Tuesday

Back to Sleep

Received Tuesday, June 9, 2009
Perspective and Opinion on ISYN I am a nanny who has been doing a bit of babysitting for different families on the weekends to supplement my income.

I am a firm believer in SUPERVISED tummy time for infants, and also for always putting an infant down to sleep on its back.

Last night I babysat for a new family with a 3 month old baby. Mom told me to put baby to sleep on his tummy. What would you do?

38 comments:

Name said...

Uhhh... I would put him to sleep on his stomach like the mother asked.

BostonsGirl said...

Whatever the mom says shes the boss its not your baby and that has been a debated issue. Even doctors don't agree so its up to mom. I'm sure it will be fine either way it has been fine obviously for the past 3 months I hardly think it will change with you.

MinuteMuggle said...

I would do what the mother told me to do. She knows her child best. Many babies do roll over at that age, and also some sleep better on their belly.

emily said...

Is the crib free of stuffed animals, blankets, etc. and does it have a tightly fitted sheet? If the answer is yes, don't worry about the mother's decision, and she's obviously taken care in creating her child's sleep space. If the answer is no, then you might want to carefully & diplomatically point out your concerns.

Nanny In San Diego said...

If the mother said put the baby on his or her tummy, I would do so. Unless a parent asked me to do something that I thought was neglectful or abusive, I would just follow the instructions per diem.

Momkat said...

I would tell the mom flat out that you can't do that. If the baby were to die of SIDS under your watch, it would be your word against the mom's when the ambulance came into the house to find a dead baby.

Don't do it! said...

Three years old is absolutely too young to put a baby to sleep on his/her tummy. Don't do it! Even if you weren't charged with negligence you would have to live the rest of your life knowing a baby died under your watch! Don't do it!!!!!!!!! If the mom wants to take the risk, that's her problem (but she's stupid for doing it).

Pick a name said...

I would do as the mother asked and put baby to sleep on his stomach. If you have a problem with it, find another job.


Also 3 months it is "Safer" to put a baby on their stomach. Their neck muscles are stronger and if they need to move their head, they will.

Nanny Sarah said...

I agreed with momkat- if the mothers says to put the baby on her/his tummy, do so. BUT maybe have mom and dad sign a contract stating it is ok to put the baby on her/his tummy. After all, daycares do this. And will save you if something would to, gosh-forbind- happen. You need to have signed proof. Trust me, being a nanny in that situation before- you need proof.

nycnanny said...

I would do what she told you to do. Maybe there is a reason that she puts the baby to sleep on its tummy?? My niece ALWAYS slept on her tummy as a young infant due to bad acid reflux. They got a pad in the crib that monitored the heart beats just in case BUT they also got their pediatricians approval that sleeping on the tummy is not the end of the world. She wouldn't sleep on her back, not then and not now.

honest nanny said...

put the baby on his tummy.

my charge, though laid on his back before bed, always ends up turning himself onto his tummy.

i was also a tummy sleeper.

if the crib is cleared of toys, blankets or other suffocating devices you have to assume it is the safest environment you could make it.

SIDS is a sad and terrible thing that could happen to anyone. If you can't handle the pressure of a baby sleeping on your watch then maybe you shouldn't be in this line of profession.

Clo said...

You do your job how the person paying you has instructed you to do your job.

It isn't that big of a deal. Me and my brother were both tummy sleepers, my 2 year old nephew was a tummy sleeper for a large portion of his infant year, and my 3 month nephew is ONLY to be put to sleep on him tummy unless someone is right next to him to watch him sleep on his back, doctors orders.

By that age they can lift up their head and move it so they won't just smother. You don't know the reason, so just do it.

And not all doctors are back sleeping advocates. Some firmly press back sleep, some think tummy sleep. This is a matter that is debated and nobody is STUPID (Ahem, "Don't do it!") for their beliefs that are shared by others all over the place.

Momkat said...

