Safe sleeping

This is a fact sheet to inform parents about the safe sleeping position for babies.

How to reduce the risk of sudden infant death

Research has identified several key infant care practices that reduce the risk of sudden and unexpected infant death, including SIDS and fatal sleeping accidents.
To sleep baby safely and reduce the risk of sudden infant death:

• sleep baby on the back from birth - never on the tummy or side;
• sleep baby with head and face uncovered;
• avoid exposing babies to tobacco smoke before and after birth
• provide a safe sleeping environment night and day: safe cot, safe mattress, safe bedding and safe sleeping place;
• sleep baby in their own cot or bassinette in the same room as their parents for the first 6-12 months.

A safe sleeping place reduces the risk of sudden infant death and fatal sleeping accidents.
To provide a safe sleeping environment for an infant:

• always place baby on the back to sleep, never tummy or side;
• put baby's feet at the bottom of the cot
• the cot must meet the Australian standard for cots;
• use a firm, clean mattress that fits snugly in the cot;
• no additional mattresses or extra padding should be placed in a travel or porta cot;
• tuck in bedclothes securely so bedding is not loose;
• keep quilts, doonas, duvets, pillows, cot bumpers, sheepskins and soft toys out of the cot or sleeping place.

An infant sleeping bag that is the correct size for baby with a fitted neck,arm holes or sleeves and no hood is a safe and effective way to keep a baby's head and face uncovered, as it makes extra bedding unnecessary.

Bouncinettes, prams and strollers have NOT been designed as sleeping products and therefore, no baby should be left unsupervised if they fall asleep in these environments.

Effects of smoking on infants and children

Infants and children are at a higher risk of damage from passive smoking than adults because of their smaller developing bodies, higher breathing rates, and less developed respiratory and immune systems.Infants of mothers who smoke or who are exposed to second hand smoke are placed at increased risk of SIDS. Smoking is among the most important modifiable risk factors in reducing the risks of sudden infant death.
You can reduce your baby's exposure to cigarette smoke by:

• keeping the car and home smoke-free zones;
• designating outside smoking areas away from open windows and doors;
• smoking after feeding baby, not before;
• change your and your baby's clothing often during the day to remove contaminated clothing;
• not bed-sharing with baby if you are a smoker;
• not smoking while you are pregnant.

Sleeping with your baby

In many families, the mother or father share the same bed or sleeping surface as their baby. In some circumstances sharing the same sleep surface may increase the risk of sudden infant death.

SIDS and Kids recommends the safest place for a baby to sleep is in a cot next to the parents' bed for the first 6 to 12 months of life. However, if you choose to co-sleep with your baby, the following guidelines may make it safer:

• Sleep baby on the back from birth - never on the tummy or side.
• If baby lies on his or her side to breastfeed, baby should be returned to the supine (back) position for sleep.
• Make sure the mattress is firm and flat.
• Make sure that bedding cannot cover baby's face or overheat baby (use lightweight blankets and remove pillows, doonas and other soft items from the environment that could cover baby).
• Sleep baby beside one parent only, rather than between two parents, to reduce the likelihood of baby becoming covered by adult bedding.
• Ensure partner knows baby is in the bed.
• As an alternative to bedding, an infant sleeping bag may be used so that the baby does not share the adult bedding.
• Do not 'wrap' baby if sharing a sleep surface, as this restricts arm and leg movement.
• Make sure baby cannot fall off the bed. A safer alternative is to place the mattress on the floor (be aware of potential situations where baby can become trapped).
• Pushing the bed up against the wall can be hazardous. Babies have died after being trapped between the bed and the wall.
• Never place a baby to sleep in a bed with other children or pets.
• Babies must never be left alone on an adult bed or put to sleep on a sofa, beanbag, waterbed or soft, sagging mattress.
• Three sided-cots (a cot with one side down) may be attached to the side of the bed at the same level so that the baby has a separate environment but is still in contact with a parent during sleep.

Wrapping

For some babies, wrapping them in a light sheet or cotton muslin cloth will help them to settle and sleep. Wrapping is a safe and effective strategy to assist you to settle your baby. If you choose to wrap your baby, make sure:

• baby is placed on their back while wrapped
• baby's face and head are not covered
• baby is not overdressed under the wrap
• the wrap is firm, not tight
• you modify the wrap to meet developmental changes eg. arms free
• once 'startle' or Moro reflex begins to disappear (around 3 months of age)
• the infant is not bed-sharing or sharing a sleep surface with another person while wrapped.
• the appropriate age for wrapping is up to 6 - 12 months, depending on the infant.

Strategies to reduce the risk of positional plagiocephaly (flattened area on the head) developing:

• Place your baby on their back to sleep.
• Change your baby's head position every sleep.
• Have lots of tummy time when awake.
• Regularly change the position of toys that your baby likes to looks at.
• Encourage baby to turn his/her head to either side when you talk or play with him/her.
• Put your baby to sleep at either end of the cot or reposition cot to face a different direction.
• Carry your baby in the upright position.
• Avoid prolonged periods in car seats, strollers, swings and bouncers.
• Do not change to a softer mattress.
• Do not change your baby's sleeping position to side or prone (tummy) position.
• Do not use a pillow or roll to keep your baby's head in position.

For more information

Contact SIDS and Kids on 1300 308 307 or visit the website sidsandkids.
To access the full set of fact sheets - Baby and early childhood health issues and concerns.

This information is provided as general information only and should not be relied upon as professional or medical advice. Professional and medical advice should be sought for particular health concerns or manifestations. Best efforts have been used to develop this information which is considered correct and current in accordance with accepted best practice in Queensland as at the date of production. The State of Queensland (Queensland Health) does not accept liability to any person for the information provided in this fact sheet nor does it warrant that the information will remain correct and current. The State of Queensland (Queensland Health) does not promote, endorse or create any association with any third party by publication or use of any references or terminology in this fact sheet.