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 would say something- imagine if there was a cot death you would never forgive yourself.

I was in a similar position when a not too close relative had a baby and wasn’t strapping her in the car seat properly- I did it in a way of ‘when JJ was a baby I put my hand here and tightened like this so I knew he was secure without being hurt- I’d rather say than not but I’m in no way saying what you have to do as you’re mom who always knows best’ this worked well as I didn’t ‘tell’ it was more of a ‘comparison’. It was also f2f so obviously tone of voice etc makes a big difference- texts can be read wrong!

I had no sleep safety drilled into me during my pregnancy 2 years ago although a health visitor and GP did both mention at checks after baby was born. Co-sleeping is now supported with guidance of safe ways to do it and lullaby trust has info on it.

I also would have thought like you given a prolonged NICU admission that this would be info she had been given but you can’t guarantee anything. There are cracks in the nhs that some people slip through, or perhaps she was too overwhelmed to take in the information with a poorly newborn / recovery from birth / travel to and from NICU which depending on gestation can often be quite significant. I don’t think we can say with certainty she has the correct information although agree with others if partner is smoking in the house with a preterm baby and she has agency over decisions then doesn’t bode well for outcome of conversation.

As many other PPs have said, I would address in an inquisitive nonchalant “crazy how all the advice changes all the time” or “what kind of support / did you have special instructions in NICU” kind of way - ideally face to face or via telephone.

There may be a legitimate reason - As others have stated she may only be doing this for daytime naps or when she can watch them or their May be safety concerns with reflux.

Back in the 80s we were all advised go put our babies on their tummies, that was the advice of the time. This was fine for DS as he was able to lift and turn his head from birth.
I wouldnt put a baby who couldnt do that on their front.
Sleeping on their front did stop the startle reflex waking them up all the time and stopped excessive reflux but you have to look at the SIDS research and decide.

If acid reflux is involved all the sleeping advice changes. Your cousin will have had plenty of advice from the hospital staff.

To all those who say things like "Her baby, her choice" - do you apply this in all situations? So whatever unsafe or unkind child-rearing practices someone might be following whether through ignorance, carelessness or deliberate malice even, you believe the parents" autonomy is sacrosanct and must be prioritised above the child's wellbeing?

I read this view quite a lot on here and I find it chilling, to be honest. It's a is the child isn't a person in their own right, but somehow a piece of property belonging to the parents for them to treat as they please......

OP, my view is very different. I think you absolutely should say something, and to be honest I am struggling to see why you find the prospect of doing so so scary/off-putting. These are your family members - you know, love and care for them, and they you. They will obviously understand that what you say comes from a place of love - why would they be up in arms about it, never speak to you again etc? Do people really react so strongly if somebody questions something they are doing, or gives advice? It must be an exhausting way to live if so.

Simply say that your understanding is that babies are less safe sleeping on their fronts, and have they had any advice regarding this. Presumably she will either say "Yeah, I asked about it, it's fine for XYZ reason" or "I wasn't aware of this as the baby slept on her front in hospital, but thanks for flagging that, I'll check it now".

She presumably loves her baby and wants it to survive, so why on earth would she be angered by advice that makes this more likely?

Just to add, my baby used to sleep on her side, when she was ever so tiny (she was almost full term but born on the 0.6rg centile - no idea why as she is average height now as a teen). From a couple of weeks of age she could somehow wriggle onto her side. (She was a very squirmy baby - she wrggled all the way off the bed once - most terrifying and guilt-inducing moment of my life). I told the HVs who said that once the baby can move position you have to let them sleep in the position they choose, as the only alternative is to stay awake all night moving them back into position......

I think it's because women don't like the thought of others suffering/dying when it's preferable. Humanity, bascially.

We can't all be cold hearted solipsists, though I agree it would make life less stressful if you never worried or face a toss about what could happen to anybody else!

I agree with this.

My daughter was six weeks premature and in the NICU for about 10 days. She was on her stomach that whole time but, as others have said, they’ve got all the monitors and 24hr supervision. I never put her on her stomach because I’d have been terrified of SIDS.

Both mine survived - just saying.

But lots of babies didn't, hence the advice changing 🙄

That's like saying 'I've never worn a seat belt, and I've always been fine'

Yes, if you say something OP, just say it and own it.

I'd just say something like "I was worried when you said she is going down on her front as I was told not to. I know the advice changes [ which it does. Can't remember all the iterations, but there were differences with swaddling, not swaddling, dummies etc and my mum was horrified I put mine on their backs, as when we were babies she was taught to out us on our tummies] and it may well be different for NICU babies, but have you definitely checked with them that is ok? I don't want to interfere, but I would rather you think I'm a pita than not mention it."

If she is offended, I guess she is offended. But at least you have been straightforward.

Both my son's were premature and my youngest spent 111 days in NICU struggling with his breathing. Sleeping on his tummy facilitated his breathing. We were sent home with the instruction to keep him on his tummy and had a monitoring pad given my NHS (not to be solely relied on). We had to complete several CPR courses before discharge. I would not interfere as you are normally well trained in NICU :)

So I'm guessing they're 40's -50's?

Since advice changed from when they were born the SIDS rate has dropped 5 fold.
Your 2 children from decades ago do not make it OK.