Safe sleep remains an important topic. While parents have access to information through an ever-growing number of channels, new sleep products continue to enter the market. BabyWereld speaks with Mieke Cotterink, child safety expert at VeiligheidNL, about the key recommendations, innovations and the responsibility of the baby products industry.
For Cotterink, one phrase sums up the essence of safe sleep: ‘Less is more. A safe sleep environment does not have to be complicated. A simple cot, a firm, flat mattress and no soft materials around the baby. That is really all you need.’
Why does safe sleep remain such an important issue?
‘Because sudden infant death still occurs, unfortunately,’ Cotterink explains. ‘Since the 1980s, enormous progress has been made and the number of cases has fallen significantly. But it still happens, and it is every parent’s worst nightmare.’ According to Cotterink, continued attention is particularly important today. Parents receive advice from maternity care professionals and child health services, but also from family, friends, social media and AI. ‘Unfortunately, these sources do not always convey the same message. Parents genuinely want to do the right thing and give their baby the very best. Those high expectations, combined with an overload of information, can actually make things more complicated. That is why we need to work together to provide a clear and consistent message.’
ABOUT MIEKE COTTERINK
Mieke Cotterink is a child safety expert at VeiligheidNL, the Dutch knowledge centre for injury prevention. She researches serious accidents involving young children and translates these findings into practical advice for parents and professionals.
As a member of the European Child Safety working group, she advises on safety standards for baby and children’s products. Mieke is also a permanent jury member of the Baby Innovation Award and regularly appears in the media as an expert. In addition, she is an important source of expertise for professionals working in maternity care, youth healthcare and childcare.
What do we know about sudden infant death?
Although the exact cause is unknown, there are indications that a baby’s arousal mechanism may play a role. ‘Normally, a baby wakes up when they are not getting enough oxygen. In babies who die suddenly and unexpectedly in their sleep, this mechanism appears not to function properly.’ This is why it is important to prevent situations in which a baby may receive less oxygen, for example due to soft materials or bedding around the face. ‘You do not know which baby may have an impaired arousal mechanism. That is why you want to prevent these potentially dangerous situations for every baby.’
Back sleeping remains the foundation
The most important sleep recommendation remains unchanged: always place a baby on their back to sleep. Back sleeping has been recommended since the 1980s, and this change has contributed to a significant reduction in sudden infant deaths. Yet Cotterink still regularly hears comments such as: ‘We used to sleep on our stomachs too, didn’t we?’ Another common remark is: ‘My baby is simply a stomach sleeper.’ ‘A child is not born a stomach sleeper. I completely understand that parents who are getting very little sleep eventually try everything. But until a baby can independently roll from back to stomach and back again, the advice remains to place them on their back to sleep.’ Once a baby can independently roll from back to stomach and back again, they can choose their own sleeping position.
‘A child is not born a stomach sleeper.’
What role does the baby products industry play?
Cotterink believes manufacturers, distributors and retailers all have an important responsibility. Many products are developed with good intentions, to provide comfort or solve a problem. However, they can sometimes introduce new risks. One example is soft cot bumpers and padded sleep products. ‘To an expectant parent preparing the nursery, these can look attractive and cosy. But soft materials can pose a risk if a baby’s face comes into contact with them. What’s more, a soft bumper serves no essential purpose.’ Parents are in a vulnerable position, she says. ‘An entirely new world opens up to them, and they do not always have enough knowledge to assess which products are sensible to buy. As an industry, you therefore have a responsibility.’
Is innovation always progress?
Cotterink regularly encounters innovations that make her question whether they genuinely offer an improvement. Examples include large soft toys designed to soothe a baby through movement or touch, or devices that continuously rock a cot or pushchair. ‘Sometimes I wonder: is this really helpful? A large soft toy should never be in a baby’s bed in the first place. But with products that provide continuous movement, you can also question whether you want a child to become dependent on that.’ A baby may enjoy being rocked to sleep, but if movement becomes essential for falling asleep, this can cause problems later on. ‘We hear from childcare professionals, for example, that some children struggle to sleep because they are used to always being rocked or moved to sleep. There seems to be a solution for almost every problem, but sometimes those solutions create new problems and risks.’
