Safe Infant Sleep: How to Implement it

I’m here to tell you the basics of safe sleep (and how to implement it), but please know that this blog does not come from a place of judgment in any way.  If you have previously practiced unsafe sleep... It’s ok. I DID IT TOO. 

Even though I knew my daughter would be safer on her back, before I knew anything about pediatric sleep and how to help her, I used several unsafe sleep methods to try and get her to fall asleep and stay asleep. I was beyond exhausted and desperate. Now, I’m not promoting it AT ALL. But I want you to know that I really do get it.  I do not judge you whatsoever. I understand that sometimes we do/have done things that are unsafe when we’re half asleep, confused, desperate, or feel like you have no other option.

I’ve been there, done that. You are NOT alone. But I’ve also come out the other end, thanked the good Lord nothing bad happened, and moved forward with a safe sleep environment for my daughter ever since. Oh, and she sleeps amazing too so that’s a bonus! I want to help you come out of the other end too.

I began learning more about HOW to implement safe sleep whilst also getting better sleep when Lily was 7 weeks old…. This is a thing by the way!!! Even your baby CAN sleep well in their bassinet/crib if you help them learn (and some are just unicorn natural sleepers obv). 

It blew my mind too. Babies don’t have to be up every 2 seconds in the night beyond the first few weeks. Yes, they’ll wake for a feeding, but you can get great sleep in between, safely!

If you’re struggling with a baby that can’t seem to be happy sleeping on their backs,  make sure to get started with your sleep education journey by downloading my free course.

ANYWAYS, back to safe sleep. It’s actually not as complicated as you think. When following the recommendations of the American Academy of Pediatrics (AAP), the main thing to remember is the ABC’s of Safe Sleep:

A - Alone 

B - On their backs

C - In their crib/pack n play/bassinet

Inside the crib, you want it to be totally bare, except for a tight fitting sheet, your baby, and perhaps a pacifier if they take one.                                                 

When practicing safe sleep you want to avoid any of the following in the crib:

1. Loose blankets of any kind (even “breathable”). Have your baby sleep in a sleep sack (or a swaddle if under 8 weeks old and not yet rolling). My favourite safe sleep sacks/swaddles that I’ve personally used myself are: Ollie Swaddle, Kyte Baby, and Zipadee Zip.

2. Bumpers of ANY KIND! Unfortunately, despite their safety risk, bumpers are still marketed and sold on the market, but they’ve shown to be very dangerous for your baby. You will want to avoid any kind of bumper, including mesh bumpers. This is because bumpers not only pose a suffocation risk, but also as a strangulation and entrapment risk, which the mesh material does not compensate for. If your baby is getting their legs stuck between the crib slats, I suggest using a sleep sack for prevention, and if it becomes a consistent problem, you can opt to use a pack n play until it resolves. The risk of having bumpers is much higher than any risk of a little bump or bruise from being stuck in the slats or banging on the side of the crib.

3. Loveys, cuddly toys, or pillows - Up until at least 12 months old, you want your crib to ONLY have your baby in their sleep sack (perhaps with their pacifier) inside of it. Loveys or cuddly toys can be used during bedtime routine, but not for sleeping in the crib until after it is deemed safe by the AAP (12 months+). Pillows are not necessary for under 2 year olds, and should be avoided but you can leave it later too! They really don’t need one. When it is time to introduce a pillow, make sure it is relatively small and firm.

THE AMERICAN ACADEMY OF PEDIATRICS ISSUED ITS POLICY STATEMENT GIVING RECOMMENDATIONS TO PARENTS FOR CREATING SAFE SLEEP ENVIRONMENTS FOR THEIR CHILDREN. YOU CAN READ THE POLICY STATEMENT HERE:  SIDS AND OTHER SLEEP-RELATED INFANT DEATHS: UPDATED 2016 RECOMMENDATIONS FOR A SAFE INFANT SLEEPING ENVIRONMENT

Recommendations via the AAP for safe sleep include:

• Back to sleep for every sleep -Infants should be placed to sleep on their backs for every sleep by every caregiver until the child reaches 1 year of age. Side or tummy sleeping is not safe, nor advised. If your baby begins to roll by themselves, it is safe for them to stay there as long as the crib is clear. Read more about how to survive the rolling stage overnight in my blog here. 

