Awareness and adherence to current evidence-based information regarding safe sleeping recommendations is of utmost importance. As midwives, we advise families of this essential education to encourage preparation, readiness, and knowledge to enhance a positive safe transition into parenthood.

When babies under one year of age die unexpectedly in their sleep, it is referred to as Sudden Unexpected Death in Infancy (SUDI). Such deaths are often found to be associated with fatal sleep accidents or Sudden Infant Death Syndrome (SIDS). Fatal sleep accidents occur when babies suffocate, get trapped or strangled by objects in their sleeping environment. Whereas SIDS describes circumstances when no apparent cause of death is found after thorough investigation.

Since safe sleeping practices and campaigns were introduced and implemented, the incidence of SUDI has reduced by 85%. This statistic is a true testament to the effectiveness of current safety guidelines. Educating families is fundamental to enhance understanding as our number one priority is the health, well-being, and safety of our precious children.

The safe sleeping recommendations are as follows:

• Always place baby on their back to sleep, not on the tummy or side. Sleeping on their back ensures protective reflexes are working effectively. Arousal and swallowing mechanisms are needed to protect the airway and work best when a baby is placed to sleep on the back, reducing the risk of suffocation, overheating, and choking.
• Ensure baby’s face and head remain uncovered as babies control their temperature through these areas. This decreases the risk of overheating and suffocation by maintaining a clear airway. Avoid the use of hats, beanies or bonnets when sleeping.
• Regardless of baby sleeping during the night or day, a safe sleeping environment must be always provided. The suggested place for baby to sleep is in their own sleep space, with a safe mattress and bedding. The mattress must be firm, flat and the right size for the cot and comply with Australian standards. Safe bedding is lightweight, firmly tucked in and pulled up only to the chest. Any loose bedding may occlude the airway and cause suffocation. Safe sleeping bags are well-fitted across the neck and chest, with baby’s arms out and no hood present. 
• Babies should always be placed on their back to sleep with feet at the bottom of the cot. This encourages air flow around the baby’s head. In addition, it reduces a baby’s ability to move down the cot and potentially underneath blankets that may cause suffocation.
• Sleep baby in a safe cot in the same room as the adult caregiver for the first six to twelve months.
• Maintain a smoke free environment for baby before and after birth. Smoking during pregnancy and around baby once born increases the risk of SUDI. This includes second-hand smoke. Adequate hygiene practices after smoking and before interacting with baby is essential.
• Breastfeeding is the optimal form of nutrition and has multiple benefits for both mother and baby. Research concludes breastfeeding a baby more than halves the odds of a baby dying suddenly and unexpectedly. As midwives, we acknowledge that breastfeeding is not always easy or possible. Parents who feed their baby infant formula or supplementary feeds will reduce the risk of SUDI when all other safe sleeping practices discussed are implemented.
• Avoid adding extra items to the cot as this increases the risk of overheating and suffocation. Unsafe items include soft toys, loose blankets, doonas, lambs wool, pillows and cot bumpers. Any additional objects added to the cot are an extra hazard to baby and may obstruct breathing.
• Never leave baby unattended on an adult bed, beanbag, couch, pillow, cushion or with a sleeping adult positioned on a sofa or chair.
• Position baby’s cot away from hanging cords from blinds, curtains or electrical appliances that may cause strangulation. Avoid placing heaters or electrical appliances near the cot to reduce the risk of overheating, burns and electrocution. Never use items such as electric blankets, hot water bottles and wheat bags for babies.

The implementation of safe sleeping strategies aims to protect, nurture, and ensure safety. Evidence-based research empowers families by enhancing confidence, awareness and competence when caring for infants. Knowledge and understanding optimises a positive and enjoyable transition into parenthood. Overwhelming feelings of anxiety, apprehension and stress will be reduced when safe sleeping recommendations are adhered to and applied to a baby’s sleeping environment.

For more valuable information regarding safe sleep recommendations visit rednose.org.au