Teaching Safe Sleeping Practices

Childbirth educators cover essential topics like pregnancy, labor, childbirth, and postpartum basics, including infant feeding and recovery. However, one topic that may not get as much attention is safe infant sleep—and it’s crucial. Safe sleep practices impact not only infant health but also the well-being and peace of mind of the entire postpartum family.

Let’s take a close look at this topic—why it’s important to teach, what to cover, and how best to address the topic.

The Importance of Teaching Parents About Safe Sleep

According to the Academy of American Pediatrics (AAP), each year roughly 3,500 infants die suddenly while sleeping in the U.S. These deaths are largely due to three main causes:

• Sudden infant death syndrome (SIDS).
• Deaths from accidental suffocation.
• Death from strangulation.

These are sobering statistics, but the good news is that many of these deaths are preventable. That’s why organizations like the AAP and CDC promote educating new parents on how to put their babies to sleep safely. Knowing and following the rules for safe infant sleep saves lives and helps keep babies safe.

But while the basic rules for safe sleep sound simple, they are actually a bit more detailed and nuanced than they seem on the surface. Not only that, but parents tend to have lots of questions about how to implement them, especially if they are breastfeeding their babies at night and may want to do some bedsharing.

What to Cover in Your Classes

In your childbirth education classes, it’s vital to cover the basic rules about safe sleep with your clients. These include such AAP recommendations as:

• Putting baby to sleep on their backs for both naps and nighttime sleep.
• Putting baby to sleep on a firm, flat surface (no wedges, inclines, or devices that prop baby up).
• Putting baby to sleep on a clear surface, with only a well fitted sheet; this means NO pillows, blankets, toys, crib bumpers, etc.
• Making sure that baby’s sleep surface meets the standards of The Consumer Product Safety Commission (CPSC) and that the sleep product hasn’t been recently recalled.
• Transferring baby to a crib as soon as possible if they fall asleep in a car seat, stroller, swing, or other type of infant carrier. Sleeping in an upright position can cause their head to fall forward, which may restrict their airway and increase the risk of suffocation.
• Never falling asleep while holding baby on a soft surface, such as a couch, armchair or other soft cushion; parents and caregivers who do so risk having the baby getting stuck, strangled, or suffocated.
• Breastfeeding, if possible, to protect against SIDS.
• Not smoking or allowing smoke near baby, especially in the room where they are sleeping.
• Dressing baby in light, breathable layers, taking care not to overheat them.

Answer Frequently Asked Questions

These “sleep rules” can get a little tricky when you are talking about various scenarios that new parents face that may bend the rules. It’s important to have open and honest conversations about this. For example:

1. Parents may wonder what they should do if their baby rolls onto their stomach during sleep.
2. Parents are often surprised or voice objections to the idea of placing no pillow, bumpers or blankets in a crib.
3. Parents expect to breastfeed at night, and may want to do some bed sharing with their infant so everyone gets more sleep.

It’s helpful to know how to address these common concerns, and to have some answers at the ready to the questions that invariably come up. Here are some responses to the three questions above:

1. According to the AAP, if a baby is old enough to roll onto their belly during sleep, then it’s okay to let this happen. However, parents and caregivers should continue to put babies on their back, and ensure there aren’t pillows, blankets, or other objects in the sleep space.
2. While it is fun to arrange a baby’s sleep space with soft pillows, crib bumpers, and teddy bears, these all pose suffocation and strangulation hazards. That doesn’t mean that parents can’t decorate their child’s space! Just keep these items away from where baby will be sleeping.
3. The AAP wholeheartedly recommends breastfeeding, and they also recommend having babies sleep in the same room with their mothers to make breastfeeding easier and to monitor them during sleep. However, they don’t recommend that mothers and babies sleep on the same surface together.

The Academy of Breastfeeding Medicine (ABM) has a more nuanced approach. They understand that breastfeeding parents may end up sharing a sleep surface with their baby, and so they offer tips for making this as safe as possible, including:

• Remove extra pillows or blankets from the parents' bed.
• Ensuring the bed is firm and flat.
• Placing the mattress on the floor, or ensuring there are no spaces where baby could be trapped between the bed and wall.
• Placing baby to sleep on their back.
• Never falling asleep while holding baby on a soft surface, such as a sofa, chair, or recliner.

You might consider sharing the ABM guidelines with breastfeeding parents, which can be found here.

Other questions might come up along the way, and eventually you will know how to respond. But it’s okay if you don’t know the answer right away! You can tell your clients that you will do some research and get back to them.

Ideas for Teaching Safe Sleep

When teaching safe sleep to clients, you can employ many of the same tactics you do when teaching any other topic, such as using visual aids, videos, doing brainstorming sessions, partner work, and having Q&A sessions. Plumtree Baby's parent books Settling In with Baby and Newborn Care and corresponding PowerPoints thoroughly cover safe sleep, including visuals. In addition, the following handouts, videos, and interactive tools might be helpful as you teach this topic:

• Academy of Breastfeeding Medicine Handouts
• Safe to Sleep Shareable Resources from the National Institutes of Health
• Safe to Sleep Campaign Resources from the WIC Works Resource System

When talking about safe sleep with parents, it can be good to start with open-ended questions, so that parents are able to honestly bring up any concerns that they may have. It’s also important to not respond to questions with judgment, as many parents simply aren’t yet informed about some of the safe sleep rules.

Some open-ended questions to consider posing to parents include:

• What concerns do you have about your baby’s sleep?
• What have you heard about safe sleep practices for babies?
• Where do you expect your baby to sleep? What are your preferences?

The Bottom Line

Remember that when it comes to teaching safe sleep, you are there as a resource and guide, but not there to offer specific recommendations or advice, especially to parents who are unsure about how to follow the safe sleep best practices. If there’s a parent who needs more information, or recommendations specific to their circumstances or concerns, you should always refer them to their OB-GYN, midwife, child’s pediatrician, or other healthcare provider.

Wendy Wisner, Freelance Writer and Lactation Consultant (IBCLC)

Sources

The Academy of American Pediatrics. How to Keep Your Sleeping Baby Safe: AAP Policy Explained.

Academy of Breastfeeding Medicine. Bedsharing and Breastfeeding.

Centers for Disease Control and Prevention. Helping Babies Sleep Safely.

National Institutes of Health. Safe Sleep Environment for Baby.

Safe Sleep North Carolina. Talking to Families about Safe Sleep.

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