‘There seems to be a solution for almost every problem, but sometimes those solutions create new problems and risks.’
Combination products require extra attention
The growth of multifunctional products also deserves careful consideration, according to Cotterink. From a sustainability perspective, products that can be used for longer and for multiple purposes are attractive, but different applications may also involve different safety requirements. She gives the example of a carrycot that can also be placed on a stand and used as a cradle indoors. ‘A carrycot is primarily designed for outdoor use while walking, with a parent present. Different considerations apply when a baby is sleeping indoors in a cradle without constant supervision. With combination products, it is therefore essential to assess whether the product is genuinely suitable for every intended use.’ Safety standards exist for many baby products, but new products do not always fit neatly into a single category. ‘That raises questions such as: which category does this product actually fall into? Which safety requirements apply?’
Bed-sharing or a bedside crib?
There is still some confusion around co-sleeping. A bedside crib means that the baby sleeps in their own separate cot next to the parents’ bed. This is different from bed-sharing, where the baby sleeps on the same mattress as the parents. ‘Parents ultimately make their own choices, but it is important that they understand the advantages and disadvantages and can make an informed decision based on accurate information.’ Sharing the same bed increases the risk of sudden infant death, particularly during the first four months. For vulnerable babies, this increased risk lasts longer, up to six months. ‘A bedside crib can offer a good alternative: the baby is close by, but has their own separate sleep surface.’
When should a baby use a sleeping bag?
A frequently asked question is when a baby can start sleeping in a sleeping bag. For a newborn, a cot can initially be made up safely with bedding positioned low in the cot. Once the baby becomes more mobile, often at around six weeks, a properly fitting sleeping bag is the safest choice. ‘From the moment a baby starts moving and shifting around in bed, a well-fitting sleeping bag on its own is the safest option. Additional bedding is no longer necessary.’
SAFE SLEEP WEEK – ONE CLEAR, CONSISTENT MESSAGE
Safe Sleep Week takes place from 21 to 25 September. VeiligheidNL organises the week together with its partners to provide professionals and parents with reliable information about safe sleep and the prevention of sudden infant death.
Social media and AI are also becoming increasingly important sources of information. ‘The rise of AI brings new challenges. Information from all kinds of sources is brought together, while it is not always clear whether something comes from an official organisation or from someone sharing their personal experience.’
According to Cotterink, this makes clear and consistent communication more important than ever. The baby products industry also has an important role to play. Retailers speak to parents at exactly the moment they are making decisions about cots, mattresses, sleeping bags and other sleep products.
‘Parents want the very best for their baby. It is up to us to make sure they have the right information to make safe choices.’
ADVISE PARENTS ON THE 4 PRINCIPLES OF SAFE SLEEP
VeiligheidNL has summarised its key advice for parents in ‘The 4 Principles of Safe Sleep’. For professionals in the baby products industry, these are four important points to discuss with parents when they are purchasing sleep products. The recommendations are based on the Dutch national youth healthcare guideline for the prevention of sudden infant death.
- ON THEIR BACK
Place a baby on their back to sleep until they can independently roll from back to stomach and back again. Sleeping on the stomach or side is not recommended.
- IN THEIR OWN COT
A separate cot or cradle is the safest place for a baby to sleep. Advise parents to keep their baby close to the parents’ bed for the first six months. A safe bedside crib can be a practical solution.
- IN A SLEEPING BAG
Once a baby becomes more mobile, a well-fitting baby sleeping bag is the safest choice. Additional bedding is no longer necessary.
- IN AN EMPTY COT
No cot bumpers, baby nests, side-sleeping pillows or large soft toys. Soft materials can obstruct a baby’s breathing if their face comes into contact with them.