Infant Safe Sleep

Creating a Safe Sleep Environment for You and Your Baby

Unsafe sleep environments are responsible for four to six infant deaths in Vermont each year. This happens when a baby is unable to breathe because something covers their mouth or nose.

A safe sleep environment means ensuring there is nothing about where the baby sleeps that could prevent their ability to breathe. Some of these things may be blankets, pillows, bumpers, toys, loose clothing, or even pets and other people. Babies can get also accidentally become wedged in mattresses, recliners or among couch cushions and pillows.

By being aware of safe sleep tips and guidelines — like putting your baby to sleep on their back, in a safety-approved crib — parents and everyone who cares for a baby will know the best ways to help their little ones sleep safe and sound.

What you can do to create a safe sleep environment

These safe sleep guidelines help ensure that your baby’s breathing remains clear and unobstructed, and that your baby does not get into a position that could cause injury. Everyone who takes care of your baby—mom, dad, siblings, grandparents and sitters-- should follow these safe sleep guidelines.

  • Always place y Brochure coverour baby on their back to sleep. Sleeping on their side or tummy is not advised. Do not use any pillows, cushions or blankets to prop your baby. Use a firm mattress, closely fitted to the sides and bottom of the crib. Use the mattress that is with the safety approved crib. Do not use adult mattresses, air mattresses or folded blankets.
  • Use a crib that meets the current safety standards (such as meets the mattress standards and the 2-3/8 inch slot openings).
  • Keep the crib cleared of objects such as pillows, comforters, soft bedding or stuffed animals. Don't use the crib for storage, such as for other clothes or household items.
  • Don't bundle the baby too tightly in heavy blankets or clothing. Consider using a one-piece sleeper/suit. The room temperature should be kept comfortable as if for a lightly clothed adult.
  • Keep your baby’s head and face uncovered. It is best to use a one-piece sleeper/suit. If a blanket is used, it should be tucked in firmly and only reach as far as the baby’s chest.
  • Babies should sleep separate from, but close to their parent or caregiver. The baby should sleep in a crib or bassinet that meets safety standards that is placed near the bed, instead of sleeping in the bed with the parent or other children or pets.
  • Breastfeeding your baby is always encouraged because it has important health benefits for both the baby and mother. A simple practice is for mother to bring the baby into bed for breastfeeding or comforting, and then return the baby to the crib/bassinet when everyone is ready to sleep.
  • Never let a baby fall asleep with another person. This is especially important if that person is smoking, tired or ill, has taken medication, drugs, alcohol, or substances that cause drowsiness, or if that person extremely overweight. However, all parents of babies are tired and may unintentionally fall asleep with the baby, creating a risky situation.
  • The American Academy of Pediatrics recommends that babies be offered a pacifier at nap time and bedtime. Do not reinsert the pacifier if the baby refuses it or falls asleep. Do not coat the pacifier with anything sweet. The pacifier should be cleaned regularly. Delay pacifier use until after 1 month of age if the baby is breastfeeding.
  • Encourage “tummy time” when the baby is awake and observed by an adult. Tummy time means that the baby can play and get exercise while laying on his tummy.
  • Never smoke around a baby. Perhaps this is a good time for baby's caretaker to consider quitting. To find out more call 1-800-QUIT NOW.
  • Do not put the baby to sleep on an adult bed or sofa or recliner. Sometimes a baby is injured by rolling off an adult bed or sofa or they will get caught in the crevasses of the couch.
Safe Sleep Q & A

Many parents have questions about how to place their baby to sleep safely. There are several guidelines for parents and caregivers which are summarized here. Also, as you have more questions, the best thing to do is to talk with your health care provider or pediatrician. They can help you make a Safe Sleep plan for your family. For more information on Infant Safe Sleep download the brochure “Keep Your Sleeping Baby Safe.”

 

Below are some Frequently Asked Questions around the Safe Sleep Guidelines:

Q: What is the best way for baby to sleep? Baby in Crib

A: The best way for a baby to sleep is Alone, on their Back, in a safety approved Crib – and easy way to remember this is A, B, C.

Q: Why does a baby have to sleep Alone, what does that mean?

A: Babies are safest when they are sleeping in a safety approved crib without any objects in the crib. This means no blankets, toys, pillows or bumper pads. Babies can easily become covered, wrapped up, or pressed against an item and suffocate or become strangled by it. This risk is also for co-sleeping too; babies have died because of adult sleeping situations or by adults' bodies being too close to the baby and causing suffocation. Baby should sleep Alone, But Close – babies should sleep in your room, in a separate space, up to a year.

Q: What is SIDS? What does it have to do with Safe Sleep?

A: Sudden infant death syndrome (SIDS) is the sudden death of an infant under 1 year of age that can’t be explained, even after a thorough investigation by a doctor or medical examiner. Sudden unexpected death of an infant (SUDI) is any infant death that is unexpected and initially unexplained. Therefore, SIDS is a form of SUDI. However, these safe sleep guidelines are to help parents prevent their babies from accidentally being suffocated from such dangers as blankets in a crib or getting caught in couch pillows.

Q: My baby is not at risk for SIDS, so why can’t I sleep in a bed with my baby? I enjoy the feeling of closeness when I sleep with my baby.

A: There is no research to show that there is a safe way to sleep with your baby (co-sleep) at this time. Every year, some babies in Vermont die from accidental suffocation, strangulation or entrapment (getting stuck between a sleep space and a wall, for example). Often times this was during a co-sleeping situation or an unsafe environment such as sleeping on a couch, with a blanket or pillow. Many parents who co-sleep with children when they were infants report times when they had a “close call” – for example, they woke up and the baby had wiggled under the covers at the bottom of the bed.

