Caring for Our Childen, 3rd Edition (CFOC3)

Chapter 2: Program Activities for Healthy Development

2.2 Supervision and Discipline

2.2.0

2.2.0.2: Limiting Infant/Toddler Time in Crib, High Chair, Car Seat, Etc.

Frequently Asked Questions/CFOC3 Clarifications

Reference: 2.2.0.2

Date: 10/13/2011

Topic & Location:
Chapter 2
Program Activities
Standard 2.2.0.2: Limiting In-fant/Toddler Time in Crib, High Chair, Care Seat, Etc.

Question:
Please provide more contexts surrounding the research that informed the recommendation that “children should not be left to sleep in equipment, such as car seats, swings, or infants seats that do not meet the ASTM International (ASTM) product safety standards for sleep equipment.”

Is part of the intent regarding this standard to educate parents about safe infant sleep practices or is it actually dangerous for infants to sleep sitting up, or both?

Answer:
Both. Extended periods of time in the crib, high chair, car seat, or other confined space limits infants’ physical growth (gross motor development) and also affects their social interactions. Injuries and Sudden Infant Death Syndrome (SIDS) have occurred when children have been left to sleep in car seats or infants seats.

Please see the Standard’s rationale and references for information on related injuries and SIDS.


A child should not sit in a high chair or other equipment that constrains his/her movement (1,2) indoors or outdoors for longer than fifteen minutes, other than at meals or snack time. Children should never be left out of the view and attention of adult caregivers/teachers while in these types of equipment/furniture. A least restrictive environment should be encouraged at all times. Children should not be left to sleep in equipment, such as car seats, swings, or infant seats that does not meet ASTM International (ASTM) product safety standards for sleep equipment.
RATIONALE
Children are continually developing their physical skills. They need opportunities to use and build on their physical abilities. This is especially true for infants and toddlers who are eagerly using their bodies to explore their environment. Extended periods of time in the crib, high chair, car seat, or other confined space limits their physical growth and also affects their social interactions. Injuries and Sudden Infant Death Syndrome (SIDS) have occurred when children have been left to sleep in car seats or infant seats when the straps have entrapped body parts, or the children have turned the seats over while in them. Sleeping in a seated position can restrict breathing and cause oxygen desaturation in young infants (3). Sleeping should occur in equipment manufactured for this activity. When children are awake, restricting them to a seat may limit social interactions. These social interactions are essential for children to gain language skills, develop self-esteem, and build relationships (4).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.1.3.1 Active Opportunities for Physical Activity
3.1.4.1 Safe Sleep Practices and Sudden Unexpected Infant Death (SUID)/SIDS Risk Reduction
5.3.1.10 Restrictive Infant Equipment Requirements
5.4.5.1 Sleeping Equipment and Supplies
5.4.5.2 Cribs
REFERENCES
  1. Kornhauser Cerar, L., C.V. Scirica, I. Stucin Gantar, D. Osredkar, D. Neubauer, T.B. Kinane. 2009. A comparison of respiratory patterns in healthy term infants placed in care safety seats and beds. Pediatrics 124:e396-e402.
  2. Benjamin, S.E., S.L. Rifas-Shiman, E.M. Taveras, J. Haines, J. Finkelstein, K. Kleinman, M.W. Gillman. 2009. Early child care and adiposity at ages 1 and 3 years. Pediatrics 124:555-62.
  3. Bass, J. L., M. Bull. 2008. Oxygen desaturation in term infants in car safety seats. Pediatrics 110:401-2.
  4. New York State Office of Children and Family Services. Website. http://www.ocfs.state.ny.us/main/.