safe sleep for newborns

Safe Sleep for your Baby Reduce the Risk of Cot Death

Key Points 4 Always place your baby on their back to sleep, both night and day.

4 Keep your baby smoke free during pregnancy and after birth.

4 The safest place for your baby to sleep at night is in a cot in your room.

4 Place your baby with their feet to the foot of the cot.

4 Make sure your baby’s head and face stays uncovered when asleep.

4 Keep the cot free of soft objects and anything loose or fluffy.

4 Breastfeed your baby, if possible.

Don’t smoke during pregnancy.

Don’t smoke or allow anyone to smoke in the home or in the car.

Never fall asleep in bed with your baby if you or your partner smokes.

Never share a bed with your baby when you have taken alcohol or drugs (including medication that may make you drowsy). ✖ It is not safe to bed share if your baby is less than three months old or was born prematurely or had a low birth weight. ✖ Never fall asleep with your baby on a sofa or an armchair.

1 ✖ Don’t let your baby get too hot. ✖ ✖ ✖ ✖

What is cot death?

Cot death is another name for Sudden Infant Death Syndrome (SIDS). It is the sudden and unexpected death of a seemingly healthy baby during sleep. No cause of death can be found, even after a post-mortem examination.

However, cot death does not only happen in a cot. It may happen in a pram, bed, car seat, baby seat or anywhere a baby is sleeping.

A seemingly healthy baby is put down to sleep and when next checked they are found dead. There has been no sound or sign of a struggle.

Cot Death is: • sudden and unpredictable • a recognised medical disorder • one of the main causes of death in babies from four weeks to one year of age • most common between two and four months of age (although it can happen to older babies) • only diagnosed when all other causes of death are ruled out • not caused by immunisations • not caused by vomiting or choking • not suffocation.

Because we do not know what causes cot death, we cannot completely prevent it. But research has shown that you can take steps to significantly reduce the risk of cot death. If you follow the advice in this booklet you will help reduce your baby’s risk as much as possible.

Please share this information with everyone who looks after your baby: family, friends, child-minder, crèche, babysitter etc.

2

Back to sleep Always place your baby on their back to sleep, both night and day.

Babies who sleep on their tummies have a higher risk of cot death.

Always place your baby to sleep on their back, both night and day. This does not increase the risk of choking if they vomit.

If a baby vomits/spits up while sleeping on their back, it will go back down the oesophagus as it is underneath the trachea (gravity).

Cellular blanket (allows air to circulate)

When babies are sleeping on their tummy any vomit will pool at the opening of the trachea making it easier for the baby to choke.

Trachea

Oesophagus

Oesophagus

Trachea

Make sure everyone who looks after your baby uses the back to sleep position.

It is not safe to place your baby on their side to sleep because they may roll onto their tummy.

When your baby is older and able to roll from back to front and back again, let them find their own position to sleep. However you should still place them on their back at the start of sleep time.

3

Plagiocephaly (flat head) If your baby always lies with their head in the same position they might develop a ‘flat head’, this is known as plagiocephaly.

You can prevent this when putting your baby down to sleep, by turning their head so that sometimes they face left and sometimes they face right.

Sleep positioners and other similar products including pillows Do not use sleep positioners and other similar products as they do not prevent cot death or flat head and are a suffocation risk.

Pillows and cushions of any kind are not necessary and should not be used as they are a suffocation risk.

Elevating your baby’s sleep surface does not reduce reflux and is not recommended.

Keep the cot free of soft objects and anything loose or fluffy (e.g. cot bumpers, duvets, toys, wedges, bedding rolls, etc.).

Sitting and carrying devices Baby seats, car seats, slings, carriers and other similar products are not recommended for routine sleep for your baby.

Sleeping in a sitting position can cause your baby’s head to fall forward and restrict their airway making it difficult for them to breathe.

If your baby falls asleep in a sitting position they should be placed on their back to sleep as soon as possible. Babies should not be left sleeping unsupervised while in a seated position.

Tummy Time Tummy time helps your baby to strengthen their muscles and helps to prevent flat head. It is important to begin from birth. When your baby is awake place them on their tummy on a firm flat surface, while you supervise.

Never leave your baby alone on their tummy and If your baby falls asleep when on their tummy, be sure to place them onto their back.

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your baby is more likely to be born pregnancy.

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Smoke-free zone for your baby

DoSIDS notA5 smoke or allow1anyone to 14:23 smoke in5 the home or in the car. booklet 2011:Layout 09/12/2011 Page Being exposed to cigarette smoke after birth also increases a baby’s of cot2011:Layout death. It1 is09/12/2011 most important that no one smokes around your SIDS risk A5 booklet 14:23 Page 5 Smoke-free zone for your baby baby. When you go out, don’t bring your baby into smoky places.

