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.

The problem most people have with things like owlet etc is that by the time they detect an issue, the baby is already in distress, and while they might warn of a problem they don’t prevent the problem, but they can make people complacent, and they are no substitute for practicing safe sleep, checking your baby regularly yourself, putting them to sleep in the same room as you etc. People use them as a caveat - “oh it doesn’t matter that we’re not following the guidelines because we have the owlet” but it doesn’t make the situation safe for the child in the first place. A bit like saying “it’s fine to drive drunk because I’m wearing a seatbelt”.

As you don't know the full story, especially about the smoking, I think you should keep out of it

I’d say something out right. Just once, then it’s out. It is then up to them. Hopefully if a midwife visits while she is asleep they see it and can give advice.

You could send her the poster for safe sleep 7. Let her know you wouldn’t normally give unsolicited advice but this has been playing on your mind because it can be dangerous with her being so small. Sleeping on your chest is different to being alone on a Moses basket.

If you see, are told of other concerns, I’d then report to your local health visitor. You can google the number.

I think there’s a difference between telling a parent they are doing wrong and interested curiosity.
I would say . “Ahh she’s lovely I’m glad she’s home with you , was wondering why she’s sleeping in her front , is this something that’s advised these days ? I remember there being a big campaign many years ago about safe sleeping where all babies were put on their backs but things change . She’s so gorgeous hope you are enjoying being home with her .

She’s well aware her baby is small and vulnerable.

Personally, I would say the baby is beautiful and ask if there’s anyway they can help the baby settle on her back but know sometimes babies do as they choose! Non judgmental & curious.

Thanks for the comments all.
She’s sent me a photo this morning of baby in her Moses basket overnight with knitted blankets up to her neck and another loose blanket over the top.
I’m trying not to come across judgemental but I am concerned, you can just see baby’s bead poking out of the blankets.

I haven't read the whole thread so apologies if this was already mentioned. The thing about sleeping on one's tummy (holds for adults too) is that it has a good effect on the vagus nerve. It acts pretty much like a tranquiliser. Some babies may need that to get a good night's rest? If so, I'd think it would be a better idea to let the child sleep in whatever way works best for that baby, and if she/he is a tummy sleeper then wear a monitor that works.

I’m surprised so many posters are saying it’s not your business. Of course you can say it gently and politely to your cousin. I wouldn’t want to not say anything for fear of offending and something terrible happened.

Monitors don’t work. Babies who do die of SIDS often die on their front. Do not give this type of outdated advice. NHS and other guidelines do not advise this. My babies would have preferred being on their fronts early due to reflux but I didn’t risk it.

Or Could kill a baby because they can’t breathe?!?!?

Nothing wrong with blankets imo, but they need to be thin wool or cotton, and well tucked in so there's no chance of baby suffocating. I always put my babies to bed well swaddled, with a cotton sheet folded down over two wool blankets, and there was no chance of them getting free and somehow suffocating themselves.

It doesn't sound like that's the case here.

Just be honest, and say 'X, I hate to be interfering, but it doesn't seem like you're following safe sleeping guidelines (link to guidelines) and it's making me concerned for Y. With the risk of SIDS you're supposed to sleep them on their backs, and these days you're not supposed to have blankets either. I just had to say something - although I won't bang on about it either.'

Id maybe lightly suggest she talk to her health visitor about safe sleeping positions for newborns.

Something like. Oh she is gorgeous, have you spoken with your midwife/health visitor about sleeping positions ? (Obviously make it a bit more personal)
L

I think you have to say something OP, and just take the risk that your relative thinks you're overstepping. I would be too anxious to leave it without saying something.

I would respond to say something like 'I just wondered if your midwife had spoken to you about safe sleep practices? Please don't think I'm being judgmental because I can only imagine how hard it has been having your baby in the NICU and I think you're doing a great job. But tummy sleeping and blankets in the cot are both associated with a significant increase in the risk of SIDS. The lullaby trust has loads of information on safe sleep practices if you want to read more. As I said I think you're doing brilliantly, I just wanted to share that'

FWIW I spoke to a relative of mine about her putting her baby in the car seat in a big puffy coat with the harness not tight enough on his arms and I thought she would be really defensive because she can be nippy, but she actually took it incredibly well and appreciated it was said with the well-being of her baby being the most important thing.

definitely say something but I’d make it complimentary and conversational and not even use words like ‚judgemental‘ or ‚interfering‘ in the message

This is really awful advice. Front sleeping is associated with a significant increase in the risk of SIDS. This baby already has two other significant risk factors (prematurity/ low birth weight and living in a house with a smoker), it's really important that they don't compound the risk with front sleeping and loose blankets in the cot.

It's not about what makes the baby sleep better - lots of babies sleep better on their fronts. It's about following the steps which have resulted in an 81% reduction in SIDS deaths since the campaign for back sleeping started.

No way that’s so condescending and bitchy.

Just say “aww she’s so cute etc. is she allowed to sleep on her front now as we were always told to make sure that they sleep on their backs? I’m so pleased she’s finally home”

She’s the one bringing up the sleep position so it’s normal to comment on it.

Advice does change and so it’s likely that this ok to do in her situation but if not you’ve mentioned it and done your bit.

There are some dangerous comments here, saying things like maybe the advice has changed, NICU babies can sleep in their front when they get home, babies with reflux should sleep on their front, etc.

None of those are true:

https://www.lullabytrust.org.uk/baby-safety/premature-babies-and-multiples/premature-babies/

OP, you’re going to have to find a tactful, interested way to address this. Perhaps blame the busy-ness of NICU or the fact one professional must have assumed another had told her, or whatever, and imply it’s the hospital’s fault not hers. Then link her to the above advice.

Did you not know it is feet to foot? Feet of the baby at the foot of the pram or cot.

But it is the babies life they are supposed to be protecting...

Id more bothered about a parent smoking in the house, the SIDS risk is far more increased from second hand smoke exposure than sleep position

Before the baby left NICU she would’ve been talked through proper care by the nurses. Some even have a practise ‘flat’ for parents to stay in over night. She’s either following advice (or ignoring advice) of someone far more qualified than you, so I’d just keep quiet tbh.

My youngest was a preemie and yes they are all on their front in NICU. I believe it’s easier for them to breathe.
My says n always slept on his front after that however we always had an angel care baby breathing monitor.
The smoking is a massive no, they ask about this a lot in NICU even that you shouldn’t allow visitors who smoke and may have it on their clothes to be near the baby.
As long as the cot is completely clear they should be fine on their front apparently the risk is because they actually sleep more deeply on their front.
i had a friend who was a paediatric nurse in child protection at the children’s hospital and her son slept on his front. She told me that every SIDS death she had ever seen had involved co-sleeping

The nice often put my baby on their tummy to sleep but they explained ut was ok there as it was monitored. I think I would find the right time and gently ask if the parents knew about kids from being on tummy.

*nicu, not nice

Ds was 4lbs when I brought him home and there was no conversation about safe sleeping at all. He slept on his front in the SCBU but in his back at home.