Blankets and Bedding

Buying for your baby and setting up the nursery is a delightful time for new parents, but in addition to choosing the cutest styles, it's also important to be fully aware of the important safety issues around getting the right blankets and bedding for your baby.

The issue of cot death, more commonly known now as Sudden Infant Death Syndrome or SIDS, is one that sends a chill through the heart of any expectant parent or parents of young babies. In 2010, in England and Wales, there were 254 unexplained infant deaths. That figure equates to a rate of 0.35% per 1,000 live births with unexplained deaths accounting for 8% of all infant deaths that year.

The statistics are sobering, but there are measures parents can take with their baby's bedding to help reduce the risks.

Why it's Important to Keep Your Baby Cool

Whilst the causes of cot death aren't fully understood, overheating is known to be a factor, so it's very important that your baby is kept cool during their sleep times.

Before you can gauge what bedding your baby needs you need to know the temperature of their room. You can invest in a baby monitor with a temperature reading, so you can monitor the heat in the room easily via the parent handset. Some models will beep if it goes above a certain level. If you don't have a monitor, an ordinary room thermometer will do, though you will have to pop in and out of the room yourself to keep an eye on the level.

It's probably going to be easier to remove layers of bedding and clothing than manage to drop the actual room temperature, but try to keep your baby's room cool. The ideal temperature is 16-20C. Research has shown that living rooms can be much warmer than bedrooms, so remember that this advice applies to the room your baby will be sleeping in.

It might help to keep curtains drawn during the day so the heat of the sun doesn't warm up the bedroom and open widows to allow air in and help to keep the whole home ventilated. You can also use a room fan if you are struggling to keep the temperature down.

To check your baby isn't too cold or hot, feel their tummy or neck. It's normal for their hands or feet to feel cool, so don't use these body parts to try to get an idea of your baby's temperature. You may think they are cooler than they actually are and add unnecessary layers of bedding or clothes.

How to Choose Safe Bedding for Your Baby

It's recommended that you use a new mattress with each new baby, as a link has been established between cot death and second-hand mattresses. It's most apparent if the mattress has come from another household, but there is still a greater risk if you use a mattress already slept on by a sibling at home.

Buy a mattress that is flat, firm, well fitting and waterproof on the outside. If you are re-using a mattress, make sure it has a waterproof cover and that there are no cracks, tears or holes. Clean and dry the mattress thoroughly and make sure it is still firm and flat with no sagging and fits the cot properly.

What Sheets Should I Choose?

Go for snug, fitted sheets in cotton for the mattress so your baby can't become tangled in them. Layer your baby's bedding with cotton sheets and use cellular blankets that allow the air to circulate. Sheets and blankets are easy to add and remove if the temperature changes.

The NHS provides guidelines on how many blankets you should be using. Assuming your baby is wearing a nappy, a vest and a sleep suit and is covered by a sheet, at 20 degrees you can use one blanket and at 16 degrees you can use two. A blanket that has been folded counts as two.

If it is very hot during the summer or you are on holiday abroad, your baby might not need anything more than a vest to sleep in and a light, cotton sheet for cover.

What to Avoid

Avoid duvets and coverlets that may cause your baby to get too hot. Never use a hot water bottle or electric blanket. It's also advisable to steer clear of cot bumpers. A study by the American Academy of Paediatrics in 2011 warned that babies can become trapped or suffocate against cot bumpers. Your baby won't need a pillow until they are one year old.

When putting your baby down for a sleep it is advised to use the 'Feet to Foot' position. This means that your baby should be placed on their back with their feet touching the cot's foot. Doing so helps prevent them sliding down underneath the bedding. All sheets and blankets must be tucked in and the covers should only come up to your baby's shoulders.

A baby also loses excess heat from their head, so ensure they're not wearing a hat in bed and that their head can't get covered with bedclothes, as these can lead to overheating.

Swaddling

Swaddling newborns is a way of making some babies feel more secure and less disturbed by the little jerks and movements they make in their sleep. It can also help them calm down if they are over-stimulated. By creating a slight pressure on the baby's body it can give a sense of security because it can feel like being back in the womb.

However, The Foundation for the Study of Infant Deaths (FSID) advises caution against swaddling as recent research suggests it could be an emerging risk factor for cot death. The Royal College of Midwives also advises against swaddling for this reason, but also because of concerns over the proper development of babies' hips. 

If you do want to swaddle your baby, talk to your midwife or health visitor first, and follow these basic guidelines:

• Use thin materials and don't cover your baby's head
• Wrap your baby so that their legs are free to move - they should be able to move them up and outwards without any restriction

What About Baby Sleeping Bags?

Another option, instead of layers of bedding, is to use a baby sleeping bag. Sleeping bags zip or clip securely onto your baby, so they can't wriggle down into them in the way they might with sheets and blankets. Make sure you get the right size for the weight of your infant so it fits properly.

Much like a duvet, sleeping bags come in different togs to suit different temperatures. These products have a guide giving information about what clothes your baby should wear with them. For example, during the summer, a light 0.5 tog sleeping bag might be worn with just a vest, whilst in the winter, a heavier 2.5 tog bag could be worn with a full set of pyjamas if the temperature in the room is low. Always read the manufacturer's instructions as they may vary between products.

Safe sleeping advice isn't just for evening bedtimes. Make sure you also apply it when your baby has a daytime nap in their cot or Moses basket. Remember, it can get hot during the day in the summer, so your baby can quickly begin to overheat.

Research shows that the second month is when most cot deaths occur and that almost 90% happen by six months. By the time your infant is one year old, the risk has almost passed as very few cot deaths happen after a year.

Parental awareness of safe sleeping has helped to cut the number of cases, so it's important to follow the guidelines as they have been proven to be effective.