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Safe to Sleep

Safe to Sleep is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Safe to Sleep rather than just read about it. In short: The Safe to Sleep campaign, formerly known as the Back to Sleep campaign, is an initiative backed by the U.S. National Institute of Child Health and Human Development (NICHD) at the U.S.

Safe to Sleep — main illustration
Safe to Sleep — illustration

Key takeaways

  • Safe to Sleep belongs to science; place it in that map before memorising details.
  • Learn the definition first, then one example that makes the definition concrete.
  • Connect Safe to Sleep to a quantity you can measure, compute or draw — that is where exam questions come from.
  • Reproduce the core statement of Safe to Sleep from memory before moving on to harder problems.

Reference excerpt

The Safe to Sleep campaign, formerly known as the Back to Sleep campaign, is an initiative backed by the U.S. National Institute of Child Health and Human Development (NICHD) at the U.S. National Institutes of Health to encourage parents to have their infants sleep on their backs (supine position) to reduce the risk of sudden infant death syndrome (SIDS). The target age group of the campaign is 0–1 years of age, because this is when babies are at the greatest risk of experiencing SIDS. Since "Safe to Sleep" was launched in 1994, the incidence of SIDS has declined by more than 50%. However, there has been a rise in infant sleep-related suffocation events. Consequently, the campaign has broadened its goal to focus on safe sleep conditions and further preventative measures.

History

In 1992, the American Academy of Pediatrics (AAP) recommended that babies sleep on their backs or sides to reduce the risk of SIDS (a revised statement in 1996 retracted the side-sleeping option). NICHD launched the "Back to Sleep" campaign in 1994 to spread the message. The campaign was successful in significantly reducing the percentage of babies sleeping on their stomachs (prone position). It was found, however, that a significant portion of African-American babies were still sleeping on their stomachs; in 1999, an African-American baby was 2.2 times more likely to die of SIDS than a white baby. Thus, then Secretary of Health and Human Services Donna Shalala and Tipper Gore refocused the "Back to Sleep" campaign on minority babies.

Campaign In 1985, Davies reported that in Hong Kong, where the common Chinese habit was for supine infant sleep position (face up), SIDS was a rare problem. In 1987 the Netherlands started a campaign advising parents to place their newborn infants to sleep on their backs (supine position) instead of their stomachs (prone position). This was followed by infant supine sleep position campaigns in the United Kingdom (as "Back to Sleep"), New Zealand, and Australia in 1991, the U.S. and Sweden in 1992, and Canada in 1993. This advice was based on the epidemiology of SIDS and physiological evidence, which showed that infants who sleep on their backs have lower arousal thresholds and less slow-wave sleep (SWS) compared to infants who sleep on their stomachs. Thus, infants sleeping on their backs are more easily awakened. In human infants, sleep develops rapidly during early development. This development includes an increase in non-rapid eye movement (NREM) sleep – which is also called quiet sleep (QS) – during the first 12 months of life, in association with a decrease in rapid eye movement (REM) sleep – which is also known as active sleep (AS). In addition, slow wave sleep (SWS) – which consists of stage 3 and stage 4 NREM sleep – appears at 2 months of age, and it is theorized that some infants have a brain-stem defect which increases their risk of being unable to arouse from SWS (also called deep sleep) and therefore have an increased risk of SIDS due to their decreased ability to arouse from SWS. Studies have shown that preterm infants, full-term infants, and older infants have greater time periods of quiet sleep and also decreased time awake when they are positioned to sleep on their stomachs, meaning these babies are harder to wake when sleeping on their tummy. In both human infants and rats, arousal thresholds have been shown to be at higher levels in the electroencephalography (EEG) during slow-wave sleep. In 1992, a SIDS risk reduction strategy based upon lowering arousal thresholds during SWS was implemented by the American Academy of Pediatrics (AAP) which began recommending that healthy infants be positioned to sleep on their back (supine position) or side (lateral position) instead of their stomach (prone position) when being placed down for sleep. In 1994, a number of organizations in the United States combined to further communicate these non-prone sleep position recommendations, and this became formally known as the "Back To Sleep" campaign. In 1996, the AAP further refined its sleep position recommendation by stating that infants should only be placed to sleep in the supine position and not in the prone or lateral positions. Since the launch of the campaign, the incidence of SIDS has declined by more than half. However, 3,400 babies (ages 0–1) still die per year from SIDS and sleep-related suffocation events despite the implementation of this campaign. The AAP and further research has shown that there are preventative measures that can be taken to control environmental factors to prevent such adverse events.

