When we become parents ‘safety’ often takes on a huge new role in our lives. We suddenly feel the responsibility of keeping this new life safe and protected. Sleep safety is something we have probably never had to think about before, and now even restful slumber has safety protocol.
In the UK, all new parents should receive safe sleep information from midwives or health visitors. This advice mostly focuses on avoiding SIDS and accidental death.
In this article we are going to look at the reasons behind the sleep safety advice, and look at keeping rooms safe for baby sleep. The Lullaby trust Quick tips for safe sleep are at the end as a handy guide and you can print the CalmFamily sleep safety handout to keep at home.
What is SIDS?
One of the key concerns of parents when it comes to baby sleep safety is SIDS risks. SIDS stands for Sudden Infant Death Syndrome. This is when a baby dies, usually whilst sleeping, and no reason can be identified. It does not include accidental death, such as smothering. Because SIDS is sudden and unexpected it can feel like we can do nothing to keep our babies safe. However, this is not true.
SIDS risk reduction advice
The NHS and Lullaby trust, amongst other organisations, produce advice on minimising SIDS risks. We will look at the reason for each of these pieces of advice.
- Place babies on their back in a cot to sleep.
- Place babies in the “feet to foot” position in a cot or crib.
- Keep the cot clear
- All sleep before 6 months should be in a room with the parents
- Do not smoke in pregnancy or let anyone smoke in the same room as a baby
- Do not share a bed with their baby if the parents have been drinking alcohol, or if they are drug takers or smokers
- Never sleep with a baby on a sofa or armchair
- Parents should not let their baby get too hot or too cold. Keep the baby’s head uncovered.
- Breastfeeding is recommended.
Understanding baby sleep safety advice:
Place babies on their back in a cot to sleep:
Babies are at higher risk of SIDS when sleeping on their fronts. This position may cause babies to sleep more deeply, as frequent rousing is protective against SIDS. It may also be that young babies are not able to move their head if they are struggling to breathe, and this is more likely to occur if they are on their front, than on their back.
Place babies in the “feet to foot” position in a cot or crib.
When babies shuffle they usually wriggle head first. Placing a baby with their feet at the end of the cot means they have space to wriggle. This gives them the best chance of being able to wriggle away from blankets if they get over their face.
Keep the cot clear
Cuddly toys and cot bumpers are hazards that can end up covering a baby’s face and increasing suffocation risk. Pillows are not recommended until after 12 months at least.
All sleep before 6 months should be in a room with the parents
This means both nighttime sleep and naps. The presence of other people in the room may trigger more frequent rousing. This does not necessarily mean fully waking up, but coming into a lighter sleep. This lighter sleep and frequent rousing appears to reduce risk of SIDS.
Do not smoke in pregnancy or let anyone smoke in the same room as a baby
A baby’s risk of SIDS increases if the birth parent smokes during pregnancy, or the baby is exposed to smoking after they’re born.
Parents must not share a bed with their baby if the parents have been drinking alcohol, or if they are drug takers or smokers
This most accurately reduces the risk of accidental death in a bed. A baby bedsharing with a parent who has drunk alcohol, taken drugs, or who smokes, is at increased risk of injury. This is because these cause adults to sleep more deeply and be less aware of the baby in their bed. This is not a SIDS reduction baby sleep safety recommendation. This baby sleep safety advice reduces risk of smothering or crushing.
Parents must never sleep with a baby on a sofa or armchair
Again, this baby sleep safety advice reduces risk of accidental death, not SIDS. Sofas and armchairs are a very high risk sleep environment, and it is not possible to make them safe for babies. When a baby sleeps with a parent on a sofa or in an armchair there’s a significant risk of slipping down between their parent and the arm of the sofa, or between cushions. This risks crushing and/or suffocation.
We look a little more at this risk in the article Is bedsharing dangerous? Talking about risks.
Parents should not let their baby get too hot or too cold. Keep the baby’s head uncovered.
There is a strong link between SIDS and overheating. Getting too cold is also a problem because young babies struggle to maintain their own body temperature. Not wearing a hat is important. We usually dress babies so their face and head is the only bare part. We usually add a blanket for sleep. In order to be able to cool themselves down to prevent overheating we need to leave their head uncovered.
Their face should always be uncovered. Anything over their face reduces airflow and can result in suffocation.
Breastfeeding is recommended.
Babies who are not breastfed have a higher risk of SIDS than babies who receive human milk whether expressed by their parent, fed directly from breast/chest, or from a milk donor. Breastfeeding helps to minimise SIDS risk.
- Research hasn’t found any link between mattresses and SIDS.
- Cot mattresses need to be clean and dry with no tears, cracks or holes. If possible it is ideal to purchase a new mattress for each baby.
- The mattress needs to fit the cot without gaps.
Making the room safe
We also need to think about hazards in rooms where babies might sleep. This may be your room, a nursery, or any other room they may nap in. Because safety guidance says up to 6 months babies should nap in a room with a caregiver present, that often means we have them nap in whatever room we need to be in. So, let’s think about how to make them safe.
- Being too close to a radiator can cause overheating. If there is nowhere else a baby can sleep then you can turn the radiator off or down.
- Ensure blind cords are fixed appropriately, and don’t dangle near a baby. Blinds cords can cause a strangulation risk.
- Make sure the room and sleeping space doesn’t have any choking hazards. A good rule of thumb: anything that fits into an empty toilet paper roll could be a choking hazard.
Electricity and wiring
- If there are a lot of wires in baby’s room from the lamp, music player, humidifier, etc. it may be worth using a wire guard. Any wire, cord or cable can become a strangulation risk.
- Can your baby get to the stairs if they wake up? Do you need to make the stairs safe?
- It might be a good idea to use a stairgate to prevent access to the stairs.
For some parents having a monitor is comforting, for others it induces paranoia. Listen to your instincts and remember that unless you really can’t hear your baby without one then a monitor isn’t really a safety device. They give some parents peace of mind without disturbing their baby unnecessarily.
Simple sleep safety checklist:
There’s a lot to think about here, but mostly once you have your rooms set up safely you only have to think about a few simple things for each nap or night time’s sleep.
Here are the quick and simple sleep safety guidelines from the Lullaby Trust:
Things you can do
- Always place your baby on their back to sleep
- Keep your baby smoke free during pregnancy and after birth
- Place your baby to sleep in a separate cot or Moses basket in the same room as you for the first 6 months
- Breastfeed your baby
- Use a firm, flat, waterproof mattress in good condition
Things to avoid
- Never sleep on a sofa or in an armchair with your baby
- Don’t sleep in the same bed as your baby if you smoke, drink or take drugs or are extremely tired, if your baby was born prematurely or was of low birth-weight
- Avoid letting your baby get too hot
- Don’t cover your baby’s face or head while sleeping or use loose bedding
Want to support parents with sleep?
If you are passionate about supporting parents with the reality of parenting, love sharing evidence backed information about the reality of sleep, and want to support parents to find ways to meet their own and their baby/child’s sleep needs then training with CalmFamily as a sleep specialist may be right up your street!
Find out more about training to offer SleepCalm today.