Why do we talk about safe sleeping:

Around 446 babies and toddlers die suddenly and unexpectedly every year in the UK.

In 2022, the unexplained infant mortality rate was highest for mothers aged under 20 years, at 0.81 deaths per 1,000 live births. This is almost 3 times higher than all other age groups.

The rate of SIDS in low birth weight babies (2.5kgs/5 and a half pounds or under) is 4 times higher than babies born above this weight.

The peak age for SIDS is 1-2 months, however it’s important that families are encouraged to continue with room-sharing up to six months as 91% of SIDS occur during this period.

65% of unexplained deaths in 2022 were boys.

Using a pillow can increase the risk of SIDS by up to 2.5 times

Safe Sleep guidelines:

• always on their back
• clear cot or sleeping space
• feet to foot
• firm, flat, waterproof mattress
• in the same room, for the first 6 months
• room temperature 16-20 degrees
• safest place is separate cot or moses basket
• breastfeeding
• if using a dummy use for every sleep

Room temperature:

The recommended room temperature is 16c - 20c for babies. This is important as you do not want the room to be too hot or cold. 

Sudden infant death syndrome also known as SIDS becomes a higher risk for babies who get too hot.

To check the temperature you can use a room thermometer as this is an accurate way to find out. 

Co-sleeping:

It is important for babies to sleep on their backs in their own separate sleep space that is clear and flat: 

• cot
• moses basket

This is because it is can reduce SIDS.

How to co-sleep more safety:

How to share a bed more safety:

• keep adult bedding away and pillows away from the baby
• remove headboards that are slatted or decorated
• do not bring older children into the bed
• do not bring pets into the bed
• make sure your baby can not be trapped
• make sure your baby will not be able to fall off the bed
• do not leave the baby alone in an adult bed

What bedding does my baby need?

What products are not recommended for sleeping?

• bumpers, pillows, thick bedding
• being near radiators, direct sunlight, window or air conditioning
• cigarettes/smoky environments
• toys/comforters
• wedges/straps/sleep positioners
• pods/nests/rolled up towels

Co-bedding; Safer sleep for twins:

Co-bedding is when two or more siblings share a sleep space. If parents do this they need to be aware of the following:

• the babies must sleep on their back
• they must have their heads facing one another
• their feet must be on opposite ends of the cot
• they can also be side-by-side with their feet at the bottom of the cot
• once the babies can roll or move around the cot they will need their own separate space

Co-sleeping for premature babies:

Premature or low birth weight babies have a higher risk of sudden infant death syndrome (SIDS) if they share a sleeping safe with a sleeping adult. Due to this it is important to avoid co-sleeping with premature babies until they are one year from their due date. 

Make sure the babies sleep space is in the same room as their parent for at least six month past their due date. 

Make sure to have a safe sleeping space for the baby nearby if the parent is tired. 

Safer sleeping during summer:

Safer sleeping during winter:

During winter it can be hard to maintain the baby's sleep safe temperature, the recommended temperature being 16C - 20C. It is important to make sure that the baby does not overheat as research has shown babies are safer when they are a little bit cooler compared to being too hot.

In the winter it is important to not use the following as this can overheat the baby:

• do not use a hot water bottle
• do not use weighted blankets 
• do not let the baby sleep in hats, hoods or outdoor clothings when they are indoors or in a care
• do not place your baby need a radiator
• do not use a cot bumpers

Safer sleep while on holiday:

If the baby is sleeping away from home due to them being on holiday it is important to take with either a cot, travel cot or moses baskets as they are all ideal sleep spaces for travel. 

If they do not have one they can contact the hotel or accommodation prior to going on holiday if they have any available. 

Safer sleep for temporary accommodation:

Housing services at Medway Council:

• for any household going into TA with an under two we ensure we have identified if they have a cot available to them. If they don’t we have a supply of cots to issue to clients free of charge and to keep
• if the client is in an emergency or cannot get to us we will supply a voucher so that they can purchase a cot that day
• whilst we cannot make anyone take a cot, all the Rehousing team have been made aware to advise households that the NHS discourage co-sleeping for new-born babies and to provide access to the cot wherever possible
• bedtime Bundles for equipment whilst in temporary accommodation - Bedtime bundles referral form | The Lullaby Trust

Safer sleep for emergency or unplanned situations:

• make sure the baby sleeps on their back
• make sure that their is a clear cot or sleep safe

If a cot or moses basket is not available you can use:

• travel cots
• prams
• co-sleeping (but make sure to follow co-sleeping guidelines)
• baby sleeping in a Pram
• baby boxes 

Safer sleeping in travel cots:

• do not be tempted to place folded blankets or towels under, travel cot mattresses are thinner however they are safe for the baby to sleep on
• make sure the baby is sleeping on their back in the feet to feet position at the bottom end of the travel cot

Safer sleeping for prams:

If a baby is sleeping in a pram it is important to make sure the pram has the following:

• the pram's sleep space is completely flat
• the mattress is firm and waterproof
• the mattress has no cushioned or raised edges
• make sure the pram's hood can be pulled back
• make sure the cover also known as an apron can be removed

Safer sleeping for prams indoors:

• make sure the base of the pram is flat
• make sure the hood is down when indoors
• do not cover the pram/buggy
• check baby's temperature regularly 
• make sure to remove the carry cot apron when indoors
• make sure to read the manufacturers guidance

Safer sleeping for baby boxes:

Baby boxes are made out of cardboard and are designed for babies to sleep in. Baby boxes are not suitable or meant to be used for long-term as babies can outgrow them quickly. But they are a safer option then co-sleeping or bed sharing and if a parent is fleeing a situation. 

When using a baby box it is important to make sure:

• do not lift the box while the baby is in it
• do not put the lid on the box while the baby is in it
• make sure the box is clear when being used
• do not place extra bedding in the box on top or underneath the mattresses 
• make sure the box is placed on solid ground and will not fall over
• do not use the box if it gets wet ot soiled
• make sure pets stay away from the box 

Safer sleeping for car seat:

• make sure to avoid driving for long distances with pre-term and young babies
• take regular breaks throughout long journeys
• if the baby slumps forward - make sure to stop straight away and sit the baby upright
• use a baby seat that is rear-facing
• use a baby seat that is right for the baby's weight
• only use the car seat for transport only
• make sure the car seat meetings safety standards 
• try not to buy a second hand car seat as you may not be aware of it's safety

It is important to make sure the baby does not overheat while being in the car as this increases their risk of SIDS. Make sure to remove any hats or outdoor clothing and to regularly check the baby is not getting too hot. 

Car seat law within the UK (for children under 3 years old):

must always use the correct car seat for your child's age, height and weight, if this is not available they are not allowed in the car to travel and this is illegal (only exception is in a taxi but only if the correct seat is not available)

Involvement of Fathers:

It is also important to address fathers in the education of safe sleeping. 

Local Child Safeguarding Practice Review (LCSPR) on the death of three-month-old Isabel; she had been co-sleeping in bed with her mother. Isabel was subject to a child protection plan and it is thought (but not confirmed) that Isabel’s death was a tragic accident linked to an unplanned sleeping environment where drugs and alcohol were present. From this review, the findings where:

• father was not included in discussions around safe-sleeping.
• lack of professional curiosity about who the father was and the role of the father.

Influencers:

We recommend following families that follow Lullaby Trust on social media so they can be influenced by evidence based practice in hopes they will post up to date information.