SIDS risk factors Risk factors for SIDS can be divided into three major categories: maternal, infant, and environmental factors. The factors mentioned below are modifiable and preventable to help decrease the occurrence of SIDS and sleep-related suffocation events.

Preventive measures Several precautions focused on controlling environmental factors can be taken to minimize the risk of SIDS and sleep-related suffocation events. Per the safe to sleep campaign, these preventive measures can be taken to decrease the rate of SIDS and sleep-related suffocation events:

Sleeping on back Sleeping on a firm/hard surface Nothing in the crib or bassinet other than the baby No stuffed toys, loose blankets and/or crib bumpers Room sharing This is different from sharing a bed with an infant. This entails sleeping in the same room as one's baby but making sure the baby has a safe sleeping space free of the aforementioned risk factors. Use of a pacifier while the baby is sleeping The concept behind the use of a pacifier during sleep is that these babies do not sleep as deeply and might be more easily arousable; thus, they are less likely to have an adverse sleep-related event. Tummy time Regular tummy time helps to strengthen babies' core, neck, and shoulder muscles. These muscle groups are essential in helping babies to turn their head and bodies to avoid suffocating during sleep. Avoiding sleep in a car seat outside of the car A car seat is only safe to sleep in while in the car. Avoiding sleep in an inclined chair (e.g., Rock 'n Play Sleeper, rocking swings, etc.) without constant supervision Breastfeeding Regular prenatal care No smoking during pregnancy Avoid secondhand smoke exposure Up-to-date immunizations

See also Sudden infant death syndrome Tummy time Plagiocephaly United States Department of Health and Human Services

Footnotes

References

… excerpt ends here. Continue reading the full article.

Illustrations

Safe to Sleep: The campaign logo, illustrating a baby sleeps on a supine position
The campaign logo, illustrating a baby sleeps on a supine position
Safe to Sleep: A plot of SIDS rate from 1988 to 2006
A plot of SIDS rate from 1988 to 2006

Worked examples

Example 1 — a first encounter with Safe to Sleep

Start with the simplest possible case. Write down what Safe to Sleep claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Safe to Sleep before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Safe to Sleep ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Safe to Sleep

In research
Safe to Sleep appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry
Engineering practice reuses Safe to Sleep in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom
Safe to Sleep is common in secondary-school and first-year university syllabi. It links to neighbouring topics 1994 establishments in the United States, Children's health in the United States, Health campaigns, so understanding it makes those chapters shorter.
In everyday life
Look for Safe to Sleep outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.
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How to study Safe to Sleep in 20 minutes

  1. Read the reference excerpt below once, without taking notes.
  2. Close the page and write down what Safe to Sleep means in your own words.
  3. Compare your version with the excerpt and mark what you missed.
  4. Work through the three examples above with pen and paper.
  5. Explain Safe to Sleep out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Safe to Sleep in simple terms?

The Safe to Sleep campaign, formerly known as the Back to Sleep campaign, is an initiative backed by the U.S. National Institute of Child Health and Human Development (NICHD) at the U.S.

Why does Safe to Sleep matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Safe to Sleep?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Safe to Sleep.

Tags

  • 1994 establishments in the United States
  • Children's health in the United States
  • Health campaigns
  • National Institutes of Health
  • Projects established in 1994
  • Tipper Gore

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