The only time it's safe to put a baby to sleep on its stomach (unless there is specific directions from the pediatrician--which I would want to see in writing)--is if the baby is old enough to roll over from his front to back, or back to front--unassisted. I like the suggestion from the poster who wants you to get a signed waiver from the parents--and I would probably ask that the pediatrician sign it too.

OP said...

Gee I didn't think I would get such a negative backlash from this! I was just curious as to what everyone else would do!
I put the baby to bed on his tummy just like his mom told me to. I was just curious about what other nannies would do in this, or any other similar situation. Because I have only ever been told that a baby should be put to sleep on their back. Even when a baby is able to roll over, they should still be put to bed on their back, and if they roll over onto their stomach THAT is okay.

I CAN handle the pressure of having a baby sleep on my watch, thank you very much... the orginal post did not read "the mom asked me to put baby to sleep on his stomach and I flipped out and cried and didn't end up putting baby to sleep at all!"

I suppose I did get opinions, though!

This is a serious issue said...

Ladies,
This is a serious issue. If you, your kids, the neighbor down the street, or Santa Claus slept on his/her tummy and didn't die of SIDS does not mean another baby won't. If a child is genetically predisposed to SIDS, or has other risk factors (such as being exposed to cigarette smoke, being a low birthweight baby, etc.) he/she may not be safe sleeping on his/her tummy. The OP is absolutely correct. You should always put a baby to sleep on his/her back...and if the child can turn over on his/her own that's fine. As a nanny I would not accept the liability of following a mother's directions--without a note from the pediatrician stating that there is a medical reason for putting a child to sleep on his/her tummy.

Psh said...

To BostonsGirl:

Your statement about the baby obviously being fine sleeping on his tummy for the past 3 months, and hardly thinking it would change for OP is silly. Babies don't die more than once from SIDS.

That is like saying that since for the past 3 months you've been driving drunk and you haven't died, it's hardly going to change when you drive drunk tonight. I think it is luck luck luck, and you never know when your luck will turn!

Tales from the (Nanny)Hood said...

Well, I would ask the mom why baby needs to sleep on his stomach. You can do that gracefully, explaining that you have always put babies "back to sleep" and you are simply curious as to why her child is a tummy sleeper.

Then you'll have your answer, and since you don't seem to be terribly worried anyhow, I would guess you will do what you are doing now.

Me, I would be uncomfortable putting baby on his tummy to sleep, simply because it only takes one breathing issue for baby to die. That's why I would ask, and if the reason wasn't medical, I would reconsider working for these parents.

Hmmmm said...

Hmmmmm...I supposed it depends on how lucky you feel. Me? I wouldn't take the chance.

TC said...

Do what the mother wants, honestly I think the SIDS thing is over hyped. I've known far to many babies that have slept on their tummies with no problems than kids that have. In fact I've only known one child to die of sids and he wasn't on his tummy when it happened.

TC said...
This comment has been removed by a blog administrator.
DenverNanny said...

I agree with previous posters: I wouldn't do it unless mom put it in writing and signed it. You are the one "in charge" and you could be charged and go to to jail for a long time if anything happened...

Manhattan Nanny said...

The strength of the neck/ability to lift the head isn't the issue. It is currently believed there is a genetic disposition that has to do with not waking from sleep enough to move the head when re breathing exhaled carbon dioxide and not getting enough oxygen. This happens when lying on the stomach.

From The American Lung Association site.

http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2060727&content_id={DD8EAC73-1371-4129-9D82-0220D296D5E9}&notoc=1&gclid=CPudgLTL_poCFRd75QodMQlZdA

"There are many theories as to what actually causes SIDS. Some health experts believe that SIDS babies are born with brain abnormalities that make them unable to awaken from sleep when exposed to high carbon dioxide or low oxygen levels, leading to abnormal breathing or heart function.
The most important risk factors to be aware of are:

maternal smoking during pregnancy;

prone sleep position (lying face down), which can cause the baby to breath in too much carbon dioxide and not enough oxygen; and

secondhand smoke exposure."

