How To Safely Sleep Your Baby

Babies spend so much of their lives sleeping, it is important to make sure that they are in a safe place during sleep. And I know this can feel like a lot of rules, your baby is so precious, they are worth it. The safest place to sleep your baby is in a full-sized cot in your bedroom from birth. In Australia cots have safety standards which means they have to pass strict guidelines around size, height of upper and lower settings, distance between bars, mechanism that allows side to go up and down, materials used and more.

Always sleep baby on their back
Safe cot that meets the current mandatory Australian safety standard
Firm, flat well fitted mattress, no gaps between mattress and cot side
Safe bedding: sheets and blankets made from natural fibres
No quilts, pillows, cot bumpers, wedges, soft toys, woollen underlays
Keep head and face uncovered, no hats, short sheet cot, see below
Keep baby’s environment smoke free before and after birth
Sleep in a safe cot in parents’ room for the first 6-12 months
Breastfeed your baby if able
Dress your baby in warm clothing but not hot so they won’t overheat
Avoid sleeping baby on couches and makeshift bedding
Ensure all your baby’s carers know how to sleep your baby safely

Make up the cot short sheeted with baby’s feet at bottom and sheets and blankets tucked in firmly with no loose sheets, so they can’t wriggle down under the sheets.

Or use no blankets at all and just a safe age and size/weight appropriate swaddle or sleeping bag.

Benefits of your baby sleeping in your room include, having them close for night time feeds and settling as well as being able to check on them more easily and more often.

Try to have your baby sleep in a safe cot in your room for the first 6 to 12 months. If your home doesn’t allow for this, that is okay, a safe cot and safe sleep environment matter most, just check on your baby regularly.

SIDS & SUDI:

The following risk factors are associated with most Sudden unexpected deaths in infancy (SUDI) including Sudden infant death syndrome (SIDS) and fatal sleep accidents in both Australia and abroad:

Sleeping on tummy or side.
Face and head covered with bedding leading to overheating or asphyxia.
Smoking during pregnancy or after birth.
Soft sleep surfaces, woollen underlays, water beds, pillows, soft mattresses.

By following the Red Nose Safe Sleeping Guidelines, your baby will be much safer.

Temperature:

Put two fingers down onto baby’s chest to check, if hot or sweaty they are too hot, reduce clothing or blankets. Checking hand or foot temperature does not give a true indication as often these are cold, especially when asleep.

Room temperature:

The main danger is becoming too hot as this has been associated with SUDI. In hot weather if you don’t have air conditioning, you can try using a pedestal fan in the room (not pointed directly at your baby) and dressing them in light clothing.

Keep cords from blinds, mobiles and electrical appliances away from the cot, as your baby gets older they will try to reach and pull things into their cot.

Clothing for sleep:

Clothing to sleep your baby in should be simple, comfortable and breathable fabrics with no hood or decorative lace which could become tangled or dangerous for your baby. A singlet or similar and one more layer of clothing is generally enough, I found an all in one suit the most comfortable and practical for changing nappies. In very hot weather only one layer such as a singlet and nappy only is best. No hats should be worn during sleep unless in the first 24 hours of life, these can overheat your baby.

Safe wrapping/swaddling:

Swaddling helps your baby to feel confined and secure as they were in the womb, it also reduces the chance of rolling. There are many different methods of wrapping but as long as it is firm over the upper body to contain the hands and loose around the hips so that their legs can fall open in a frog like position this will enable normal hip development. In hot weather use breathable fabrics like cotton or muslin and reduce clothing layers.

Swaddle bags are popular as no wrapping skills are required, make sure these are the correct size and not too large as their head could slip down into the bag.

As they lose the startle reflex, usually around 3 months, try to leave their arms out and wrap from the chest down. As soon as they show any signs of trying to roll, it is time to stop wrapping altogether, as they need their arms free to roll back safely. This is often around 4 months but every baby is different, and some start earlier

Once they are rolling they need to have their hands and arms out. Look for a sleeping bag with a fitted neck and armholes, no hood, and sized for your baby’s weight rather than their age.

Co-sleeping:

Many parents bring their baby into their bed at some point, especially in those exhausted early weeks, I did this with three of my four babies. While a cot in your room is the safest place, if you do find yourself sharing a bed with your baby, it is worthwhile knowing how to make it safer. How to co-sleep more safely .

Other Unsafe Sleep Products Marketed for Babies:

Never use weighted blankets or sleeping bags, electric blankets, wheat bags or hot water bottles with babies. These are not safe.

No sleep positioners, wedges or anti-roll devices, and try not to let your baby sleep in rockers, bouncers or inclined loungers, these are for supervised awake time only.

Reflux:

Even if your baby suffers from reflux and vomiting, which is very common in babies less than 3 months of age, it is still safest to sleep them flat on their back rather than tilting or elevating the mattress, as their protective mechanisms work best in this position. Any vomit is likely to go back down into the stomach and not into their airways. Elevating the cot actually increases the risk of your baby slipping down into the blankets. Although it can be worrying to see your baby bring up milk, sleeping them flat on their back keeps them safest. In particular circumstances a paediatrician may suggest elevating the cot or other sleep positions other than back sleeping however this should take into account safe sleeping guidelines and the baby’s medical needs, in my experience this does not happen often.

There is a lot to remember here and it can feel overwhelming when you are already tired. Try not to worry about getting everything perfect, every small step you take makes your baby’s sleep space safer. If you have any questions, the Red Nose Safe Sleep Advice Line is a wonderful resource on 1300 998 698, or talk to your maternal and child health nurse. You know your baby best and you are already doing a great job by learning about this.

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