WRITTEN BY ROBYN HUNT
Registered Counsellor,
Certified Car Seat Technician &
Safe Sleep Consultant
A safe sleep space is one with no loose blankets, duvets, pillows, sheets, toys, or cot bumpers. Your baby’s cot should be completely clear with nothing but a properly fitted waterproof sheet over an approved and firm cot mattress.
With this in mind, many parents wonder how they will keep their babies warm while they sleep. This is where sleep sacks can be used as a safer alternative to blankets.
Sleep sacks were designed to replace blankets but still keep your baby or toddler warm while they sleep. Sleep sacks cannot be kicked off so you can rest easy knowing your little one is covered and warm throughout the night, without the risk of loose blankets which increase the risk of suffocation, strangulation and entrapment.
How do I keep my baby warm while they sleep?
Although blankets are made to keep us warm when we are cold, loose blankets are not safe for babies under the age of 1 year old. For babies, blankets pose a potential risk for causing suffocation, entanglement, and strangulation. Blankets can also be kicked off easily resulting in a cold and uncomfortable baby.
A loose blanket, or one that becomes unwrapped poses a suffocation risk because babies do not have sufficient muscle strength and coordination to move it off their face if it were to accidentally be pulled over their heads.
This recommendation comes from the American Academy of Paediatrics (AAP) and is based on data used to reduce the risk of SIDS. Certain precautions and guidelines should still be followed once your child is older than 1 year to have a blanket in their bed.
The size of the blanket as well as the thickness, the type of fabric and if it has any type of edging are important aspects to consider when choosing an appropriate blanket.
The use of a loose blanket in a cot should not be confused with the use of a blanket to swaddle your baby. A blanket can be used to swaddle your baby, however, it can unravel and become loose.
Approved swaddles are the recommended way of keeping your newborn baby warm, without the risk of loose blankets. It is suggested that you swaddle your baby for the first 2 months and stop immediately when they start showing signs of rolling. Once you stop swaddling your baby, you can use a sleep sack. .
What are sleep sacks?
A sleep sack can be described as a wearable blanket. Commonly, the hands and arms of the baby are free (through dedicated arm holes) and the child’s torso, legs and feet are covered and contained inside the sleep sack. A sleep sack replaces loose blankets in your baby’s sleep space which could cover your baby’s face and cause accidental suffocation.
Why are sleep sacks recommended?
As mentioned, a safe sleep space for a baby is one with no loose bedding, blankets, or other soft objects. This is where a sleep sack is useful when wanting to keep your baby warm during sleep times but keep them safe from potential hazards as well. Sleep sacks that do not act as a swaddle and allow the baby to move freely can be used until your baby is older (within the manufacturers guidelines).
When can my baby start using a sleep sack?
Your baby can start wearing a sleep sack from birth as long as it is the appropriate size for your baby. Before purchasing, make sure to read the age and weight recommendations for that specific sleep sack to ensure optimal safety. Many parents prefer using a swaddle in the first month or two, but a proper fitting sleep sack is a safe alternative.
Are sleep sacks safe?
Sleep sacks are a safer alternative to blankets and other coverings intended to keep a baby warm. They also allow free movement of your baby's hips, which prevents hip dysplasia that can result from tight / incorrect swaddling. However, in order for a sleep sack to be used safely; one must adhere to the guidelines given by the manufacturer regarding height limits, weight limits, age limits and temperature variations.
All sleep sacks should adhere to the standards developed in response to the European Commission mandate M/497 Standardisation mandate on the safety of child-care articles. The standards that have been published for sleep sacks are as follows: “BS EN 16781: Textile childcare articles. Safety requirements and test methods for children's sleep bags.”
Australian brands should be INPAA approved.
This testing is voluntary and manufactures are not obliged to submit their sleep sacks for the testing. It is advised to purchase a sleep sack that adheres to these standards to ensure optimal safety.
Many locally made sleep sacks available on the South African market have not been tested and may have safety concerns.
What type of sleep sacks are available?
