Safer Sleep advice from The Lullaby Trust Advice for parents and carers
- Always place you 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 six months
- Breastfeed your baby if you can
- Use a firm, flat, waterproof mattress in a good condition
- 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 if your baby was born prematurely or was of low birth weight
- AVOID letting your baby get too hot or too cold (somewhere between 16-20 degrees is about right)
- DON’T cover your baby’s face or head while sleeping or use loose bedding
- This advice should be followed for naps, not just night time sleep.
Always place your baby on their back to sleep
- You should always place your baby on their back to sleep and not on their front or side (unless your doctor has advised you of a medical reason to do so)
- Sleeping a baby on their front or side greatly increases the chance of SIDS
- It is important that you always put your baby on their back as part of their regular sleep routine – the chance of SIDS is particularly high for babies who are sometimes placed on their front or side
- If your baby has rolled onto their tummy, you should turn them onto their back again
- Once your baby can roll from back to front and back again, on their own, they can be left to find their own position
- The best way to make sure your baby sleeps on their back is to do this from day one, and keep putting them to sleep on their backs for every day and night time sleep. It is also important that you keep the same routine for your baby, as babies who are normally slept on their backs but sometimes slept on their fronts are at a great risk of sudden death.
Sleep safe, sleep sound, share a room with you
Place your baby to sleep in a separate cot or Moses basket in the same room as you for the first 6 months, even during the day. A large study of evidence from across Europe found that the risk of sudden infant death was significantly reduced when the infant slept in the same room, but not the same bed, as the parents.
- The safest place for your baby to sleep for the first 6 months is in a separate cot or Moses basket in the same room as you
- The chance of SIDS is lower when babies sleep in a separate cot in the same room as their parents
Never sleep on a sofa or in an armchair with your baby
This is one of the most high risk situations for your baby. Studies have found that sharing a sofa or armchair with a baby whilst you both sleep is associated with an extremely high risk of SIDS. One study found that approximately one-sixth of infants in England and Wales who died of SIDS were found sleeping with an adult on a sofa. Make sure that you do not accidentally fall asleep with your baby on a sofa. If you think you might fall asleep, put the baby down in a safe place to sleep. If you are breastfeeding, have your partner stay up with you, breastfeed in a different position where you are confident you might not fall asleep, or feed the baby somewhere else.
Avoid letting your baby get too hot
It is important to make sure that your baby is a comfortable temperature – not too hot or too cold. The chance of SIDS is higher in babies who get too hot.
A room temperature of 16-20°C, with light bedding or a lightweight well-fitting baby sleep bag that is comfortable and safe for sleeping babies.
It can be difficult to judge the temperature in the room, so use a room thermometer in the rooms where your baby sleeps and plays. A simple room thermometer is available from The Lullaby Trust online shop. For more information please call 020 7802 3200.
Advice on room temperature is intended as a guide. Every baby is different, so while it’s important to be informed about overheating you need to check your baby regularly to see if he or she is too hot. Feel the baby’s tummy or the back of their neck (your baby’s hands and feet will usually be cooler, which is normal). If your baby’s skin is hot or sweaty, remove one or more layers of bedclothes.
Babies who are unwell need fewer, not more bedclothes. Babies do not need to wear hats indoors, nor sleep under a duvet or quilt.
Remember that the safest place for your baby to sleep is in the same room with you for the first six months – this will be especially helpful in judging the temperature they will be sleeping at.
Keep your baby smoke free during pregnancy and after birth
Scientific evidence shows that around 30% of sudden infant deaths could be avoided if mothers didn’t smoke when they were pregnant. Taken together with the risks of smoking around a baby at home, this means that smoking could be linked to 60% of sudden infant deaths.
- Both you and your partner should try not to smoke during pregnancy and after the birth
- Smoking both during pregnancy and after your baby is born greatly increases the chance of SIDS, and your baby can be affected by either you or your partner smoking
- You should also keep your baby out of smoky areas – Don’t let people smoke near your baby and keep your home, car, and other places your baby spends time, smoke free
- If you or your partner smoke, you should not share a bed with your baby as this greatly increases the chance of SIDS even if you do not smoke in the bedroom
- If you smoke 1-9 cigarettes a day during pregnancy you are more than 4 times as likely to have a baby die as a sudden infant death than a woman who didn’t smoke at all during pregnancy.
