Check out almost any newborn baby picture, and if it was taken in a U.S. hospital, chances are the infant will be wrapped up in a familiar white flannel blanket with a blue-and-pink stripe.
That could be about to change as a blanket alternative—known as a wearable blanket or a sleep sack—makes inroads in hospital maternity wards as part of a campaign to promote safer sleep for babies.
More than 4,500 infant deaths each year occur suddenly due to factors including accidental suffocation and heart malfunctions and are broadly categorized as Sudden Unexpected Infant Deaths, or SUIDS. Roughly half can’t be explained after investigation and are classified as Sudden Infant Death Syndrome, or SIDS. SIDS rates have declined more than 50% since 1999, as research has shown putting babies on their backs to sleep decreases the risk and a national education campaign has emphasized the importance of consistently doing so.
At the same time, rates of deaths classified as accidental suffocation have risen, and many SUIDS cases are linked to unsafe sleep environments, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics’ 2011 guidelines warning against loose crib blankets are part of an expanded ‘Safe to Sleep’ program sponsored in part by the National Institute of Child Health and Human Development.
Swaddling infants in a blanket is an age-old practice that can help comfort a fussy baby. But incorrect swaddling can be a health threat: Too loose, and a blanket can unwind and hinder breathing; too tight, and it can cause serious hip problems. The International Hip Dysplasia Institute recommends that infants’ legs should be able to bend up and out at the hips, not tightly wrapped straight down and pressed together.
Infant sleep sacks, with fabric flaps that swaddle the baby’s arms to the body and close securely, are meant to make swaddling safer and easier by giving babies a secure feeling and freedom of leg movement without danger of loose fabric around the head. As part of safe-sleep education programs, 1,000 hospitals are receiving free annual allotments of SleepSack-branded wearable blankets based on birth rates from Halo Innovations Inc., of Minnetonka, Minn. Company founder, Bill Schmid, lost a daughter to SIDS in 1991.
At Abbott Northwestern Hospital in Minneapolis, baby blankets now are used only to dry off and present newborns to parents. After that, the newborns go into sleep sacks. Sarah Scherbring, a first-time mother who delivered her son, Owen, at the hospital in January, calls the safe-sleep information from prenatal classes ‘very eye-opening.’ As a result, she avoided overstuffed bedding she had been thinking about buying in favor of an undecorated crib with a firm mattress and a tight flat sheet.
‘These infant deaths are preventable accidents that remain a silent epidemic in our country,’ says Michael Goodstein, a member of the AAP’s task force on SIDS and a neonatologist at York Hospital in York, Pa. ‘Wearable blankets are completely appropriate in place of a blanket,’ he says, as long as the size is appropriate and it doesn’t result in overbundling, which overheats infants and increases the SIDS risk. In Pennsylvania, a 2010 law requires hospitals to provide information on SUIDS and SIDS risks and to ask parents to sign a voluntary acknowledgment form.
Amanda Albright, who gave birth to triplets in January at York, says nurses and doctors ‘were very hands on’ about instructing her and her husband how to use sleep sacks and avoid putting other items in the crib. They have lined up two cribs with no extra bedding along their bedroom wall for daughter Macy and son Reid, and have a third ready for Lena, who is still in the neonatal intensive care unit. They won’t be sleeping with the babies, Ms. Albright says. ‘It is very intimidating at first to learn about the risks, and there are some that you can’t control,’ she says. ‘But we have to practice the prevention steps that we do know about.’
Halo and others sell wearable blankets at retail as infant sleepwear priced from $25 to $30. In 2006, Mr. Schmid began offering newborn-size sacks at no charge to hospitals that pay shipping costs. Hospitals can buy replacements at just over cost and at a discount to give or sell to new parents. Halo gives some proceeds to SIDS research and prevention groups such as First Candle, of Bel Air, Md., and it provides hospitals educational materials from First Candle promoting sacks over blankets. Halo says the groups use its funding at their own discretion and it isn’t aware of specific studies linking wearable blankets to a lower risk of SIDS.
Medline Industries, of Mundelein, Ill., supplies about 40% of hospital baby blankets and says sales of its 60-year-old Kuddle-Up line of familiar striped blankets, caps and other pediatric apparel are up about 5% this year. Medline sells the blankets to hospitals for $1.50 to $2.50 each and recently began offering a sack-type garment for $7.50 to $8.50.
Jennifer Walrich, Medline senior product manager, says while the company isn’t seeing an ‘overwhelming trend’ in hospital requests for sleep sacks, there is definite interest. ‘If the blankets were to go away in five years, we will always have another product that fits their needs,’ she says. Safe-sleep guidelines don’t specifically recommend eliminating swaddling in blankets, she notes, but rather warn that blankets shouldn’t be allowed to come loose in a crib.
Still, nurses who have long prided themselves on their blanket-swaddling technique—sometimes called ‘baby origami’—now are delivering stern warnings about how easily blankets can get loose. Karen Shirley, director of maternal-newborn services at HCA Inc.’s Chippenham Hospital in Richmond, Va., says some babies ‘are like little Houdinis. One minute you think you’ve swaddled them tightly, and the next minute they don’t have one part of the blanket left on them.’
With their Velcro closures and zippers, the Halo sleep sacks can’t be sent through hospitals’ industrial laundries, the way blankets are, and instead must be sent out for special washing, adding to costs. But given the risks of loose blankets, ‘it’s the only way to go,’ says Marilyn Maggioncalda, clinical nurse specialist in the neonatal intensive care unit at Hurley Medical Center in Flint, Mich. Her unit puts new babies into sleep sacks while they’re in the hospital and sends each one of them home with a free sack of their own.
SOURCE: The Wall Street Journal
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