Sleep sacks are available in a range of sizes, T.O.G.s, fabrics, and designs. Sleep sacks are available in many sizes ranging from prem to 6 years. It is important to ensure you purchase the correct size for your baby’s age, weight, and height.
There are sleep sacks available for winter climates and summer climates. The weather that the sleep sack is suitable for will depend on the T.O.G (see information on the T.O.G below) and the fabric (see information on the fabric below) of the sleep sack
Some sleep sacks open in the front with a zip and others close over the shoulders with snaps and a zip down one side of the sleep sack. Both designs are perfectly safe as long as the zips or snaps stay closed while baby sleeps. These openings make for easy nappy changes during the night.
Sleep sacks are available in various fabrics which will depend on the climate. In hot climates, a sleep sack made from muslin is breathable and cool but will still give your baby the comfort of a blanket. Cotton is suitable for all climates as the layers can be increased to make the sleep sack warmer by increasing the TOG. There are also sleep sacks made from fleece for colder climates. (See below for Information on the tog of sleep sacks)
Are there any sleep sacks that are not safe for use?
Although most sleep sacks are safe, there are a few that one should avoid.
There are a few sleep sacks on the market that are labelled as “sleep sacks” or “sleeping bags” but perform like a swaddle with the baby’s arms inside the sleep sack. These are dangerous for baby’s older than 2 months old as if the baby rolls over; he/she will not be able to manoeuvre themselves into a safe position and this increases the risk of accidental suffocation and Sudden Infant Death Syndrome (SIDS).
WHICH? recently did a study on sleeping bags/ sacks. WHICH? is a United Kingdom brand name that tests products, highlights inferior products, and offers independent advice.
The safety problems uncovered by WHICH? included neck openings that are too wide, which could lead to a baby slipping down into the bag and suffocating. They also found inaccurate T.O.G ratings that could lead to a baby seriously overheating. Additionally, many bags simply didn’t provide key safety information in the instructions.
Read more here:
Are weighted sleep sacks safe?
Weighted sleep sacks should only be used under the strict supervision of a doctor. Weighted blankets are used for medical reasons and they are designed and made specific to each child. A weighted sleeping bag is not a one size fits all garment as it is based on the child’s exact weight and medical concern.
According to occupational therapists, the use of weighted sleep sacks or blankets, is only for sensory processing disorders, crisis/trauma victims, or people experiencing symptoms of depression, mania, anxiety, psychosis, paranoia, or detoxification.
Weighted sleep sacks or blankets are dangerous if not recommended by a medical professional.
The danger of these can be explained by the following example:
A sleep sack may contain 3 x 28g weights. A 4.5kg baby is 4536 grams. So an 84g weighted blanket is 1.87% of their body weight. Now, 1.875% of an 82kg adult is 1.6kg. That is the weight directly on an infant’s chest when using a weighted sleep sack. That amount of pressure can restrict the baby’s breathing severely.
There are no safety standards for weighted sleep sacks, hence why they are NOT recommended without a doctor's strict supervision.
Are there sleep sacks available for different climates?
Sleep sacks come in a variety of designs, sizes, and thermal resistance (otherwise known as the “T.O.G”).
Thermal resistance is a measure of thermal insulation of an area. In other words, it is a measurement of how well the sleep sack can keep your baby warm. The T.O.G of sleep sacks range from 0.2 to 3.5. The higher the tog, the warmer the sleep sack is. For example, a sleep sack with a 0.2 tog will be ideal for summer climates and a sleep sack with a 3.5 tog will be ideal for winter climates.
It is extremely important to put your baby in a sleep sack with an appropriate tog for the current temperature of the baby’s room or sleep space. If a baby is dressed too warmly, they may overheat which increases the risk of SIDS.
To avoid overheating; the ideal room temperature should be between 16-22°C and your baby should not wear more than one layer extra than what an adult would wear to be comfortable in the same climate. Your baby’s head should also be uncovered when sleeping to avoid suffocation as well as overheating.
Conclusion
If you practice safe sleep principles, purchase certified and approved bedding and sleep wear, and make sure your baby is in a safe environment when sleeping, you can rest easy knowing you have done everything you can to ensure your baby is safe AND warm while sleeping.
