Safe sleep environments for babies

Safe sleep environments protect baby airways during sleep and make it easier for babies to breathe. In a safe sleep environment, your baby sleeps on their back, on a firm, flat and level surface, in a space that’s clear, not too hot and smoke free. Check your baby’s sleep environment at home, child care and any other place your baby sleeps. Safe baby sleep environments: easier to breathe, safer to sleep Wherever and whenever your baby sleeps, they must be able to breathe easily. And your baby can breathe easily when their airways are open. A safe sleep environment helps to keep your baby’s airways open and reduces the risk of sudden unexpected death in infancy (SUDI) including sudden infant death syndrome (SIDS) and fatal sleep accidents. A safe sleep environment for your baby involves a: Safe sleep surface: firm, flat and level A sleep surface is what your baby sleeps on or in. For a sleep surface to be safe, it must be firm, flat and level. A firm, flat and level surface might be on a mattress in a cot or portacot, bassinet, baby box, pepi-pod or co-sleeper that meets the Australian Consumer Goods (Infant Sleep Products) Safety Standard 2024. You might also be able to create a safe sleep surface while co-sleeping. A safe sleep surface has safe bedding. This includes a tight-fitting fitted sheet over a well-fitted waterproof mattress protector. The mattress protector shouldn’t be padded or soft. This makes it more likely that your child will be able to breathe easily, even if they roll over. These are soft, curved, inclined, uneven or unstable. They include: sheepskin or lamb’s wool underlays couches, with or without someone else makeshift bedding, pillows, beanbags and waterbeds Child car seats protect your baby from injury in car crashes, but sleeping on an incline can make it harder for your baby to breathe easily. It’s best to check your baby’s breathing and take regular breaks during long drives. There are many cots and other products on the market. Many make claims about protecting babies against SUDI. But a cot, portacot, bassinet, baby box, pepi-pod or co-sleeper that meets the Australian Consumer Goods (Infant Sleep Products) Safety Standard 2024 is the safest place for your baby to sleep, provided that it’s well-maintained and clean and has a well-fitting, firm mattress and safe bedding. Safe sleep space: clear, not too hot and smoke free Your baby’s sleep space is what’s around your baby while they’re sleeping. A safe sleep space is clear of anything that might stop your baby from breathing easily, including things that pose strangulation or suffocation risks. For example: Your baby’s face and head are uncovered. There are no doonas, pillows, nests, loungers, cot bumpers, mattress padding, soft toys or sleep positioners around your baby. Your baby’s coverings are lightweight and tucked in securely at your baby’s chest level with their feet positioned at the bottom of the cot. Or your baby is using a safe infant sleeping bag or suit instead of coverings. There are no teething necklaces, dummy chains and so on attached to your baby. A safe sleep space also protects your baby from overheating. For example: Your baby is dressed in clothing that’s warm but not hot and isn’t wearing a beanie or hat. Wearing a beanie or hat can cause your baby to overheat very quickly. The room is neither too hot nor too cold. If you’re using heating or cooling, it should be set to a moderate temperature and directed away from your baby. There are no electric blankets or hot water bottles. And in a safe sleep space, there’s clear space around your baby. If your baby is in a cot or portacot, there should be a 30-cm clear space around it, with no items that your baby can reach, like plastic, blind cords, mosquito nets and electrical cords. If you’re co-sleeping, consider whether the sleep space is big enough. It needs to fit everyone who sleeps there, with room for a clear space around your baby. Keep your baby’s environment smoke and vapour free, before and after birth. The link between SUDI and smoking or vaping is strong, even when parents smoke away from their babies. If you want to quit smoking or vaping and you’re finding it hard, call Quitline on 137 848. You could also speak to your GP or child and family health nurse. Safe sleep position: baby on their back A sleep position is how