OP, To answer your question. Iif I were in your position I would ask the reason for sleeping tummy down, and whether it has been discussed with the ped. If there is no medical reason, and the baby isn't rolling over on his own, I would put him on his tummy as per mom's choice, check on him every ten minutes, and never sit for them again.

Nanny in Sandy Eggo said...

Wow...I cannot imagine someone going to jail just because the baby was on his or her tummy...in fact I never heard of such a thing. Even if you put the baby on his or her tummy and told the investigator the parents told you to do so and you were only following directions, etc...I am sure it would be okay. I mean, c'mon worse case scenario...the baby died of SIDS (God forbid!)and the parents denied they specifically instructed you to put baby on tummy, I am still sure once it was determined to be a SIDS related death (again, Heaven Forbid!!!), you would not be tried, prosecuted then jailed for putting a baby on the tummy. I mean there was no intent on committing a crime or anything. That wouldn't even be considered neglect by law...people are overreacting...I knew a daycare owner who actually had a baby die of SIDS in her care and nothing ever happened to her.

Manhattan Nanny said...

TC,
"I've known far to many babies that have slept on their tummies with no problems "

Back in the day there were no car seats or belts. Kids bounced around in the back seat. Most survived, so I guess by your logic they are unnecessary?

jeepers creepers someone doesnt like babies said...

Not too mention that "far too many" implies that "damnit, and they survived anyway".

Jeesh said...

Sandy Eggo Nanny,

What about the fact that a baby DIED? One that you knew and cared about. And that you had to witness it first hand?

Jail is besides the point.

Kip said...

Cannot believe TC thinks SIDS is overhyped, that has to be one of the most ridiculous things I have read in the comments section of this site, and that is saying a lot.

TC said...

My cousin died from sids so I spent a lot of time researching and I keep up with current research on sids. I DO think it's over hyped, I'm not denying it happens but it doesn't happen for the most part to 'normal' children, there is almost always other factors that contributed to a child dying. My cousin had many health problems and spent the first 6 months of his life in the hospital, he died a month after he was home and it was labeled sids.

I was there a few years later when my cousin had another baby, I was there to see the fear in her eyes. I watched him while she worked because she was too afraid to leave him with anyone other than family. I remember the blisters he got from wearing the monitor 24/7 that checked his breathing and heartbeat...the monitor he was only supposed to wear when he was sleeping. I remember lugging that machine around with me everywhere and realizing it was much heavier than the diaper bag. I remember my heart dropping every time it started screeching at me only to learn a wire had come unsnapped.

I stand by my comments. Do as the mother says. It's her child to raise as she sees fit. For the most part as long as the crib is free from soft items like toys and the child doesn't have any other mitigating factors it will be fine sleeping on it's stomach

Momkat said...

All of you who say tummy sleeping is fine, you're taking an enormous risk unless there's a medical reason for putting an infant to sleep on his/her tummy. SIDS is not over-hyped. There's a national "back to sleep" program for good reason--and it's backed by an enormous amount of solid research. Jail, or no jail. If I was watching a baby and the baby died of SIDS that would haunt me for the rest of my life--especially if I could have prevented the death by putting the child to sleep on his/her back.

Momkat said...

I want to underscore that last point again--would you want to take any action, whatsoever, that could cause a child to die????? Think about it. It must be the most horrific experience to come into a room and see a dead baby in a crib--AWFUL!!!!!!! And knowing that everything that could have been done--including back sleeping--to prevent the death wasn't done. I would never, ever, ever, ever want to take a risk with another human beings life. It's not being over cautious--it's having good sense!

Momkat said...

"I knew a daycare owner who actually had a baby die of SIDS in her care and nothing ever happened to her."

Nothing happened to her? I'm sure she still has nightmares about what happened--if she has any compassion at all (and I'm sure she does). NOW...imagine if she had put that child to sleep on his/her tummy, when that's not recommended, and the baby died. Even if she doesn't go to jail--she has to live every single second of the rest of her life knowing she could have POSSIBLY (and I know it's not absolute) prevented that death. That would be HORRIBLE to live with! Again, think about it.

ct nanny said...

