Dear Rachel,
What I want to get across is not to change the "back to sleep" campaign but
to put the emphasis that only supine at all times, if not in the plastic
bucket, does have negative outcomes for babies.
Because the evidence has been so strong and the push very big everyone is
telling parents that they are only to put their babies on their backs.  I
have been standing in rooms as instructions are given out by the baby's
doctor.  "you must always put your baby on their back, never their stomach."

Now, the original message was supine for sleep but many clinicians just find
it easier to make it blanket and feel their are no negative effects by making
the blanket statement.  Parents are afraid to put their babies prone, ever.
I want to see clinicians be responsible and give full descriptions to
parents, supine for sleep, prone during the day while with baby.
I would like to see some research on the negative effects of not giving these
correct directions.  I truly believe the incidence of Reflux has increased
with the back to sleep, but this may be more to do with poor instructions to
parents.
In our NICU, when a baby has reflux they are placed prone because this is
best for digestion.
By the way side lying is not the better position for Reflux.
I am frustrated with not knowing how to get the message out there.  I do talk
to as many moms as I can but that is not enough.
Ann Perry RN IBCLC
Boston, MA


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