Q: What about “baby boxes” or babies sleeping in cardboard boxes?

A: Parents may have questions about the recently available cardboard boxes that are made for babies to sleep in. These are sometimes referred to as “Finnish baby boxes” because they are used in Finland. There have been stories in the media suggesting that baby boxes are responsible for the low infant mortality rate in Finland. However, the data show that all Western countries have seen a decline, similar to that in Finland, in infant mortality since the early 1900’s, although parents in these countries have not widely used boxes for their babies. The Vermont Department of Health does not currently support the use of cardboard boxes for infants due to the lack of research on their relative safety. We suggest parents use a crib or portable crib that meets the safety standards set by the Consumer Product Safety Commission. Find out more information on the American Academy of Pediatrics website.

Q: When should we use a pacifier?

A: Pacifiers can help sooth babies, but it is ok if you choose to not use one. If you are breastfeeding you should wait to use a pacifier until your milk supply and feeding patterns are well established, at about four weeks old. Babies who are fed using a bottle can start with a pacifier sooner. Often a baby will find his own fingers to suck on that will also help in self-soothing.

Q; What is the latest on swaddling my baby?

A: When your baby is a newborn, a snug (but not tight) swaddle with a light weight baby blanket may help sooth your baby’s fussiness. Be sure to place your baby on her back every time especially if swaddled. You should stop swaddling by about two months old, because that is the age when babies start to roll over. If they are swaddled, they may be at risk of rolling over in the swaddle and end up in the risky position of side or tummy sleeping.

For more information on safe sleep download the brochure.

Sudden Infant Death and Sudden Unexplained Infant Death

What is Sudden Unexpected Death of an Infant (SUDI)?

Sudden unexpected death of an infant is any infant death that is unexpected and initially unexplained. Usually, the cause of the death is determined after a thorough investigation and autopsy by a medical examiner. The deaths that remain unexplained are defined as sudden infant death syndrome (SIDS). Therefore, SIDS is a type of sudden unexpected death of an infant.

What is Sudden Infant Death Syndrome (SIDS)?

Sudden infant death syndrome (SIDS) is the sudden death of an infant under 1 year of age, which remains unexplained after a thorough investigation including a complete autopsy, examination of the death scene and review of the clinical history. Researchers are still working to understand the causes of  SIDS. SIDS is not caused by suffocation, child abuse, immunizations, vomiting, choking or by minor illnesses such as a cold or infection. SIDS is not contagious.

Confusion between Infant Safe Sleep and SIDS:

Sometimes infant safe sleep is discussed along with Sudden Infant Death Syndrome (SIDS.) SIDS is when a sudden infant death cannot be explained even after a though investigation. Researchers are still working to fully understand the causes of SIDS. The information here is about infant safe sleep and helping parents to know how to place their baby for sleep in a way that will reduce the risk of accidental suffocation.

What Practices May Contribute to the Sudden Unexplained Death of an Infant?

  • Placing the infant on tummy or side when sleeping.
  • Placing the baby on loose bedding or soft sleep surfaces such as, quilts, comforters, sheepskin, pillow-like toys, pillows; or sleeping on a soft surface such as a waterbed, couch or chair. These keep the baby from breathing easily.
  • Exposing the baby to any tobacco smoke during and after pregnancy.
  • Sharing a bed with the baby and other children, adults, or pets.
  • Overdressing or bundling the baby too tightly in heavy blankets or a room that is too hot.

Tips for Creating a Safe Sleep Environment

Review these steps with anyone who cares for the baby, including relatives, grandparents, childcare providers and babysitters.

  • Place babies on their back to sleep. Side sleeping is not advised. Do not use any pillows, cushions or blankets to prop the baby.
  • Use a firm mattress, closely fitted to the sides and bottom of the crib.
  • Use a crib that meets the current safety standards.
  • Keep the crib free of soft objects such as pillows, comforters, soft bedding or stuffed animals.
  • Don't bundle the baby too tightly in heavy blankets or clothing. The room temperature should be kept comfortable as if for a lightly clothed adult. Grandma Babysit
  • Be sure the baby’s head and face are uncovered. Consider using a one-piece sleeper/suit. If a blanket is used, it should be tucked in firmly and only reach as far as the baby’s chest.
  • Never smoke around a baby. And, if you are a smoker and are the parent of a newborn, perhaps this is the time to try to quit smoking: Visit the Department of Health's Quit Line website for help or call 1-800-QUIT-NOW.
  • Breastfeeding has important health benefits for babies. Babies may be brought into bed for breastfeeding or comforting, but should be returned to the crib/bassinet when the parent is ready to sleep.
  • Never let a baby fall asleep with another person, especially if that person is smoking, tired or ill, has taken medication, drugs, alcohol, or substances that cause drowsiness, or is extremely overweight.
  • The American Academy of Pediatrics recommends that babies be offered a pacifier at nap time and bedtime. Do not reinsert the pacifier if the baby refuses it or falls asleep. Do not coat the pacifier with anything sweet. The pacifier should be cleaned regularly. Delay pacifier use until after 1 month of age if the baby is breastfeeding.
  • Encourage “tummy time” when the baby is awake and observed by an adult. Tummy time means that the baby can play and get exercise while laying on his tummy.
  • Be sure everyone knows about safe sleep for your baby: Tell everyone who cares for your baby about the safe sleep practices that you are using. If your are using child care for your baby, remember that, in Vermont, licensed child care providers are required to use safe sleep practices. Thus it will be easier for your baby have the same routine of safe sleep both at home and at child care.
  • Remember that new babies are growing quickly and need to eat frequently. This is why they may be awake so much at night. It is normal that you baby may not sleep through the night until he is several months old.