As is often pointed out, parents can do as they wish with their children, but paid caregivers take extra precautions. Ask the mom why baby needs to sleep on his tummy. If it's not medical, explain your concerns (frame it in terms of liability to yourself so that she doesn't feel like a bad parent for putting baby on his tummy). Either get her to sign or a written waiver or have her agree that you can put baby on his back.

Portlander said...

I'm shocked how many people on here would follow the mom's orders without questioning the safety of the request- aren't y'all the same crowd who criticizes nannies for being six inches away from a stroller? Placing a baby on her back to sleep is a basic safety measure that saves lives. A 3 month old who is used to sleeping on her stomach can be retrained to sleep on her back.

MinuteMuggle said...

I agree that a signed waiver is in order. At a daycare I worked at, any parent who did not want their child to be put to sleep on their back needed to sign one. They did NOT have to give a medical reason, however, and I don't think they should.

Portlander: we are not "all the same crowd." We all have different opinions about things. I myself am shocked by people who are shocked that others do not share their opinions 100 percent of the time. You shouldn't generalize like that about the posters here. They actually put forth a wide range of opinions.

Portlander said...

You're right, MM, I didn't mean to imply that this site is a monolith. I was being flip. But I am very surprised that so many commenters on this post would ignore extremely important safety advice. I believe that this site is concerned with the safety of children, though sometimes the opinions seem extreme to me. I'm surprised that anyone who cared for children wouldn't follow the guidelines of the back to sleep theory. As caregivers we have to be advocates for children's safety. Putting a 3 month on their tummy to sleep is a huge risk, and one I wouldn't take, as a professional.

mom said...

I would do exactly what the mother asked. If you do differently and, God forbid, SIDS or some other unforseen tragedy strikes while the child sleeps in your care, you may be toasted.
The best and safest sleep positions have never been firmly established for infants and, in fact,popular medical opinion changes from time to time on this issue. This is a debatable issue and so you should defer to the mom's preference.

If a mom asked you to do something that is indesputably unsafe to her infant then you should obviously refuse. Refuse the job altogether and, if the activity she engages in is serius enough to warrant it, alert the authorities that her child is in recurring danger.

mom said...

PS I put my son in his crib on his back once when he was newborn (actually at a 45 degree angle because I was worried about what actually ended up transpiring)...just long enough to use the bathroom. He vomited and choked on it. Thank God we were still in the hospital, as the nurse caught it and cleared his airway. She then yelled at me for laying him down in on his back, as the popular medical advice at that time was to put babies on the stomach. I hadn't wanted to do that either because I wondered how his little burrito wrapped body would hold his face out of the mattress enough to breathe. After that, I put my babies to sleep on their sides with their backs up against the crib. Everybody is alive and well.

cali mom said...

I have heard nothing debatable about the risks of putting babies to sleep on their stomachs, other than the prevailing theories of 20 years ago that the risk of choking on vomit was greater than the risk of suffocation. If anyone can link any RECENT challenges to the prevailing knowledge about the risks of SIDS, I'd be very interested to read them.

My son had a major reflux problem when he was tiny, and his doctor advised to keep him upright for a full 30 minutes after he finished eating (Nursing/bottlefeeding, actually.) THEN lay him on his back, feet against the bottom edge of the bed, covers tucked in tightly pulled up no higher than the nipple line. Swaddling was also strongly advised against.

I'd go with the suggestion of having the parents sign the waiver if they INSIST baby must sleep on the tummy. God forbid something happens and as someone said, it's the parent's word against babyitter's, and mom could argue that babysitter had more experience caring for infants than she did and should have known better, advised against tummy sleeping, etc. Seriously, just because mom had read something theorizing that baby car seats are actually more dangerous than laying a baby down on the floor of the car because they might become trapped in case of an accident, would you follow those instructions without question?