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Safe Sleep Tips by Guest Blogger, Kai Holder


Safe Sleep Tips: Preventing Injuries Related to Infant Sleep by Guest Blogger, Kai Holder


Kai Holder is a second year MD/MPH candidate at Northwestern University. She is interested in maternal-child health, health equity and injury prevention.


The phrase “SIDs”, otherwise known as Sudden Infant Death Syndrome, may frighten many caregivers, however there are numerous health behaviors that caregivers can learn and implement that lower a babies risk for sleep related causes of infant death.[1]We use the word caregivers, because learning about sleep injuries and healthy sleep behaviors is important for each adult that takes care of the infant, not solely the parents. Each person involved with the baby’s care should learn about safe sleep.1


Information about Sleep Related Infant Death


Sleep related infant death is the sudden, unexplained death of a baby aged one year or less.[2] Physicians and scientists are not yet sure what causes sleep related death in infants, but they are working tirelessly to understand the causes of it. Although the causes of sleep related infant death is largely unknown there are numerous methods to reduce the risk this, as an infant’s sleep environment can impact sleep related injuries in infants.


Risk Factors for Sleep Related Causes of Infant Death[3]


Studies demonstrate that various factors put infants at higher risk for sleep related causes of infant death.


Babies are at higher risk for sleep related injuries if they:

· Sleep on their stomachs.

o Of note infants, who normally sleep on their backs but are then placed to sleep on their stomachs for shorter lengths of time, for example a nap, are at very high risk for sleep related causes of infant death.

· Sleep on soft surfaces.

o For example, an adult mattress, couch, chair, or who sleep under soft coverings.

· Sleep on or under soft or loose bedding.

· Get overheated during sleep.

· Are exposed to second-hand smoke in utero or in their environment.

· Sleep in an adult bed with parents, other children or pets, otherwise known as co-sleep.

o This behavior is exceedingly dangerous if

§ The baby is younger than 11 to 14 weeks old.

§ The baby is covered by a blanket or quilt.

§ The baby sleeps with more than one bed-sharer.

§ The adult smokes, recently drank alcohol or is tired.


How to Reduce the Risk of Sleep-related Causes of Infant Death[4]


· Always place the baby to sleep on their back to sleep

o Sleeping on the back position is the safest sleep position for all babies until they are one year old. Remember to do this every time the baby sleeps.

o Some parents are afraid that the baby may choke in this sleep position, but research demonstrates that babies are not more likely to choke when placed on their backs to sleep.

· Use a Firm and Flat Sleep Surface covered by a fitted sheet in a crib

o Many caregivers are not sure what is meant by the word firm. Firm in regard to a safe sleep surface is defined as, a hard surface. A mattress designed for a baby may seem uncomfortable to a caregiver, but this is the way the mattress is intended to feel.

o Soft surfaces are very dangerous for an infant because if the baby lays on a soft surface the surface may conform to the shape of the baby’s head and may increase the likelihood for the baby to inhale his or her own carbon dioxide.[5]

o Additionally, soft surfaces increase the risk of suffocation in the case where the baby rolls over and gets their head caught in the mattress.

o Always place the baby in a crib or bassinet that meets current safety standards[6].

· Do not place other bedding or soft items in the sleep area.

o Items such as blankets, soft toys, baby bumpers, and any other miscellaneous items should not be placed in the infant’s sleep area because they can increase suffocation, entrapment, and strangulation.

o Many caregivers believe that crib bumpers can prevent injury, but research shows that this is not the case.

o Keeping these items out of the crib protects the infant.

· Always place the baby to sleep alone.

o Co-sleeping is when caregivers share a sleeping area with an infant.[7]

o Co-sleeping is always associated with an increased risk of sleeping related deaths in infants. Even if the baby seems uncomfortable and upset it is always best to have the baby sleep alone in their sleeping area.


In summary, always remember the ABC’s of sleeping when you put an infant to sleep. [8]


A: Alone

B: Back

C: Crib



[1] NIH. (2021.). About sids and safe infant sleep. Safe to Sleep: Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://safetosleep.nichd.nih.gov/safesleepbasics/about. [2] NIH. (2021.). What is sids? Safe to Sleep: Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://safetosleep.nichd.nih.gov/safesleepbasics/SIDS. https://safetosleep.nichd.nih.gov/safesleepbasics/risk/factors. [4] NIH. (2021). Ways to reduce the risk of sids and other sleep-related causes of infant death. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://safetosleep.nichd.nih.gov/safesleepbasics/risk/reduce. [5] Safe Sleep Academy. (2021). Why is my baby's sleep surface so firm? Safe Sleep Academy. https://www.safesleepacademy.org/babys-crib-mattress-firm/. [6] United States CONSUMER PRODUCT SAFETY COMMISSION. (2021, June 3). Safe sleep – cribs and infant products. CPSC.gov. https://www.cpsc.gov/SafeSleep. [7] Raising Children Network. (2021, January 29). Co-sleeping with your baby. Raising Children Network. https://raisingchildren.net.au/newborns/sleep/where-your-baby-sleeps/co-sleeping. [8] Pathways. (2021, March 29). The ABC's of Safe sleep for your baby. Pathways.org. https://pathways.org/abcs-of-safe-sleep/.

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