• Use a firm sleep surface - Infants should be placed on a firm sleep surface (ie. firm mattress in a crib) covered by a fitted sheet with no other bedding or soft objects to reduce the risk of SIDS and suffocation. Infants should never be left to sleep on sofas, chairs, or in sitting devices (ie. rock and play, inclined sleepers, mamaroos, swings etc.). Soft bedding remains a risk for infants older than 4 months and should not be added to the crib. Safe sleep surfaces include cribs, bassinets, and pack n plays with their included mattress. 

• Breastfeeding is recommended - Breastfeeding is associated with a reduced risk of SIDS. Unless contraindicated, it is recommended that mothers breastfeed exclusively or feed with expressed milk for six months, in alignment with recommendations from the AAP.

• Room sharing without bed sharing - Parents are encouraged to have their infants sleep in their parents' room, close to the parents' bed but on a separate surface for at least six months, preferably a year. However, sleeping in a separate room is NOT associated with an increased risk of SIDS and it is considered safe.
  

• Offer a pacifier at nap time and bedtime- Pacifiers have actually been shown to have a protective effect to the incidence of SIDS, with the decreased risk ranging from 50-90%. You can read more about pacifiers and SIDS here. It’s totally fine if your little one hasn't taken to it, but if they do, offer the pacifier before sleep. You don’t need to keep replacing it every time it falls out. Make sure you do not not use pacifiers that attach to infant clothing or attach to objects, such as stuffed animals or other items that may be a suffocation or choking risk.

A QUICK WORD ABOUT BED-SHARING AND THE “SAFE SLEEP 7”

Now please remember, I am not here to judge! I know we are all trying to just be the best parents we can be. And like I said before, I’ve done it too when I was really struggling. 

I get a lot of questions about bed-sharing, co-sleeping, and the “Safe Sleep 7” whenever I discuss safe sleep, so I feel the need to address it. 

I will start off by saying that I KNOW for many people, the idea of bed-sharing is completely natural and normal. And perhaps it is for some (or even many), but the point of this blog is to share education on safe sleep, and how to avoid risks of Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Infant Death Syndrome (SUIDS). 

With that being said, bed-sharing has shown to be the single largest risk factor for sleep-related infant deaths, with more than 69% of all sleep-related infant deaths being associated with bed-sharing. Researchers analyzed 8,207 deaths and found that 69% of the infants were bed-sharing when they died. Read more about this in the AAP Publication from August of 2014 here.

ALTHOUGH THE SAFE SLEEP 7 DOES CAUSE BED-SHARING TO BE SAFEER BY REDUCING THE RISK OF:

• Suffocation on bedding/blankets

• Suffocation on pillows

• Sleeping with/near an intoxicated parent

IT UNFORTUNATELY DOES NOT ADDRESS THE FOLLOWING RISKS:

• Being rolled on/crushed by parent

• Suffocation on parent’s body (e.g. breast)

• Wedging and/or entrapment

• Sinking into or suffocating on an adult mattress (which are not approved for infant sleep).

Of course, bed-sharing is a personal parental choice and responsibility, and that choice is entirely given to the parent.                                                         

“BUT WHAT IF MY BABY WAKES UP THE SECOND I PUT THEM IN THEIR CRIB? I’M TRYING REALLY HARD BUT THEY HATE IT!”

See… this is where I totally hear you. My daughter was the exact same. I would rock her or feed her to sleep. She would be absolutely out cold in my arms… but as soon as we laid her on her back.. BAM. Eyes open, crying, or just awake and wanting to party. It was SO frustrating. I remember reading all about safe sleep and thinking…

“OK, I KNOW IT’S SAFER, BUT SERIOUSLY HOW DO I DO THAT!?!?! SHE JUST HATES BEING ON HER BACK IN THE BASSINET.” 