- Even if you did smoke when you were pregnant, you should still try not to expose your baby to smoke after birth as this can help reduce the risk of sudden infant death. Quitting smoking is not easy and will require a lot of discipline, but it is an effort worth making.
For help and advice to stop smoking, try the NHS Smoking Helpline on 0800 0224 332 or visit the website http://smokefree.nhs.uk/
Any breastfeeding, even for a few days, is better than none, but most authorities including the Department of Health now recommend that babies be exclusively breastfed for at least six months. The Department also recommends that that breastfeeding is continued, with the addition of appropriate weaning foods, for as long as the mother and baby want.
Breastfed babies have a lower chance of SIDS As long ago as 1965 it was shown that babies under 3 months who died of SIDS were less likely to be breastfed than infants who did not die. Since then, numerous studies have supported the protective effects of breastfeeding, with one overview report concluding that breastfeeding reduces the incidence of SIDS by approximately half.
Even a brief period of breastfeeding can be protective for your baby. It has been shown that both partial and exclusive breastfeeding have been associated with a lower SIDS rate, but that exclusive breastfeeding was associated with the lowest risk.
Using a dummy
Some research suggests that it is possible that using a dummy when putting a baby down to sleep could reduce the risk of sudden infant death.
- If you choose to use a dummy, wait until breastfeeding is well established (at up to about 4 weeks old).
- Stop giving a dummy to your baby to go to sleep between 6 and 12 months.
- Don’t force your baby to take a dummy or put it back in if your baby spits it out. Don’t use a neck cord.
- Don’t put anything sweet on the dummy, and don’t offer during awake time.
- Using an orthodontic dummy is best as it adapts to your baby’s mouth shape.
- If you choose to use a dummy make sure it is part of your baby’s regular sleep routine.
Some people think swaddling young babies can help them settle to sleep. Whilst we do not advise for or against swaddling, we do urge parents to follow the advice below:
- Use thin materials
- Do not cover the baby’s head
- Never put them to sleep on their front
- Check the baby’s temperature to ensure they do not get too hot.
Some parents choose to bed-share with their babies. This means that their baby shares the same adult bed for most of the night, and not just to be comforted or fed. It is important for you to know that there are some circumstances in which this can be very dangerous.Bed sharing increases the chance of SIDS and is particularly dangerous if:
- Either you or your partner smokes (even if you do not smoke in the bedroom)
- Either you or your partner has drunk alcohol or taken drugs (including medications that may make you drowsy)
Similarly, bed sharing with a baby of low birth weight (2.5kg or 51/2lbs or less) or a premature baby (37 weeks or less) is strongly linked to an increased risk of SIDS.
You should never sleep together with your baby if any of the above points apply to you, or even if you just feel very tired. You must be especially careful when giving feeds that you are not in a position where you could both fall asleep in the bed, an armchair or on the sofa together.
Parents may still choose to bed-share with their baby. If this is your choice, it is important that you are informed about how to minimise the risks. It is important to note that a high proportion of infants who die as a result of SIDS are found with their head covered by loose bedding. Ensure there are no pillows, sheets, blankets or any other items in the bed with you that could obstruct your baby’s breathing or cause them to overheat.
The safest place for your baby to sleep for the first 6 months is in a separate cot or Moses basket in the same room as you.
Babies who are born prematurely (before 37 weeks) or of low birth weight (under 2.5kgs) are particularly vulnerable and it is important that all the safe sleep advice is followed. Premature babies are sometimes slept on their front in hospital for special medical reasons. When they are getting ready to go home these babies should always sleep on their back to reduce the risk of sudden infant death.
About The Lullaby Trust
The Lullaby Trust provides specialist support for bereaved families, promotes expert advice on safer baby sleep and raises awareness of sudden infant death.
The Lullaby Trust are committed to supporting research to understand why over 600 babies die suddenly and unexpectedly in the UK each year, the majority of whom appear to be healthy, and to find out more about how to prevent these tragic deaths.
Working with the NHS the Lullaby Trust run a national health-visitor led service for bereaved parents, Care of Next Infant (CONI) programme, which supports families before and after the birth of their new baby.
The Lullaby Trust campaign tirelessly, lobbying government to keep sudden infant death on the public health agenda.
The Lullaby Trust also runs an information line for parents and professionals (0808 802 6869) and a dedicated line for bereaved families (0808 802 6868). Both are free to call from landlines and mobiles.
Advice including, factsheets and the latest research can be found at www.lullabytrust.org.uk.
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