HERE TO SEE FULL REPORT