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Being exposed to cigarette smoke after birth also increases

Remember… a baby’s risk of cot death. It is most important that no one

If smokes around your baby. When you go out, don’t bring you cut to out smoking when you’re Being exposed cigarette smoke after birth also increases a baby’spregnant risk your baby into smoky places. of cot death. and keep cigarette smoke away from your baby

after birth, you greatly reduce their risk of It is most thatcan no one smokes around your baby.

Being exposed toimportant cigarette smoke after birth also increases a baby’s risk If you or your partner smoke (no matter where you smokeWhen you go out, don’t bring your baby into smoky places. ofcot cot death. death. even if you only smoke outside the home), you should not share a bed with your baby as this greatly increases the risk It is most important that no one smokes around your baby.

You can QUIT and we can of cot death.

When you go out, don’t bring your baby into smoky places.

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If you cuthelp! out smoking when you’re pregnant and keep your baby You are twice as likely to quit for good with help. away from cigarette smoke after birth, you can greatlyour reduce their risk of cot death.

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6

5

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if they are on their own in a separate room.

Keep your baby’s cot in your room for the first six months.

own in a separate room.

Keep your baby’s cot in your room for at least the blanket The safest Cellular place (allows air to for your baby to sleep at night circulate) first six months. is in a cot in your room. rate cot is safest. Bed-sharing can be dangerous.

Babies who sleep in a cot in their ot share a bed with your baby parate cot is safest. Bed-sharing can be dangerous.

14:24bedroom Page 8 parents’ are less at risk cot indeath smoke (no matter where you smoke - even if you neverof smoke bed) than if they are on own in a separate room. haveshare taken alcohol, drugs orwith medication that may maketheir you sleep ot a bed your baby

ou or your partner:

SIDS A5 booklet 2011:Layout 1

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more heavily

The safest place for your baby to sleep ou or your partner: are extremely tired is in a cot in your Keep room.your baby’s cot in your moke (no matter where you smoke – even if you never room for at least the first six our baby: months. moke in bed) Is less than three months old who sleep in ✓ Babies was born prematurely (born before 37 weeks) or a cot in their parents’ ave taken alcohol, drugs or medication that may make bedroom are less at Do not share a bed with your baby had a low birth weight (less than 2.5kg or 5.5lbs when born). ou sleep more heavily risk of cot death than if you or your partner: who share their parents’ bed can slip under the bed covers. They can roll if they are on their own re extremely tired • between smoke the (nobedmatter smoke if you never in a separate room. an adult, get caught and the where wall or fallyou out of the bed.– even

inyour bed) aby should not share smoke a bed with other children.

✗

Keep your baby’s cot in your room for the first that may make you six months.

our baby: • have taken alcohol, drugs or medication drowsy less than three months old A separate Never fall asleep with your baby cot is safest. Bed-sharing can be dangerous.

• are overtired on a sofa, couch, armchairDo ornot beanbag – with your baby share a bed was born prematurely (born before 37 weeks) or or if your baby: if you or your partner: his is very dangerous.

• is less than 3smoke months old (no matter where you smoke - even if you never smoke in bed) ad a low birth weight (less than 2.5 kg or 5.5lbs when have taken alcohol, drugs or medication that may make you sleep 8 • was premature (born before 37 weeks) more heavily orn).

Cellular blanket (allows air to circulate)

are extremely tired • had a low birth weight (less than 2.5Kg or 5.5lbs).

or

if your baby: haring can also increase a baby’s risk of suffocation as they can than three months old Bed sharing can beIs less dangerous.

It can increase your baby’s risk of nder the bed covers, roll under an adult, get caught between the was born prematurely (born before 37 weeks) or suffocation as theyhadcan slip under the bed covers, roll under an a low birth weight (less than 2.5kg or 5.5lbs when born). nd the wall or fall out of the bed. Your baby should not share a bed adult, get trapped between the bed and the wall or fall out of the Babies who share their parents’ bed can slip under the bed covers. They can roll our other children. bed. Your babyunder should not a bed children. an adult, get share caught between thewith bed andyour the wallother or fall out of the bed. baby should not share a bed with your other children.

Remember: aYour separate cot is safest.

er fall asleep with your baby ona sofa, a sofa, Never fall asleep with your baby Never fall asleep withon your baby couch, on a sofa, couch, armchair or beanbag – h, armchair – isthis is very armchairor or beanbag beanbag – this very dangerous. this is very dangerous. gerous.

8

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7

Feet to foot

Place your baby with their feet to the foot of the cot and keep their face and head uncovered.

Cellular blanket (allows air to circulate)

Place your baby to sleep with their feet to the foot of the cot, moses basket or pram so they can’t wriggle down under the covers.

Tuck blankets in loosely but securely, no higher than your baby’s shoulders.

A sleeveless baby sleeping bag may be used instead of blankets; it should be low-tog, with no hood, the correct size for your baby and conform to current safety standards.