As I later found out, there are lots of little things you can do to help them LOVE their sleep space, and better yet, sleep longer stretches when they’re ready. Here are a few of my favorite simple tips:

1. Start a little bedtime and nap time routine! It doesn’t matter how young they are, it can help so much! Click here to learn more about bedtime routines.
2. Follow awake times throughout the day. You want to make sure they are actually tired enough for a decent nap, and they’re not just having a micro nap as they’re all snuggly. For newborns this is as little as 45 minutes between naps, and for older babies between 2-4 hours. Click here to learn more about awake windows, and more specific times for your child’s age. 
3. If they are newborns, swaddle snuggly. You can swaddle until about 8 weeks or until they show signs of rolling. This muffles the moro reflex that is activated when placed on their backs suddenly, causing their arms to flail about (if you know, you know, lol). If they are out of the swaddle, opt for a cozy and safe sleep sack, such as these Kyte Baby sleep bags (not sponsored, they are just a great investment, and last FOREVER). 
4. Before laying your baby down on their backs, place them on their side in their crib/bassinet, and pat them on the back/bum softly until they are drowsy or asleep. Then gently roll them on to their backs for safe sleeping. When tiny babies are placed on their backs right away, it can trigger the moro reflex, and this helps to soften the transition.
5. Before laying your baby down, place a warm heating pad in their sleep space for a few minutes. Remove the heating pad, and THEN place them down (using the above method). This helps the space to be warm and snuggly, and hopefully an easier transition from a warm parent to a cooler bassinet or crib.
6. Implement sleep shaping or teaching in an age appropriate way. This looks different for newborns (0-16 weeks) compared to older babies (4-24 months) and older. 

If you’re ready to get started RIGHT NOW…….I offer self-led sleep guides that walk you through step-by-step on what to do at bedtime, how to handle every situation, and how to help your baby sleep through the night when it’s time!

NEWBORN SLEEP COURSE (0-3 MONTHS)

BABY SLEEP COURSE (4 - 24 MONTHS)

You are not alone! I’m here to help you get your baby sleeping safely, and better yet, much longer, or all night long if age appropriate.

HERE’S A QUICK RECAP:

• Don’t beat yourself up about past unsafe sleep practices. Many parents have struggled and been in a desperate situation. The point of this is to educate you, and point you in the right direction towards safe sleep from now on!

• Follow the ABC’s of Sleep (Alone, on their Back, in their Crib). 

• Use a firm sleeping surface with a flat fitted sheet. 

• Stay away from bumpers, blankets, toys, pacifier clips, or anything else in the crib. Pacifiers themselves are ok to be in the crib. 

• Consider using a sleep sack instead of blankets to keep the baby warm, cozy, and safe.

• Although there are guidelines for safe bed-sharing, such as the Safe Sleep 7, these do not cover several other risk factors of infant sleep related deaths, and it is recommended to have your baby sleep in their own safe space.

• Scroll back up to read several tips on helping your little one love their sleep space!! IT REALLY CAN BE YOU REALITY!

IF YOU JUST FEEL LIKE YOU’RE CONSTANTLY STRUGGLING WITH SLEEP IN GENERAL, THAT’S WHAT I’M HERE FOR!

I have several resources for you, ranging from FREE sleep guides/courses, and comprehensive self-led sleep teaching plans.

I work with families JUST LIKE YOU every single day. Families who are up every 2 hours, every 4 hours, replacing the pacifier, nursing all night long, bed-sharing, whatever it is, I can help you go from surviving to thriving!  I can help you get your baby/toddler sleeping 11-13 hours straight (with age appropriate feedings).

I CAN HELP YOU FEEL CONFIDENT IN YOUR CHILD’S SAFE SLEEPING.