Know the ABCs of safer sleeping for babies

Prevent sleep-related infant deaths and remember the ABCs: babies sleep alone, on their back, in a safe crib, in a smoke-free home

Submitted by the Erie County Department of Health

Each year, an estimated 3,400 families in the United States confront the unimaginable: the sleep-related death of an infant. Ten families in Erie County faced that devastating loss in 2021 and 2022, with additional deaths pending confirmation; unsafe sleeping environments contributed to each of these deaths.

Infants depend on their caregivers to provide a safe environment to play, grow and sleep. Infants do not have the neck strength to adjust their position when they cannot breathe. Babies also lack the coordination to move blankets or pillows that may block their nose and mouth.

“Parents and caregivers make a dangerous choice when they bring an infant next to them on a bed or couch to 'co-sleep,' ” Commissioner of Health Dr. Gale Burstein said. “There is a very real risk of suffocation with co-sleeping and when caregivers place infants on surfaces that are not meant for sleeping children.”

With colder weather approaching, the Erie County Department of Health is making residents aware how to protect infants with a peaceful, safe sleep setting.

“These ‘ABCs’ are more than simple tips or good advice,” Burstein explained. “These are the strongest possible recommendations from pediatricians and the public health community. Parents should insist that anyone spending time with their infant make sure that the infant sleeps alone, on their back, in a safe crib.”

Babies Sleep Alone

√ The infant should be alone in a crib to sleep. That means no other people or children; no pillows, blankets or toys; and no bumper pads.

√ Share your room, not your bed. The American Academy of Pediatrics (AAP) recommends room-sharing for a child’s first six months; it can reduce the risk of SIDS by up to 50%. Room-sharing makes feeding and changing your baby easier.

√ Use a wearable blanket or other type sleeper instead of blankets to keep your baby warm and safe.

Back to Sleep

√ Always place infants on their backs to sleep (“back to sleep”). The child will breathe easier, and this may help prevent sudden unexpected infant death.

√ Caregivers or grandparents may not be familiar with this “back to sleep” practice. They may prefer to place infants on their side or stomach. If you are a parent, this is your child: That means your rules are the only rules. Insist that anyone caring for your baby puts them on their back to sleep.

√ Some babies can fall asleep anywhere – a car seat, stroller, infant carrier or swing. When this happens, move the baby to a firm sleep surface – on his or her back – as soon as it is practical.

Sleep in a Safe Crib

√ Use a crib that meets current safety standards. The mattress should be firm and fit in the crib with no gaps. Cover the mattress with only a tight-fitting crib sheet. Portable cribs and play yard style cribs are also good choices.

√ Never place your baby to sleep on top of any soft surface. This includes adult beds, sofas, chairs, waterbeds, pillows, cushions, comforters and sheepskins.

√ Check to see that the bedding for your baby is safe. The AAP recommends a firm sleep surface in a child-safe crib, free of soft objects or loose bedding. Infants should not be put to sleep on waterbeds, sofas, chairs or other unstable surfaces.

√ No bumper pads of any kind should be used. There is no evidence that bumper pads prevent injuries, and there is a potential risk of strangulation or entrapment from bumper pads.

Keep Your Home Smoke-Free

√ Quit smoking to reduce your baby’s risk of sudden unexpected infant death (SUID)

√ No one should smoke in your home or around your baby.

Breastfeeding and Other Considerations

√ According to the AAP, mothers who choose to breastfeed their infant in bed should exercise caution that they do not fall asleep. This puts the infant at risk.

√ Take particular care when overtired, which could cause a caregiver to fall asleep while holding or breastfeeding the infant. The baby is then at risk of the caregiver rolling over on them or slipping down into the chair or bed frame.

√ Do not sleep with your baby, especially if you have been using alcohol or drugs (including legal, illegal, prescription, and over-the-counter drugs). Alcohol and drug use can cause a deeper sleep and decreased awareness of the infant and the surroundings. This increases the risk of entrapment and suffocation.

√ Co-sleeping – sharing a sleeping area with one or more adults or siblings – greatly increases the risk of the infant becoming entrapped in bedding or smothered during normal sleep movements. This is especially true when the person sharing the bed is obese.

For more:

√ New York State Department of Health, Safe Sleep for Babies: https://www.health.ny.gov/diseases/conditions/safesleep/

√ American Academy of Pediatrics, Parents’ Guide to Safe Sleep: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

√ U.S. Consumer Product Safety Commission, Safe Sleep: https://www.cpsc.gov/SafeSleep