Safe Sleep and SIDS Prevention: What Child Care Providers
Need to Know
Sudden Infant Death Syndrome (SIDS) is the
leading cause of death among infants
between one month and 12 months old. In
cases of SIDS death, a baby dies in her or his
sleep, and all other possible causes of death
are ruled out by a medical examiner. SIDS is
just one category of Sudden Unexplained
Infant Death (SUID). Experts aren’t exactly
sure what causes babies to die in cases of
SIDS and other types of SUID, but they do
have some suggestions to lower the risk of
death while babies are sleeping.
Here is a quick summary of some safe sleep practices you should follow if you care for infants:

Always place babies on their backs to sleep, unless the child has a medical condition and you have
written instructions from the infant’s medical provider. These written instructions should be written on
a prescription pad and include information about why it is medically necessary for the baby to sleep in a
different position and how long the alternative sleep position is prescribed. Again, this must be a
medical necessity, and not based on the child’s comfort or the parent’s preference.

Never put items – pillows, blankets, crib bumpers, wedges, stuffed animals, toys, etc. – in a crib with a
baby. A securely fitted sheet covering the mattress is all babies need.

Always place a baby in a crib with a firm mattress, rather than on a soft surface like a sofa or a chair.
Other types of restrictive equipment, such as swings, car seats, or bouncers, are not designed for safe
infant sleep. If a baby falls asleep outside the crib, you should move her to the crib as soon as possible.

Never smoke or allow anyone else to smoke in the area where babies sleep. Exposure to secondhand
smoke greatly increases the risk that a baby will die from SIDS.

Always support mothers who are breastfeeding. Babies who are breastfed for at least 6 months are at a
much lower risk of SIDS death than those who are not.

Never let babies get too hot while they sleep. Babies should be dressed in light clothing and the room
temperature should be comfortable for a lightly clothed adult.

Always encourage parents to consider a pacifier for nap and bedtime. Babies who use a pacifier while
sleeping are less likely to die from SIDS. Be careful, though, that pacifiers don’t have clips or strings
attached while the baby is sleeping.

Never stop learning about safe sleep and SIDS prevention. It is important to stay up-to-date about
recommendations for safe sleep to help prevent SIDS and other sleep-related infant deaths.

Always encourage parents to keep their child’s immunizations up-to-date. Some parents may
mistakenly believe that immunizations can cause SIDS, but in fact immunizations may lower a baby’s
risk of SIDS.

Never be afraid to talk to parents about the importance of safe sleep. Even if parents are reluctant to
accept the use of safe sleep practices, letting them know what you do in child care and the reasons why
can help them learn to better protect their baby.

Always present families with your program’s safe sleep policy upon enrollment. This helps to ensure
that all families are aware of the procedures you follow (and the importance of not deviating from these
procedures), and can serve as a starting point to talk with parents about safe sleep both at home and in
child care.
Sources:
American Academy of Pediatrics (2012). "SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant
Sleeping Environment" retrieved from http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf
National Institutes of Health (2014). "What Does a Safe Sleep Environment Look Like?" retrieved from https://www.nichd.nih.gov/sts/
about/environment/Pages/look.aspx