Safer Sleep

Sudden infant death syndrome (SIDS)

Sudden infant death syndrome (SIDS) – sometimes known as "cot death" – is the sudden, unexpected and unexplained death of an apparently healthy baby.

In the UK, around 200 babies die suddenly and unexpectedly every year. This statistic may sound alarming, but SIDS is rare and the risk of your baby dying from it is low.

The Welsh Government have produced a leaflet with advice on safe sleeping for babies to reduce the risk of sudden infant death syndrome (cot death). Please click here

The Lullaby Trust provides expert advice on safer baby sleep and raises awareness of sudden infant death. Much of their information and videos have been included on this page, but additional information can be found on the Lullaby Trust website: Please click here

How to reduce the risk of SIDS

This safer sleep advice gives simple steps for you to follow to reduce the risk of sudden infant death syndrome (SIDS). It can give you the peace of mind to enjoy this special time.

This advice is based on strong scientific evidence and should be followed for all sleep periods, not just at night.

HOW TO SLEEP YOUR BABY MORE SAFELY

All your baby needs for a safer night’s sleep - The best sleeping position for your baby

Always put your baby on their back for every sleep, day and night, as the chance of SIDS is particularly high for babies who are sometimes placed on their front or side

Please see videos below for further information

The safest room temperature for babies

It is important to make sure that your baby’s room is a comfortable temperature – not too hot or too cold. The chance of SIDS is higher in babies who get too hot. Try to keep the room temperature between 16 -20°C.

Please click here for further information

How to co-sleep more safely

Some parents choose to share a bed (also known as co-sleeping) with their babies. It is important for you to know how to do this safely and that there are some circumstances in which bed-sharing with your baby can be very dangerous

Please click here for further information

Do & Don’t

Do

  • place your baby in the "feet to foot" position – with their feet touching the end of the cot, Moses basket, or pram
  • keep your baby's head uncovered – their blanket should be tucked in no higher than their shoulders
  • let your baby sleep in a cot or Moses basket in the same room as you for the first 6 months
  • use a mattress that's firm, flat, waterproof and in good condition
  • breastfeed your baby, if you can – see benefits of breastfeeding for more information
  • make sure you use a sling or baby-carrier safely – The Lullaby Trust has more information

Don’t

  • do not smoke during pregnancy or let anyone smoke in the same room as your baby – both before and after birth
  • do not sleep on a bed, sofa or armchair with your baby
  • do not share a bed with your baby if you or your partner smoke or take drugs, have recently drunk alcohol or if your baby was born prematurely or weighed under 2.5kg when they were born
  • do not let your baby get too hot or too cold – a room temperature of 16C to 20C, with light bedding or a lightweight baby sleeping bag, will provide a comfortable sleeping environment for your baby

 

Experts do know placing a baby to sleep on their back reduces the risk, and exposing a baby to cigarette smoke or allowing them to overheat increases the risk. It's also known there's an association between sleeping with your baby on a bed, sofa or chair (co-sleeping) and SIDS.

Follow the advice on this page to reduce the risks as much as possible.

How to reduce the risk of SIDS

To reduce the risk of SIDS:

·         place your baby on their back to sleep, in a cot in the same room as you, for the first 6 months

·         keep your baby's head uncovered – their blanket should be tucked in no higher than their shoulders

·         if wearing your baby in a sling or carrier, do not cover their head with the sling material or with a muslin

·         place your baby in the "feet to foot" position, with their feet at the end of the cot or moses basket

·         do not let your baby get too hot or cold

·         do not share a bed with your baby

·         never sleep with your baby on a sofa or armchair

·         do not smoke during pregnancy or breastfeeding, and do not let anyone smoke in the same room as your baby

Place your baby on their back to sleep

·         Place your baby on their back to sleep from the very beginning for both day and night sleeps. This will reduce the risk of cot death.

·         Do not put your baby to sleep on their side or tummy.

·         Once your baby is old enough to roll over, there's no need to worry if they turn onto their tummy or side while sleeping

Do not let your baby's head become covered

Babies whose heads are covered with bedding are at an increased risk of SIDS.

To prevent your baby wriggling down under the covers, place them in the "feet to foot" position. This means their feet are at the end of the crib, cot or moses basket.

