Valerie Gommon Midwife’s Blog

Archive for the ‘co-sleeping’ Category

Well, I was on Three Counties Radio www.bbc.co.uk/threecounties/local_radio/ again last night – there was an item in the news about smoking in pregnancy and I was asked to comment.

Apparently, there is a new government campaign targeted to help pregnant women stop smoking.  The advertising campaign, from NHS Smokefree, will highlight how every smoked cigarette restricts essential oxygen to the baby; it will show that a baby’s heart has to beat harder every time a pregnant woman smokes.

According to statistics put out, around one in five pregnant women in England smoke during their pregnancy.  I have to say that I find this figure surprisingly (and alarmingly) high.  It probably doesn’t correlate with my overall clinical experience and certainly not with my Independent Practice (www.3shiresmidwife.co.uk) where almost none of my clients smoke; there is a definite correlation between social class and smoking and I guess I have usually worked in relatively affluent areas.

I think it is easy to be judgemental – people make choices in their lives, and may find smoking a relief to stressful situations, and one should not underestimate the power of addiction.  That said it is obviously harmful to smoke at any time and even more particularly when pregnant.  Women who smoke (or indeed whose partners smoke) are at increased risk or miscarriage, having smaller babies or cot death.  Additionally there are health risks for the child of an increase in coughs and colds, asthma or chest infections, meningitis, glue ear and lung cancer when they are adult.

It is important that you do not bed-share with your baby if you or your partner are smokers as this significant increases the risk of cot death www.babyfriendly.org.uk/pdfs/sharingbedleaflet.pdf, or indeed breathe too closely over a baby if you have recently smoked as you will be exhaling carbon monoxide for up to an hour after your last cigarette!

Interestingly a poll of 224 pregnant women for the campaign revealed 28% would seek help to stop smoking but were worried about being judged – this is something that we as Health Professionals need to be very mindful of – it is not our place to be judgemental, but to give appropriate information and support.  A total of 38% said they sometimes hid their smoking because they were worried about people criticising them, while 39% said they were ashamed to admit their habit to their midwife or healthcare professional.  A wider survey of more than 2,000 adults found 49% were critical of pregnant women who smoked.

The NHS Pregnancy Smoking Helpline number is 0800 1699 169 and more information can be found at http://smokefree.nhs.uk/questions/smoking-and-pregnancy/

Whilst writing the blog about baby wearing and slings a couple of days ago my thoughts turned to where the baby sleeps; this too is a subject that stirs strong feelings.  The majority of pregnant couples are now aware that it is recommended by UNICEF and FSID that babies share a room with their parents at least for the first six months, but the issue of whether to bed-share or not may seem less clear and more controversial and definitely has to be a decision of personal preference.

From my experience I would say that most couples start of expecting that their baby will sleep in some kind of crib next to their bed, but in reality after a few unsettled nights many decide that the best way of everyone getting some sleep is for the baby to spend at least part of the night tucked up in bed with parents.  Indeed it is acknowledged that bed-sharing is helpful in establishing and maintaining breastfeeding.  www.babyfriendly.org.uk/pdfs/sharingbedleaflet.pdf

Many couples are initially concerned that they would “forget” that their baby was in bed with them; however video film studies seem to refute this by showing parents moving around their babies in their sleep.  There are however sensible precautions that need to be observed if you are co-sleeping.  The baby needs to be safe and not vulnerable to falling from the bed, you need to be aware of the potential danger from pillows and overheating by slipping below the duvet and it is strongly recommended that you do not bed-share if you have taken alcohol, drugs or are a smoker however by taking sensible precautions it seems that it is probably safe and may even be beneficial to bed-share www.telegraph.co.uk/health/healthnews/3501035/Sharing-a-bed-with-a-baby-does-not-increase-risk-of-cot-death-research-shows.html and www.nd.edu/~jmckenn1/lab/index.html

The document “Reduce the risk of cot death” (FSID and Department of Health) http://www.fsid.org.uk points out that cot death is rare and that if you follow advice such as sleeping your baby on the back, you will be reducing the risk of cot death considerably.

Advice for parents to reduce the risk of cot death:

  • Cut smoking in pregnancy – fathers too! And don’t let anyone smoke in the same room as your baby.
  • Place your baby on the back to sleep (and not on the front or side).
  • Do not let your baby get too hot, and keep your baby’s head uncovered.
  • Place your baby with their feet to the foot of the cot, to prevent them wriggling down under the covers.
  • Never sleep with your baby on a sofa or armchair.
  • The safest place for your baby to sleep is in a crib or cot in a room with you for the first six months.
  • It’s especially dangerous for your baby to sleep in your bed
    if you (or your partner):
    • are a smoker, even if you never smoke in bed or at home
    • have been drinking alcohol
    • take medication or drugs that make you drowsy
    • feel very tired;
    or if your baby:
    • was born before 37 weeks
    • weighed less than 2.5kg or 5½ lbs at birth
    • is less than three months old.
  • Don’t forget, accidents can happen: you might roll over in your sleep and suffocate your baby; or your baby could get caught between the wall and the bed, or could roll out of an adult bed and be injured.
  • Settling your baby to sleep (day and night) with a dummy can reduce the risk of cot death, even if the dummy falls out while your baby is asleep.
  • Breastfeed your baby. Establish breastfeeding before starting to use a dummy.

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