Safe Sleep Policy for Babies (3 months to 1 year).

Context / New Zealand has high rates of sudden infant death compared to other developed countries. At rates of 1.1 deaths per 1000 live births, and more than twice these rates for Maori, about sixty babies die each year in this way1 and 20% of these are older than 4 months.
Currently, most sudden infant deaths are considered preventable, whatever term is used (cot death, SIDS, SUDI, SUID, unascertained, sleep accidents …). Most are expectedbecause known risk factors are involved, and many are also explainedwith accidental suffocation on the rise as a clear cause of death.
Purpose / The purpose of this policy is to provide clear direction to staff and parents on safe infant sleep in this ECE service
Policy statements / Queenstown Preschool & Nursery is committed to all babies having a safe sleep in a safe place at every sleep within this ECE setting. To this end:
QPN will provide sleep spaces/furniture that meet safety standards.
QPN will establish systems to inform families about this policy, monitor safe sleep practices, and document any and all exceptions.
QPN will provide education for all current and future staff on the safe sleep recommendations of the NZ Ministry of Health.
QPN will clarify roles, responsibilities, expectations and standards for every member of staff in implementing this policy.
QPN will implement the best practice guidelines attached to this policy.
Scope / This policy applies directly to all staff, and all environments of this ECE where babies under one year may sleep.
Principles / This policy is underpinned by the following principles: a baby’s right to protection, the right of ECE staff to know about sleep-related risks for babies and how to avoid them, and accountability of ECE staff for infant safety.
Requirements / All staff to promote; in every place and every sleep, babies placed flat, level and on the backs, cots bare of all non-essential items, faces clear.
Parents/Caregivers provided with information about infant sleep policy and arrangements before the infant is enrolled.
Role expectations of staff made clear in employment agreements and addressed in performance appraisals.
Staff education to include safe sleep evidence, best practice guidelines, briefing of parents and documentation systems.
Documentation of all and any exceptions to recommended practices that is signed by parents.

Policy Implemented October 2014.

Reviewed November 2106

Next Review: October 2018

SAFE SLEEP POLICY

Best practice guidelines

Support for early childhood education (ECE) staff in implementing the Safe Sleep Policy.

Model best practice

  • place babies flat and on their backs
  • place babies in a cot or sleep space that meets safety standards
  • keep the sleep space bare of non-essential items (pillows, toys, ‘comforters’, positioning aids, soft items of any kind, bibs, necklaces etc)
  • either tuck bedding firmly with the baby near the foot end of the bed, or use a baby sleeping bag and no covers
  • ensure that an ECE staff member is nearby.

Position babies always and only on the back

The back position is essential to safety. It facilitates breathing and enables a clear airway during a vulnerable stage of development.

Associated with placing babies on the back is the need for them to lie flat and on a level surface with no propping of baby, tilting of the bed, pillows under the head or any product or practice that may cause babies to slump and assume a ‘chin-to-chest’ position of the neck.

As babies develop the ability to change position, placed on the back is still best practice, but other considerations will be needed to ensure a clear airway throughout the sleep episode.

A doctor’s certificate is needed for any and all exceptions to back positioning of babies.

Do a safety check of the sleep environment and remove all potential hazards

Babies under one year are more vulnerable to accidental suffocation. Babies who are unable to roll have some protection from being placed on the back. However, as babies become more mobile and move about in the sleep, they can, by their own actions get into dangerous situations such as becoming tangled in loose bedding.

A hazard is anything that has the potentialfora covered face, pinched nose, chin-to chest position of the neck or pressure on or against a baby’s chest. These lead to accidental suffocation. Best practice is a sleep space bare of all non-essential items.

Hazards for babies can be in the form of pillows, loose covers, gaps between mattress and side of the bed, soft items in the bed, toys, ‘comforters’, bibs, necklaces, curtain cords near the cot, posts on the cot or gaps of more than 6 cm between rails of the cot.

Consider the age of the baby in safety checks

Younger babies may be swaddled. Swaddling, if practiced, must be stopped when babies begin to roll. Where babies are swaddled for sleep, the material must be light weight and always firm around the shoulders, loose around the hips and clear of baby’s face, with thebaby on the back. Swaddling becomes dangerous if babies find themselves on the side or front, if the swaddling material comes loose and covers the face, or if the swaddling is too tight across the hips, increasing the chances of hip dysplasia (displacement).

Older babies can roam about the sleep space so vigilance is needed in safety checks to be alert to risks of becoming tangled in bedding,strangled by dangling cords, entrapped in tight spaces, wedged into gaps.

Choose safe clothing and bedding

Babies’ sleep wear needs to be light weight, 1-3 layers, with no cords or ribbons that could constrict breathing, and no head coverings, hoods or hats that can contribute to over-heating. Bibs and necklaces must be removed before sleeping.

Where traditional bedding is used, it must be light weight such that it drapes a baby’s body, be firmly tucked under the weight of the baby, and 1-3 layers. Avoid over-bundling. Placing babies nearer to the foot end of the cot reduces the risk of getting under covers should the baby creep downward.These things become increasingly important for older babies.

Where infant sleep bags are used, these replace traditional sheets and blankets. Adjust to cooler or warmer conditions by putting more or less clothing on the baby inside the bag. Do not place covers over babies in sleeping bags as this removes the safety features of the bag for older babies.

Use safe beds

Whatever device is used as a bed for babies it must comply with safety standards.

Manage head-shape with varying the head position

Head shape needs to be managed by varying the resting spot of the head each sleep when babies are very young, and with periods of tummy time and upright time when babies are awake. Avoiding the back when sleeping is never an option for managing head shape.

Support babies to settle for sleep

Babies need help from adults to regulate themselves and this includes for falling to sleep. Supportive conditions that help babies settle for sleep include firm wrapping/tucking across the shoulders (feeling held), proximity to staff (feeling close) and repetitive soothing actions (feeling rhythm).

Document any and all exceptions to these guidelines

Document any and all exceptions to the practices in these guidelines, and seek the signature of parents. Require a doctor’s certificate for any variation to back sleeping.