your baby sleeps. The safest sleep position for your baby is on their back. This is for several reasons: The reflexes that keep your baby’s airways open work better when your baby is on their back. These reflexes include swallowing, stirring and waking up if their airways become blocked. Your baby is less likely to rebreathe air they’ve just breathed out. Rebreathed air contains less oxygen. Your baby has plenty of space around their mouth and nose, so their airways are more likely to stay open. At 3-4 months, many babies start showing signs that they can roll onto their tummies. When this happens for your baby, it’s time to stop wrapping. Your baby needs their arms free so they can push up to lift their head. Once your baby can roll easily onto their tummy and back again (at 4-6 months), keep putting your baby to sleep on their back, but let your baby find their own sleeping position. Safe sleep location: sharing parent’s room It’s safest for your baby to share a room with you for the first year of life or at least the first 6 months. The reflexes that keep your baby’s airways open work better when they’re close to you while they’re sleeping. Safe sleep environments away from home It’s best not to assume that other people know about safe sleep practices, even professional child carers. It’s a good idea to share safe sleep information with carers. For example, you could share this article or our illustrated guide to safe sleep. It’s also important to check the sleep environment at your baby’s child care setting or any other place your baby will be spending time, and make sure that the sleep surface, space and position are safe for your baby. Breastfeeding reduces the risk of SUDI including SIDS and fatal sleeping accidents. But regardless of whether your baby is breastfed or bottle-fed, it’s still very important to create a safe sleep environment that helps your baby breathe easily. This article was developed in collaboration with qualified experts, including maternal and child health nurses, MCH Line, Department of Health, Victoria.  Scientific Advisory Board review was provided by Dr Bronwyn Gould. American Academy of Pediatrics, Committee on Fetus & Newborn. (2003). Policy statement: Apnea, sudden infant death syndrome, and home monitoring. Pediatrics, 111, 914-917. American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome. (2011). Policy statement: SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128(5), 1030-1039. https://doi.org/10.1542/peds.2011-2284. American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome. (2005). Policy statement: The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleep environment, and new variables to consider reducing risk. Pediatrics, 116, 1245-1255. https://doi.org/10.1542/peds.2005-1499. Hauck, F.R., Thompson, J.M., Tanabe, K.O., Moon, R.Y., & Vennemann, M.M. (2011). Breastfeeding and reduced risk of sudden infant death syndrome: A meta-analysis. Pediatrics, 128(1), 103-110. https://doi.org/10.1542/peds.2010-3000. Mannen, E.M. (2019). Biomechanical analysis of inclined sleep products: Final report. College of Medicine, University of Arkansas for Medical Sciences. Mitchell, E.A., Freemantle, J., Young, J., & Byard, R.W. (2012). Scientific consensus forum to review the evidence underpinning the recommendations of the Australian SIDS and Kids Safe Sleeping Health Promotion Programme – October 2010. Journal of Paediatric Child Health, 48(8), 626-633. https://doi.org/10.1111/j.1440-1754.2011.02215.x. Moon, R.Y. (2016). SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for safe infant sleeping environment. Pediatrics, 138(5), Article e20162940. https://doi.org/10.1542/peds.2016-2940. Moon, R.Y. (2007). ‘And things that go bump in the night’: Nothing to fear? Journal of Pediatrics, 151(3), 237-238. https://doi.org/10.1016/j.jpeds.2007.05.028. Thach, B., Rutherford, G., & Harris, K. (2007). Deaths and injuries attributed to infant crib bumper pads. Journal of Pediatrics, 151(3), 271-277. https://doi.org/10.1016/j.jpeds.2007.04.028. Trachtenberg, F.L., Haas, E.A., Kinney, H.C., Stanley, C., & Krous, H.F. (2012). Risk factor changes for sudden infant death syndrome after initiation of Back-to-Sleep campaign. Pediatrics, 129(4), 630-638. https://doi.org/0.1542/peds.2011-1419. ACCC Product Safety – Best practice guide for the design of safe infant sleeping environments