Sleeping in Car Seats, Swings, and Strollers

 

Is it safe to let a baby sleep in a car seat or some other “sitting device” like a swing, bouncer, or stroller?

Competing Opinions

Perspective #1: For some babies, it seems that the only way they’ll go to sleep is in some sort of device. If you have to use a swing, stroller, or car seat to get your infant to sleep, by all means do it. Your child needs his sleep, and so do you.

Perspective #2: Babies die every year while strapped into sitting devices. It’s not smart to let babies sleep in sitting devices for long periods of time in situations where the caregiver might not realize that the child is in danger. It’s fine if you put your baby in a car seat while you’re driving, but get him out once you arrive. Same with your stroller. Even if he wakes up when you move him, that’s better than taking a risk.

What the Science Says

WHEN TRAVELING IN a car, make sure your baby is in a properly installed car seat. There’s no question about that. (See “Car Seats.”)

But the car seat shouldn’t be used in place of a firm, flat crib. According to a 2019 study published by the AAP, there’s a real danger in allowing an infant to sleep for long periods of time in a sitting device like a car seat. The ten-year study, which looked at almost twelve thousand infant sleep-related deaths, found that 3 percent of those deaths occurred in sitting devices, most often involving car seats. That might sound like a small percentage, but it’s big enough to be considered significant, and it’s definitely significant to those families who lost their babies.

A primary danger is asphyxiation. Especially when a car seat is improperly used, its straps can get wrapped around a baby’s neck and lead to strangulation. An infant’s airway can also be blocked when his head rocks forward, since young babies often don’t have the neck strength to lift their heads. The other key danger highlighted in the study occurs when sitting devices are set on elevated surfaces and fall, or on a soft surface where the device can tip over and lead to suffocation.

Authorities including the AAP and the CDC continue to firmly advise that babies be placed on their back to sleep at all times, both for napping and overnight.

The Bottom Line

BABIES ARE GOING to fall asleep in car seats, swings, and other devices. That’s perfectly fine. What matters is that you avoid leaving your child to sleep there, and that you keep a watchful eye on them. It’s tempting to take a nap yourself or grab a quick shower, but health authorities repeatedly warn that babies shouldn’t be placed on an incline to sleep and shouldn’t be left unattended if they do fall asleep in a swing or stroller or car seat.

That doesn’t mean not to use the gear. Car seats are a must when driving with a baby, and the AAP study points out that almost all car-seat-related deaths took place in a “nontraveling context,” meaning outside the car. But the danger is real, if relatively rare. So be sure to use the devices as intended. And communicate the dangers to anyone else who takes care of your baby. The 2019 study found that, compared with other deaths, those in sitting devices were more likely to occur under the supervision of some sort of sitter or childcare provider than with the child’s parents.

I know this is a scary subject. And I realize that there are plenty of times you can’t imagine moving your sleeping baby and chancing waking him. But this is one more area where you want to be vigilant and observe safe sleep practices for your child.

On a Personal Note

WHEN OUR KIDS were little we frequently used the stroller or car seat to help them fall asleep. I remember repeating the same protocol numerous times with each child when they were babies. First, when my child closed his eyes, I’d perform that mental calculation—you know the one—to determine just how long to let him remain in the car seat before moving him to the crib. I had to give him time to get deep enough into his sleep that he wouldn’t wake when I moved him, but not so long that if he did wake, he’d determine that he’d already had his nap and be up for the rest of the day. Any parent knows the pressure he or she can feel when aiming for that sweet spot.

Frequently I’d end up driving around the block multiple times to ensure I didn’t create a radius so large that it would prevent me from making it home in time. I’d put on the familiar lullaby playlist to create the best sleepy environment and pray for the best. Far too often, though, my whole plan would be sabotaged when the baby’s older brother, wide awake in his own car seat, would get fed up and end up yelling, “I’m so sick of these boring sleeping songs!” or “You just passed our house again! Why can’t we go home?”