Check regularly to make sure your baby’s face and head stays uncovered. If blankets slip over their face and head while they are asleep, they are at increased risk of cot death and suffocation.

Use a cot mattress that is clean, firm, flat (not elevated or tilted), that fits the cot correctly so your baby can’t get trapped in a gap between the mattress and the edge of the cot. The mattress should preferably be new, or if used in good condition (no tears). It also should have a removable and washable cover.

Remember…

Face up, face free for a safe sleep.

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Don’t let your baby get too(orhot.

Don’t let your baby too hot too cold).

Don’t let your baby getget too hot.

Overheating can increase your baby’s risk of cot death.

Overheating can increase your baby’s risk Overheating can increase your baby’s risk of A baby can overheat when asleep because of too much of cot death. A baby can overheat when cot death.

A baby can oroverheat asleep bedding or clothes because thewhen room is too hot. asleep because of too much bedding or because ofTotoo bedding orfeelclothes or check much how warm your baby is, their tummy clothes or because the room is too hot.

– itroom should feel warmhot. but not hot. If their tummy because the is too

•

feels hot or if they are sweating anywhere your baby is too warm, so remove some of the bedding.

Don’t wrap your baby in too many blankets.

Other signs include flushed, red cheeks and Sheets and cellular cotton blankets are best, as fast breathing. Don’t worry if your baby’s hands and feet feel cool – this is normal. you can adjust the temperature by adding one

°

°

20

68

18

65

16

60

Cotton cellular blankets are best, as the tiny holes allow air to circulate. Don’t wrap your not overdress your baby nappy, vest and babygro are enough. baby inor taking one away. tooDomany blankets.

You– acan adjust the They can wear less in warm weather.

• A sleeveless baby sleeping bag is a good alternative to blankets, but temperature by adding one or taking one away.

Take off baby’s hat and extra clothes as soon as you are indoors. do not use any other bedding with it.

Do not use duvets, orbaby pillows.

Make sureduvets, thequilts roomquilts your in is not too warm. The room • Do not use or sleeps pillows. temperature should range from 16 - 20oC (62 - 68oF). If the room

Your baby feels should notforwear atoo hat when being put down too warm you it is warm for your baby. Consider gettingto sleep, • Make sure the bedding can’t cover your baby’s head. Your baby should a room thermometer so that you can easily check the temperature of as babies lose heat through their head. your baby’s bedroom. not wear a hat when being put down to sleep. Babies lose heat

through their head so covering their head may cause your baby to Never warm place the your cot, pram or bed to a radiator, heater or fire in To check how baby is,next look for sweating ororfeel their direct sunshine. tummy,become overheated. it should feel warm but not hot. Other signs include flushed Don’t wrap your baby in too many blankets. Sheets and light blankets are To check how warm your baby is, look for sweating or feel their or red• cheeks breathing. best, and as youfast can adjust the temperature by adding one or taking one away. tummy- it should feel warm but not hot. Other signs include flushed, In warm weather your baby may not need any bed covers at all. Remember,

red cheeks and fast breathing.

Don’t worry if your baby’s feet feel cool - this is normal. a blanket folded in halfhands counts asand two layers.

• Don’t worry if your baby’s hands and feet feel cool - this is normal.

Do not use duvets, quilts pillows. vest and babygro are sufficient, Do not• overdress your baby - aornappy, Do not overdress your baby-a nappy, vest and babygro are sufficient, Make sure the bedding can’t cover your baby’s head. Babies lose heat use lessor less in warm weather. clothing in warmer weather. through their head so covering their head may cause your baby to become overheated.

• If your baby has a fever use less bedding than normal and seek If your baby has a fever use less bedding than normal and seek You can use a sleeveless baby grobag instead of blankets, as it will not cover medical advice if necessary. medical advice if ifnecessary. the head you use it properly. It should fit correctly around the neck so that your baby’s head cannot slip down inside the bag. It must be light, with no

Make sure the room your baby sleeps in is a comfortable temperature- Make• sure the baby in isit.aThe comfortable hood.room Do notyour use any othersleeps bedding with grobag shouldtemperature be the right size for your baby with enough room for them to move their legs and feet. not too warm or too cold. The room temperature should range from - not too warm or too cold.

The room temperature should range The also meet the relevant safety standard. o grobag should o 16-20°C (62-68°F).Use a room thermometer so that you can easily from 16-20 C (62-68 F). Use a room thermometer so that you can check the temperature.

Remember… easily• check the temperature.

Never place the cot, pram or bed next to a radiator, heater or fire or in Overheating can increase your baby's risk of cot death.

direct sunlight.

Never place the cot or pram next to a radiator, heater/fire or in 7 direct sunlight.

Remember…

Remember…

Overheating can increase your baby’s risk

Overheating of cot death.can increase your baby’s risk of cot death.

