Becoming a grandparent is exciting. You get to re-experience snuggles, hugs and all of those (mostly) wonderful baby noises and smells.
This time around, though, your grandbaby goes home after a day of fun with you. And there have been many changes in infant and child safety recommendations in recent years.
New guidelines don’t reflect badly on how we raised our own babies—we followed a different set of standards—but current research tells us more about how to prevent tragedies and poor health outcomes for little ones.
As a parent and grandparent myself, I know how uncomfortable some of these changes can feel when you put them into practice, but knowing the reasons behind them makes it easier to comply with standards.
These are just a few of the topics covered in the Grandparenting 101 class I lead for the Ohio State Wexner Medical Center:
1. Safe sleep
The “ABCs of safe sleep” are vital. That means putting a baby to sleep…
- Alone
- On their Back
- In a Crib (or bassinet or play yard)
Alone
No co-sleeping — not even a nap on the couch. Too often, the adult wakes up, but the baby doesn’t. When you’re asleep, it’s too easy to interfere with the baby’s ability to breathe.
There should be nothing in the crib with the baby but a snug-fitting sheet and a pacifier (if needed). No blankets, toys, crib bumpers or anything else before the baby is at least 1.
On their back
Sleeping on the back keeps enough space around the nose that exhaled carbon dioxide can dissipate and be replaced with fresh oxygen for babies to inhale. Being close enough to anything, including blankets, that interferes with this air exchange may cause the brain to tell the body to stop breathing.
Addressing some myths:
- There’s been no increase of babies spitting up and breathing the fluid into their lungs while back-sleeping. Because the esophagus is the lowest point when back-sleeping, they usually re-swallow the fluid.
- There’s no evidence that sleeping on the back is harmful for babies.
- Sudden infant death syndrome (SIDS) has decreased by 40% since this “Back to Sleep” campaign was started in the 1990s.
- Babies’ heads won’t be flat on the back for the rest of their lives from sleeping on their backs for a few months.
In their crib
New safety standards were instituted for cribs in 2011. Cribs made before 2011 are likely unsafe.
Cribs should have:
- No drop sides
- No cut-outs
- Space between rails no wider than a soda can
- Twenty-six inches between the mattress bottom and the top of the rails
- A mattress that fits to the sides of the crib
- A snug-fitting sheet on the mattress
Play yards (such as Pack ‘n Plays) are an appropriate alternative for a grandparent’s home. They’re safe, can double as an area for play and can easily be assembled and disassembled.
Other sleep tips
- An ideal nursery temperature is about 70 degrees. If it’s colder, then sleep sacks and/or footed pajamas can safely keep a baby warm. Overheating increases the risk of SIDS. If you’re comfortable in a T-shirt and shorts, the baby likely is, too.
- Pacifiers also can help prevent SIDS.
2. Car seat safety
Expired or secondhand car seats are a no-no. Brand-new, safety-tested car seats are best.
I typically encourage grandparents to have the parents choose the car seat brand to use, even if it’s in the grandparent’s car.
If you have a seat previously used by an older child, check the expiration date on the seat’s shell. The materials degrade over time and can become ineffective.
Never buy a used car seat — even a small fender-bender can render the shock-absorbing elements of the car seat ineffective, and secondhand car seats have unknown histories.
3. Changes in feeding methods
Until they’re about 6 months old, babies get all the water and nutrients they need from breastmilk and/or formula. A pediatrician will guide the use of formula and food introduction.
Extra water could interfere with babies’ ability to get nutrients from milk or even lead to water intoxication if they’re given too much.
Ask the parents what their pediatrician recommends for water intake and food after 6 months. Don’t add cereal to a baby’s bottle unless a pediatrician has recommended it. Yes, like many grandparents today, I used to do this with my children as babies.
Foods no longer need to be introduced in a certain order. And the most common allergenic foods are introduced as early as 6 months, depending on the pediatrician’s recommendation. Research shows that food allergies are less likely to develop with early exposure.
4. Sleeping positions
Be careful when using an inclined position item such as a bouncer or swing, as the baby’s airway may become jeopardized.
Babies should never be left unattended in anything other than approved cribs, play yards or bassinets. The U.S. Consumer Product Safety Commission allows only those terms to be used for products safe for infant sleep. Products called “sleepers” have not been rated as safe for sleep.
It’s not recommended that a baby be left to sleep in their car seat outside of its in-car position; outside of its intended use, the angle of the incline changes and may cause positional asphyxiation and death.
5. Postpartum depression vs. ‘baby blues’
Postpartum depression or postpartum anxiety can go undiagnosed because symptoms aren’t noticed or because they’re attributed to the shorter, milder “baby blues.” But postpartum depression is serious—long-term and often interfering with a new mom’s ability to care for herself or her family.
Grandparents can help watch for symptoms and assist the mother in getting the help she needs. Offering validation, time to rest and reassurance is also helpful.
6. Vaccines for grandparents
Anyone spending time with a baby should be up-to-date with vaccines. The annual flu shot and the TDaP (tetanus, diphtheria, pertussis) vaccine are important because flu and pertussis (whooping cough) are so dangerous for babies. We may be able to pass these on without exhibiting symptoms ourselves.
Until a COVID-19 vaccine is approved for children, getting a COVID-19 vaccine yourself and following the latest pandemic precautions are the best ways to avoid spreading COVID-19 to little ones. Children are less likely than adults to have severe cases of COVID-19, but they’re still at risk of some complications from the virus.
Check with your physician if you have questions about a measles, mumps and rubella (MMR) booster. Typically, this isn’t of concern for adults who have been previously vaccinated.
7. Swaddling
Swaddling can help a newborn feel secure and fall asleep.
But once that baby reaches 6-8 weeks or can roll from back to front (whichever comes first), swaddling introduces risk — they can’t use their arms to push themselves back if they roll onto their front. The blanket may also pose a SIDS risk, as the infant is strong and mobile enough to get out of the swaddle and get the blanket around their face and head.
Once a baby can roll to their tummy, you don’t need to reposition them to their back. Just be sure to put them to bed on their backs initially.
8. Diapering and baby powder
We know now that particles of baby powder can cause severe lung damage and breathing problems because babies inhale them. Powders with talc pose even greater health risks.
Instead, play it safe with FDA-approved diaper rash creams after gently cleaning the baby’s bottom with water or wipes. Parents also can ask their pediatrician about a Maalox/Aquaphor mixture that’s often recommended.
9. You can’t spoil an infant
Babies cry a lot. It’s their only way to express themselves or communicate. Responding to their cries, cuddling them, rocking them, talking softly and making shushing noises not only doesn’t spoil a baby, it fosters trust and brain development. Snuggle away, Grandma and Grandpa.
10. Adapting to parents’ ways
As the grandparent, you can be instrumental in helping the new family unit be healthy, empowered and independent. By defaulting to the parents’ ways, you’ll build a strong sense of trust. Offer advice sparingly, and praise generously.
Enjoy the freedom to love without all the responsibility.
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