The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Among the many toxic ingredients other than nicotine in cigarette smoke are the oxygen blocker carbon monoxide; benzene (a potential carcinogen); ammonia; hydrogen cyanide (which is used in making rat poison); and formaldehyde (which is becoming a prime suspect in SIDS cases).
Smoking also interferes with natural mothering and is likely to sabotage breastfeeding (lack of breastfeeding is another risk factor for SIDS). Studies show that mothers who smoke have a lower level of prolactin, one of the “bonding” hormones that regulates milk production and affects mothering behavior. A mother with less prolactin may have less awareness of her infant, an especially worrisome situation when these infants are already compromised due to exposure to smoke.
3 Put your baby to sleep on her back, not her side or stomach. SIDS rates have fallen 40 to 70 percent in eight countries that instituted national Back to Sleep campaigns, similar to infant car seat campaigns. Since the American Academy of Pediatrics (AAP) issued its first recommendation on infant sleep positioning in 1992, then began its own Back to Sleep campaign in 1994, cases in the United States have declined 15 to 20 percent. Preliminary studies suggest that back-sleeping babies breathe more easily and arouse from sleep more readily. (Arousability from sleep is a healthy, protective mechanism and one that is thought to be diminished in infants at risk for SIDS.)
The AAP recommends that all infants be placed to sleep on their backs. If your baby refuses to sleep on his back, an alternative is sleeping on his side with the lower arm extended to lessen the chance of his rolling over on his tummy. Babies with certain medical conditions, such as small jawbones or structural abnormalities of the airway, or those who suffer from gastroesophageal reflux, breathe more safely when placed to sleep on their tummies. Discuss these conditions and safe alternatives with your doctor.
4 Breastfeed your baby if possible. New research confirms what mothers have long suspected: The risk of SIDS is lower in breastfed babies. A study from New Zealand shows that SIDS was three times higher in babies who were not breastfed. There are hundreds of health-promoting and immunity-building substances in human milk that aren’t in formula. These substances cannot be manufactured or bought. Also, nonbreastfed babies have been shown to have lower sleep arousability. If you choose not to or are unable to breastfeed, the other four steps become even more important.