To put your baby in the feet to foot position:

·         tuck the covers in securely under your baby's arms so they cannot slip over their head – use 1 or more layers of lightweight blankets

·         use a baby mattress that's firm, flat, well-fitting, clean and waterproof on the outside – cover the mattress with a single sheet

·         do not use duvets, quilts, baby nests, wedges, bedding rolls or pillows

If you use a sling or carrier, make sure you use it safely.

 

The Lullaby Trust has more information and advice about swaddling your baby and using slings. Please click here

Do not let your baby get too hot or too cold

Overheating can increase the risk of SIDS. Babies can overheat because of too much bedding or clothing, or because the room is too hot.

·         When you check your baby, make sure they're not too hot. If your baby is sweating or their tummy feels hot to the touch, take off some of the bedding. Do not worry if their hands or feet feel cool – this is normal.

·         It's easier to adjust for the temperature by using layers of lightweight blankets. Remember, a folded blanket counts as 2 blankets. Lightweight, well-fitting baby sleeping bags are a good choice, too.

·         Babies do not need hot rooms. All-night heating is rarely necessary. Keep the room at a temperature that's comfortable – about 16 to 20C is ideal.

·         If it's very warm, your baby may not need any bedclothes other than a sheet.

·         Even in winter, most babies who are unwell or feverish do not need extra clothes.

·         Babies should never sleep with a hot water bottle or electric blanket, next to a radiator, heater or fire, or in direct sunshine.

·         Babies lose excess heat through their heads, so make sure their heads cannot be covered by bedclothes, slings or carriers while they're asleep.

·         Remove hats and extra clothing as soon as you come indoors or enter a warm car, bus or train, even if it means waking your baby.

Do not share a bed with your baby

The safest place for your baby to sleep for the first 6 months is in a cot in the same room as you.

It's especially important not to share a bed with your baby if you or your partner:

·         smoke (no matter where or when you smoke and even if you never smoke in bed)

·         have recently drunk alcohol

·         have taken medicine or drugs that make you sleep more heavily

The risks of co-sleeping are also increased if your baby:

·         was premature (born before 37 weeks), or

·         had a low birthweight (less than 2.5kg or 5.5lb)

As well as a higher risk of SIDS, there's also a risk you might roll over in your sleep and suffocate your baby.

 

Your baby could also get caught between the wall and the bed, or roll out of an adult bed and be injured.

Never sleep with a baby on a sofa or armchair

It's lovely to have your baby with you for a cuddle or a feed, but sleeping with your baby on a sofa or armchair is linked to a higher risk of SIDS.

It's safest to put your baby back in their cot before you go to sleep.

Do not let anyone smoke near your baby

Babies exposed to cigarette smoke before and after birth are at an increased risk of SIDS. Do not let anyone smoke in the house, including visitors.

Ask anyone who needs to smoke to go outside. Do not take your baby into smoky places.

If you smoke, sharing a bed with your baby increases the risk of cot death.

Get help and support if you want to quit smoking. Please click here

Feeding, dummies and SIDS

Breastfeeding your baby reduces the risk of SIDS.

It's possible using a dummy at the start of a sleep also reduces the risk of SIDS. But the evidence is not strong and not all experts agree that dummies should be promoted.

If you do use a dummy, do not start until breastfeeding is well established. This is usually when your baby is around 1 month old.

Stop giving them the dummy when they're between 6 and 12 months old.

Get medical help quickly if your baby is unwell

Babies often have minor illnesses that you do not need to worry about.

Give your baby plenty of fluids to drink and do not let them get too hot. If your baby sleeps a lot, wake them up regularly for a drink.

It can be difficult to judge whether an illness is more serious and needs urgent medical attention.

See spotting the signs of serious illness for guidance on when to get help. ​​Please click here

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The safest place for your baby to sleep is a separate cot or Moses basket in the same room as you for the first 6 months, even during the day.

Place your baby to sleep in a separate cot or Moses basket in the same room as you for the first 6 months, even during the day.

A large study of evidence from across Europe found that the risk of sudden infant death was significantly reduced when the infant slept in the same room, but not the same bed, as the parents.

