Protect babies in your care. Use the ABCs of Safe Sleep for every baby and every sleep.

Download a printable "Sleep Safe Environments" handout here.

The Five Commitments

Five Commitments
Programs that are awarded the designation have made the following commitments:
  1. Attend the Sleep Safe SC training provided by SCPITC. All program staff who may care for infants must attend the training.
  2. Create a Safe Sleep policy that states the importance of using Safe Sleep practices, lists the ABCs of Safe Sleep, lists items that are prohibited in cribs, and includes a commitment to use the ABCs of Safe Sleep for every baby and every sleep. Share this commitment with all staff (include in staff handbook, in new staff orientation, etc.).
  3. Inform families about the importance of Safe Sleep with all enrolled and prospective families through various modes of communication (e.g., share information when parents first tour the program, include information in newsletter, display Sleep Safe SC posters in the infant rooms, provide prospective parents with Safe Sleep information, etc.). The Safe Sleep Policy must be included in the Family Handbook or other enrollment packet.
  4. Remove all restrictive equipment in which babies might sleep from the infant rooms (e.g., swings, bouncy seats, etc.).
  5. Continue learning and sharing updates with staff and families on new research and best practices for Safe Sleep. Share your plan for annual safe sleep training for all staff and how you will stay up to date on Safe Sleep best practices, including resources you will use.

Designated Programs

Sleep Safe SC Designated programs recieve the following:
  • Decal for the main entrance
  • Sign to display in front of the building
  • Free HALO® Sleep Sacks with the Sleep Safe SC logo to be used for infants in the program while they sleep in child care
  • Sleep Baby, Safe and Snug board books for the infant room(s)
  • Handouts and other job aids to help program staff communicate with families and new hires about safe sleep practices
  • Digital badge on the SC Child Care website
  • Prominent listing on the SCPITC website
  • Social media features by DSS and SCPITC
  • Inclusion in SCPITC and DSS digital newsletters

Communicating Sleep Safe Practices with Families

The families of babies in your care look to you for guidance on keeping their babies safe and healthy in child care. If family members have questions about safe sleep practices, you can share the information below with them. Family members can also share this information with others who also provide care for their infant. Babies love consistency!

Before the baby’s first day in care, ask the family questions about their baby and routines:
Does your baby have any special sleeping routines?
When does your baby usually sleep?
Does your baby like to be rocked?
How long does your baby usually sleep at one time?Is your baby always put on their back to sleep?

Tell the family that your program uses the ABCs of Safe Sleep, meaning all babies are laid down Alone, on their Back, in a Crib. Refer to the document called “Sleep Item Guidance for Child Care” to see the kinds of items that are safe for babies to wear or have while they sleep.

Families of the infants in your child care program may have concerns or misconceptions about safe sleep practices. You may also hear ideas or opinions around this topic that you haven’t thought of before. The following information may help you to address those concerns.

Parent/Guardian Request

How to Address the Concern

“Please put my baby to sleep on his/her stomach because that’s how we put them to sleep at home.”
Infants can only be placed to sleep on their backs in child care, even if they can roll over from front to back or back to front by themselves. If they roll from their back to their stomach by themselves, you do not need to put them on their backs again. Babies are at risk of Sudden Infant Death Syndrome (SIDS) until they are 12 months old.
“My son sleeps on his side at home so please place him on his side to sleep here."
If a baby is a stomach or side sleeper, their risk of SIDS is much higher. Babies who are placed to sleep on their sides are more likely to fall onto their stomach, the position associated with highest risk for SIDS. If an infant is used to sleeping on their tummy or side at home, back sleeping in child care does not increase the risk of SIDS. However, babies who are used to sleeping on their backs and are then placed to sleep on their tummies in child care are 18 times more likely to die from SIDS.
“My daughter has a medical condition, so she needs to sleep in a swing.”
Infants in child care may only be placed to sleep on their back in a CPSC-certified crib. Sleeping in a piece of equipment like a swing, bouncy seat, or other item that raises the baby’s head above his/her feet increases the risk of positional asphyxiation. Positioners and wedges are not allowed in child care. If your child requires a prescribed medical device while sleeping, contact:Child Care Ready for All (CRAwl)
“My baby startles himself awake when he sleeps on his back so please put him to sleep on his stomach.”
The startle response is a sudden movement that is sometimes seen as scary for the baby. Sometimes the baby gasps. This protects the baby, letting them get a breath of air or to wake up slightly from too deep of a sleep.
“I don’t want my baby to get a flat head/bald spot, so she needs to sleep on her stomach.”
Some babies may develop flat spots and/or bald spots on the backs of their heads from spending long periods of time lying on their backs or having their heads pressed against a surface like a car seat or carrier too often or for too long. These flat spots/bald spots are not harmful to the baby and usually go away as the baby becomes more active and mobile.

While the baby is awake and supervised, regular and frequent tummy time on the floor can help prevent the flat spots/bald spots from developing. Limiting time in swings, bouncy seats, car seats, and other restrictive pieces of equipment can also help prevent flat spots/bald spots.

What are the risks of stomach sleeping?

Sleeping on the stomach increases the risk of overheating and rebreathing expired air (air that has already been breathed out), which can lead to: too much carbon dioxide in baby’s body (called hypercapnia) OR too little oxygen in the baby’s body (called hypoxia).

Temporary changes in heart and lung function and control, could affect the amount of oxygen getting to the brain.

Back sleeping is not associated with these risks.

What about reflux?

When baby is sleeping on their back, the opening of the tube to the lungs (also called the trachea or windpipe) sits on top of the opening of the tube to the stomach (called the esophagus). Fluids that come from the stomach have to work against gravity to get into the windpipe and cause choking.
When baby is sleeping on their stomach, the opening of the tube to the stomach is on top of the opening of the tube to the lungs. Because of gravity, fluids that come from the stomach will collect at the opening of the tube to the lungs, making choking much more likely.
Download a printable "Communicating Sleep Safe Practices with Families" here.Download a printable "Sleep Item Guide" here.

Continue Learning

FREE virtual health and safety course that includes Safe Sleep can be found HERE.
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