Family member's newborn – WWYD?

[CrumpetConnoisseur]

My cousin has recently brought her tiny premature baby home after a stay in NICU. She weighs less than 5lbs.
She sent me a photo of the baby asleep on her tummy in her Moses basket and said that this is the position she settles best in.
I have to admit I’m quite concerned. I know babies shouldn’t generally be put down to sleep on their fronts, and with her being so premature and tiny, it makes me particularly nervous.
My cousin also doesn’t want to use a breathing or movement monitor such as an Owlet, which adds to my worry, although I appreciate these aren’t recommended as a substitute for safe sleeping practices.

Obviously, I’m not her baby’s parent and I don’t want to come across as judgemental or interfere with how she’s looking after her. I also don’t know whether the NICU team has given her any specific advice regarding sleeping positions.

Would you be concerned in this situation? Would you say something to her, or leave it alone because it’s not your baby?
I just want the little one to be safe, but I also don’t want to overstep the mark.

I understand where you're coming from OP, but I wouldn't say anything, they won't thank you.

She said this: “X’ is settling in her Moses basket, she has no blanket because she gets too hot with too many layers. She’s in her favourite sleep position, on her tummy, the same as when she’s laying on us.” And she’s attached a photo of her on her tummy asleep.

Of course you are concerned. It is a close family member. I don't think the "none of your business" posts are helpful in this particular case. OP wants to know our experience and thoughts on it. I for one had no idea babies were sometimes put on their tummy in NICU.

Don't butt out.

Tell your cousin you're surprised the NICU advised her to put the baby to sleep on her stomach. See what she says. If she has decided this on her own or is taking the advice of her mother, or if she's going against the advice of the NICU, I'd even be considering calling the NSPCC for advice on what steps to take next, if I were you.

I'm also surprised the partner continues to smoke. Does he do this inside the home? Did he do this while your cousin was pregnant?

This!

@mathanxiety yes he smoked indoors while she was pregnant. I’m hoping he smokes outside now she’s born. But I don’t know.

Not her call, but absolutely her place to offer gentle, caring and scientifically accurate advice to a new parent who she presumably knows well. It’s called being caring.

I've had two extreme preemies, I would be terrified

My daughter did breathe better on her front but when she came home at a year, still on her oxygen her community nurses were insistent that she must sleep on her back, must be in the room with me, must have her sats machine attached at all times

When my son came home at 13 weeks on oxygen they still insisted he must sleep on his back but they no longer give sats machines so i just didnt sleep for longer than a few minutes with my hand on his tummy to feel him breathe

I would gently ask what advice she was given when leaving nicu about safe sleeping and about where her partner goes to smoke

The baby’s safety must come first.

Safety has been discussed at NICU.

Most likely the parents won't call it that.

I would just be honest. Say that you really don’t want to come across as judgemental or overstepping the mark but if makes you really worry. Maybe she just doesn’t know about safe sleeping?

Please explain to her that smoking around a premature baby especially if baby was very premature, needed a ventilator etc can cause them to go into respiratory distress

My ex smoked in the house unknown to me when I brought my daughter home at her original due date. She had to be rushed back in due to respiratory distress leading to respiratory failure and spent the rest of her first year in hospital

Its really not worth the risk from a smoker thinking it won't matter, they dont want to go outside etc

Do they have home visits from anyone medical? When she said she doesn't put blankets on her, I would have agreed, because it's what's recommended, then I would have asked was it part of the safe sleeping advice they were given. Check in with her again, ask open questions about how they all are. Ask is she managing to get her on her back overnight, keep it light. If your Mums are around, someone else must be noticing this?

I would. "Aww she's adorable! Mine loved sleeping on their tummies too, I wish it was safe for them to stay asleep like that. Shame sids is such a worry 😢"

I would just say I was told babies shouldn't sleep on their tummies has the guidance changed or is it different for prem babies? In an interested tone, not you're doing it all wrong. She may say that was what she was advised to do or she may go and look it up if she's been doing it because baby goes to sleep more easily like that. But you will have said what you think you need to without causing an upset.

Increased risk does not mean an absolute certainty of SIDs. The actual chance is still extremely small. There’s a risk calculator you can use

www.sidscalculator.com

From the details you have provided the odds are still just 35 in 100,000 babies.

Advice is for the obedience of fools and the guidance of wise men. Leave her to parent the way she wants to, she will likely have weighed up all the options.

Logic error here: a pissed off mother doesn't necessarily mean a safer baby.

She was taking a photo of the baby which shows she was present and observing her baby at least while she took it! I think you're right to think carefully before saying anything as that kind of sharing probably won't continue if it meets with implied criticism.

I would go gently and just try to find out more. Has she any pictures from NICU? What has she got by way of follow up support? How's that going? What's the difference if the baby sleeps on front or back? What worries does she have in this post-hospital phase? That way you might get more info about whether this situation is the result of e.g. ignorance (unlikely given NICU context) maternal instinct, maternal stress or advice from someone else, personal or professional.

(I also wonder if partner smokes inside as this would affect the risk factors I assume.)

Would you like a sledgehammer to get your point across? OP has already addressed it anyway.

I would send a really positive message about how well she and baby are doing etc, and then ask whether she’s seen The Lullaby Trust website which has lots of useful baby sleeping tips- https://www.lullabytrust.org.uk/baby-safety/safer-sleep-information/

Hopefully she reads it and sees the safe sleep guidance

This is just passive aggressive

Your comment about what she said about blankets would make me even more worried tbh. The baby should not use blankets at all, they are unsafe. If the mum doesn’t understand this, it’s a worry.
I also had a NICU baby, they mostly sleep on their tummies in there. But they are attached to monitoring devices and surrounded by nurses, it’s not the same as at home!
I would gently say something. ‘I couldn’t help but feel worried that beautiful baby Lulu is sleeping on her tummy. If you are following medical advice then obviously please ignore me, but I just wanted to check as being premature, her risk level is higher. If I can help with any other info please let me know. Lots of love to you both.”

Who cares what the parents think. They obviously need some gentle guidance on how to keep their baby safe.

Breathing and movement monitors are mixed in functionality and if they work poorly they can actually increase maternal anxiety

Article about wearable baby monitors

I don’t actually think they are much cop and the advice is to stay in the same rooM
as your baby.

as for the “subtle”‘approach. No. It’s not subtle.

Tbh I would just keep it easy breezy and say about following the sleep guidance from the lullaby trust, NICU and the midwives.

They are the baby’s parents and the baby is their responsibility. All you can do is try to offer support. But I would also choose
your battles

Not sure you understand what passive aggressive is...
(Hint, it's more like this)