As postpartum doulas, our role is to support parents during the early days and weeks after welcoming a new baby. One big component of that is helping parents maximize rest. This can be done when we provide newborn care as well as by modeling sleep techniques, so parents get rest between your visits. Whenever we work with families, it is important we emphasize safe sleep.
When we look at big box baby stores, fancy boutiques or online retailers, we see many different baby items such as bouncers, swings, and more. While most areas have safety requirements, warnings and detailed instructions, it isn’t uncommon for parents to miss warnings such as:
Do not use unattended
Only for use in a car or travel system
Warning: Not for sleep
So not place inside a crib
Most baby gear products approved for sale are safe. However, they’re only safe when used according to manufacturer’s directions.
As doulas, we need to model safe sleep during our shifts while providing supportive but safe sleep advice. We can gently explain to parents what is and is not a safe sleep surface.
Here are 4 popular but unsafe sleep spots for baby:
#1: Bouncy Seat – Not a Safe Sleep Spot
Bouncy seats provide a safe and often entertaining spot to put baby down. After all, parents need to eat, use the bathroom, etc. However, when we read the directions and warning labels, it is clear they are only to be used with supervision and are not designed for safe sleep.
Bouncy seats are safe for short periods of time, always supervised, and only for a short nap if baby happens to fall asleep. A caregiver should remain within arm’s reach and monitor baby. Again, these seats are safe when used as directed.
However, young infants have limited control of their head and necks along with a very narrow airway. Due to this, positional asphyxiation is a risk. With the angle of a bouncy seat, a tired or sleeping young infant could get their head and neck into a position which compromises their airway.
With older infants, there is a risk of injury if they attempt to climb or roll out of the seat. Always encourage clients to read manuals and follow directions. Be sure to always model appropriate use during your shifts as well.
#2: Car Seats Outside Vehicles or Approved Travel Systems
Many infants fall asleep in the car. In fact, some people will drive around when desperate for baby to get a nap in. However, a car seat in the car or on a travel system stroller is angled in a way which does not compromise baby’s airway.
However, outside of a car or travel system, the car seat can rock forward and compromise a baby’s airway. Encourage parents to read their car seat manual for clear directions on safe use as each seat is unique.
In fact, some newer infant car seats have built in features which allow the angle to be changed into a safe position for short term use outside a vehicle.
If a caregiver is nearby, closely monitoring, and angled the seat, it might be safe to allow baby to continue napping. Overnight sleep is not safe. Also, as the doula, it is important to follow safe sleep when you oversee the infant’s care. It is best to always remove the baby from a car seat if they are brought into your care that way.
#3: Couches, Recliners, and Other Furniture
As a doula, we are often set up in a living area during shifts. If you are working overnight, you might even catch a quick nap if baby is sleeping well. Big comfy furniture can be a great place to nap, if you’re an adult.
For infants, it is never safe to sleep on a couch, recliner, etc. And it is dangerous to co-sleep on couches, recliners, etc. There is a significant risk of entrapment, positional asphyxiation, and SIDS when an infant sleeps on a soft surface.
If you are working with an infant and feel drowsy, avoid sitting on a comfy couch while soothing them. Ideally, you are showing up to shifts well rested. But in the off chance you are quite fatigued, never risk falling asleep with baby on soft furniture.
#4: Big Baby Gear, Swings, etc., Are Not Safe Sleep Approved
As a postpartum doula, we’re often trying to juggle newborn care, light household organization, bottles, etc. It can be tempting to place a baby in swing and once they fall asleep, let them stay. The gentle soothing motion can keep them quite settled.
As tempting as it is, swings aren’t designed for long term sleep. Swings are safe for use with a caregiver nearby, not for unattended long-term sleep. Like the other items on this list, the angle can potentially compromise the airway.
While this isn’t typically a concern for a nap near a caregiver, it’s important to remain mindful of sleep safety. Even if the angle does not fully compromise their airway, it could impact quality of breathing and potentially increase the risk of SIDS.
There are other items, even ones with nap or sleeper in the name, but it’s important to remember that safe sleep guidelines include only firm mattresses free of plush and fluffy items or bedding, and entrapments hazards.
During your shifts, it is important for the baby sleep on a safe surface designed for infant sleep. This includes cribs, some pack and plays, bassinets, etc. Nap cushions, infant loungers, plush co-sleepers, etc., are not safe and should not be used during your shift. Many doulas include a clause in their service agreements or contracts with families that there must be a safe sleep surface available for baby during shifts.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...