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Breastfeed Breastfeed youryour babybaby Breastfeed your baby Breastfeed your baby

• Breastfeeding Breastfeeding your baby your baby reduces the Breastfeeding reducesthe the Breastfeedingyour yourbaby baby reduces reduces the risk of cot death. riskof cot of death. cot death.

Aim toto breastfeed risk risk Breastfeeding of cot death. Breastfeeding to Aim to breastfeed your baby your baby for asduration long as any extent and any duration isis you can. any extent and ofofany for as long as you can. protective against cot death. protective mothers against cot death. like to bring their • Some Some mothers like to bring baby bed tobring breastfeed.

But pay Someinto mothers like to their their baby into bed to Some mothers like to bring their babies into bed to breastfeed. careful attention to the advice on breastfeed. But pay careful babies into bed to breastfeed.

But pay careful attention to the attention to the guidelines page 7 ofonthis booklet.

But pay careful attention the guidelines safe sleep intothis on safe sleep in this booklet. guidelines on safe sleep in this booklet.

It’s safe to feed your baby in bed as • booklet.

It’s safe to feed your baby long as you put them back in their It’s safe to feed your baby in bed in bed as long as you put own cotas to as long you sleep. put them back in It’s them back in their own cot safe to feed your baby in bed their own cot to sleep. to sleep. long as as you put them back in

Soothers

Soothers

their own cot to sleep.

Some research suggests that giving a baby a soother Soothers Soothers (dummy) every time they are being put down to sleep may Some research suggests that giving a baby a • Some research suggests that giving a reduce the risk of cot death.

Some research suggests thatevery giving atime baby they a soother baby a soother (dummy) every time they soother (dummy) are being put (dummy) every time they are being put down to sleep may are being put down to sleep may reduce breastfeeding and you choose give yourcot babydeath. a downIf you to are sleep may reduce thetorisk of

reduce the risk ofwait cot until death. soother, after one month of age to make sure the risk of cot death.

Cellular If• you choose to give your baby a soother, make breastfeeding is well established. blanket If you choose to give your baby a soother, (allows air If you are breastfeeding and you choose to give your baby a sure make sure you offer it to them every you offer it to them every time they are to circulate) Don’t worry if the soother falls out while your baby is asleep. soother, wait until after one month of age to make sure going to sleep.

But do not force it. time they are going to sleep.

Cellular

breastfeeding is well established.

Do not force your baby to take a soother if they refuse it.

blanket

If you are breastfeeding and you choose (allows air If• you are breastfeeding and you choose to to circulate) to give your baby a soother, wait until Don’t worry if the soother falls out while your baby is asleep. give your baby a soother, wait until after one Do not attach strings and cords to soothers, as these could strangle your baby after one month of age to make sure or cause choke. month of them ageto to make sure breastfeeding is breastfeeding is well established.

Dowell not force your baby to take a soother if they refuse it. established.

Keep soothers clean and never dip them in sugar, honey or other foods and drinks.

•

Don’t worry if the soother falls out while

worry if and thecords soother falls out while baby asleep.

DoDon’t not attach strings to soothers, as these couldyour strangle your is baby 9 your baby is asleep. or cause them to choke.

• not Do not force your baby to take a soother if they refuse it.

Do force your baby to take a soother if they refuse it.

• soothers Do not attach strings and cords to soothers, as these could Keep clean andstrings, never dip them in sugar, or other foods and drinks.

Do not attach ribbons orhoney cords to soothers as these

could

strangle your baby or cause them to choke.

• Keep soothers clean and never dip them in sugar, honey or Keepother food and drinks. soothers clean and never dip them in sugar, honey or other

strangle your baby or cause them to choke.

9 food and drinks.

10

9

Monitors

Apnoea or breathing monitors cannot prevent cot death. These monitors alert parents/carers to apnoea (stopped breathing) or an apparent life-threatening event.

If your baby seems unwell, get medical advice early and quickly.

If your baby seems unwell and you find it hard to tell whether the illness is something minor or more serious, seek medical advice from your doctor or public health nurse.

IN AN EMERGENCY PHONE 999 or 112 Ambulance • Fire • Gardaí

Please note:

Cot death is still quite rare.

Don’t let fear spoil this precious time with your baby.

11

This booklet was produced by the National Paediatric Mortality Register in partnership with the HSE Child Safety Programme, Department of Public Health – Midlands.

If you would like more information please contact: National Paediatric Mortality Register George’s Hall, Temple Street Children’s University Hospital, Temple Street, Dublin 1.

Tel: 01 8788455 npmr@cuh.ie www.sidsireland.ie

Copies of this booklet can be ordered from www.healthpromotion.ie or from your Public Health Nurse.

Modern Printers 056 7721739

Publication date: 2017 (November) Review date: 2019 Order code: HPM00078