The safest place for your baby to sleep for the first 6 months is in a separate cot or Moses basket in the same room as you

The chance of SIDS is lower when babies sleep in a separate cot in the same room as their parents

Never sleep on a sofa or in an armchair with your baby

Sleeping on a sofa or in an armchair with your baby is one of the most high-risk situations for them.

Studies have found that sharing a sofa or armchair with a baby whilst you both sleep is associated with an extremely high risk of SIDS. One study found that approximately one-sixth of infants in England and Wales who died of SIDS were found sleeping with an adult on a sofa.

Make sure that you do not accidentally fall asleep with your baby on a sofa. If you think you might fall asleep, put the baby down in a safe place to sleep.

If you are breastfeeding, have your partner stay up with you, breastfeed in a different position where you are confident you might not fall asleep, or feed the baby somewhere else.

Click here to download Bed Sharing Fact sheet

Click here to download Back to Sleep Fact sheet

It is essential for safety that babies travel in a car seat. However, it is recommended that you avoid travelling in cars with pre-term and young babies for long distances. Research into the link between car seats and SIDS found young babies may be at risk of breathing difficulties if they travel while sitting in an upright position for too long.

For more information on car seats and SIDS please click here

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If you choose to swaddle your baby or use a sling it is very important to follow guidelines to reduce the risk of SIDS.

Swaddling your baby

Swaddling is a common practice used to help settle young babies and promote sleep. We recognise that in some parts of the world this is also referred to as wrapping, but in the UK is referred to as swaddling. Parents/carers who wish to swaddle should be informed how to do this correctly to reduce the chance of SIDS:

·      Never put a swaddled baby to sleep on their front or side.

·      Stop swaddling (with arms wrapped inside the material) when a baby shows signs of rolling as they could roll onto their tummy and won’t be able to roll back. Use materials such as a thin muslin or thin cotton sheet – DO NOT USE blankets or place any additional bedding over a swaddled baby, this could cause them to overheat

·      Ensure baby is not overdressed under the swaddle, has their head uncovered and does not have an infection or fever

·      Check baby’s temperature to ensure they do not get too hot – check the back of their neck. If baby’s skin is hot or sweaty, remove one or more layers of bedclothes.

·      Baby should be swaddled securely to reduce the risk of face-covering by loose material.

·      Swaddles should not be applied very tightly around the hips as this is strongly associated with developmental dysplasia of the hip. However, the swaddle should also be secure enough not to come apart, as loose soft bedding can increase the chance of SIDS if pulled over a baby’s head, causing a baby to over-heat or obstruct their breathing.

·      There are various swaddle products on the market for example swaddle blankets, swaddle sacks and swaddle bags. We can’t comment on their safety but parents/carers need to ensure the products meets necessary safety standards. They should be well fitted.

·      Parent/Carers should ensure they follow the product guidance. Some swaddle manufacturers recommend their product is used when a baby is a certain weight, rather than age so it is best to check on the swaddle product they choose to use.

·      We do not advise on a specific tog rating for swaddle products, we advise parents/carers to use a lower tog rating/lightweight to reduce the chance of baby overheating.

Using slings and baby-carriers

Slings and baby-carriers are useful for holding a baby hands-free, however they are not always used safely. Although there is no reliable evidence that slings are directly associated with SIDS, there have been a number of deaths worldwide where infants have suffered a fatal accident from the use of a sling. These accidents are particularly due to suffocation, and particularly in young infants.

The risk appears to be greatest when a baby’s airway is obstructed either by their chin resting on their chest or their mouth and nose being covered by a parent’s skin or clothing.

The safest baby carrier to use will keep the infant firmly in an upright position where a parent can always see their baby’s face, and ensure their airways are free. Complete guidance is available by visiting The Royal Society for the Prevention of Accidents.

When wearing a sling or baby carrier, keep in mind the TICKS guidelines:

·      Tight

·      In view at all times

·      Close enough to kiss

·      Keep chin off the chest

·      Supported back

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Improving the physical and emotional health and wellbeing of expectant mothers, infants, children and young people throughout Aneurin Bevan University Health Board Area.

(N.B: The Family and Therapies team at ABUHB is NOT responsible for the content on the webpage links that we refer to in our resource sections and linked information to external sites. All information was accurate and appropriate at the time the webpage was created.)

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