It is especially hazardous in the first 24 hours after birth when mom is exhausted, possibly medicated for pain, possibly alone in her room with baby. Family has gone home and if partner is there, he is also very soundly asleep on a chair. Her breasts don't yet stay up high, perky, and full of milk, guarding baby. They "flow" to each side of her chest. Her arms fall limp to her side on the bed. There is nothing to hold baby up on mom's chest and baby falls off, even to the floor. Mom often doesn't even hear the baby cry when s/he hits the floor. That buys baby 1 or more days in NICU for observation and care for any impact injuries.

If the RN comes in for regular checks / vitals, and finds everyone passed out, she will remove baby from mom's chest, or from mom's bed, and place baby in the baby bed.

In another instance, babe was prone on mom's chest, skin to skin, still in L&D. This was after the Apgars, weighing, exams, etc and it was time for quiet snuggling and nursing. Gramma & G-Gramma were in the room. RN left for just a few minutes and everyone fell asleep. RN came in for regular check and found baby, prone on mom's chest, mom's fingers laced to form a circle of care and the bed elevated to a 45 degree angle, but babe's face was flat on mom's chest and NOT breathing! No air space! I mean face-plant flat on mom's chest / breast. Babe was actually turning color, NOT pink! That babe got bagged or NRP care and a rush trip to NICU. Babe recovered and went home - thankfully! Mom was not obese but she and baby were Asian and both had unusually flat noses. This was first baby for mom.

Yes, it does take someone staying awake to monitor babe during those times of totally exhausted and usually medicated sleep. 

These first hospital days are very different from a nursing mom in a normal sleep situation in her home, babe on the bed beside mom, (NOT up on top of her!) no smoking, no drugs or medications, no other risk factors. 
 
Phyllis

--
Phyllis Adamson, BA, IBCLC, RLC
Glendale, AZ.
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