Safe Sleep

A safe sleep environment reduces the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death. Public Health Nurses at DCGHD are trained in safe sleep practices and are available to talk about the best ways to keep your infant safe while sleeping.
Safe Sleep Resources
There are many myths surrounding babies sleeping on their backs; however, science has proven that back is best for baby. Some commonly asked questions regarding these myths are:
Isn’t it easier for my baby to choke on her back?
No! Babies who sleep on their backs are less likely to suffocate or choke. See why babies are less likely to choke while on their backs.
My baby isn’t comfortable and doesn’t sleep as well on her back.
Babies do sleep deeper on their stomachs, but it’s safer for baby to wake through the night. When babies sleep deeper, they don’t wake up as often. When a baby is in a deep sleep and needs to take a deep breath or wake up her airway may be blocked by the mattress or loose bedding or covered in some other way, so she will be at more risk for suffocation. Back sleeping is safest for your baby!
If I put my baby on her back, she’ll get a flat head.
For the most part, flat spots on a baby’s head go away a few months after the baby learns to sit up. There are other ways to reduce the chance that flat spots will develop on your baby’s head, such as providing “tummy time” when your baby is awake and someone is watching. “Tummy time” not only helps prevent flat spots, but it also helps a baby’s head, neck, and shoulder muscles get stronger.
How long should my baby sleep on her back?
Once your baby can roll from back to belly on their own, it’s OK to leave her in the position she finds most comfortable. Remember to put your baby to sleep on her back for the first year.
Remember these ways to keep baby safest:
- Don’t cover baby’s head with a blanket or over bundle in clothing and blankets.
- Avoid letting the baby get too hot. The baby could be too hot if you notice sweating, damp hair, flushed cheeks, heat rash, and rapid breathing.
- Dress the baby lightly for sleep. Set the room temperature between 68 to 72 degrees.
An empty crib is best. Many parents believe baby won’t be warm or comfortable without bumper pads, blankets, pillows, and stuffed animals, but these items can be deadly. Babies can suffocate on or be strangled by any extra item in the crib.
This is how to keep baby safe:
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Won’t my baby hurt herself between the slats of the crib if there are no bumpers?
There have been no cases of babies who have seriously hurt themselves by getting stuck between the crib railings. Babies aren’t capable of exerting enough force to break an arm or leg between the crib slats. Consider the option of a baby waking up because her hand or foot may be caught. She will cry and wake you, but she will be alive and breathing.
With all the information being thrown at new moms, it’s tough to sort out fact from fiction. The American Academy of Pediatrics (AAP) recommendations are based on science and extensive research. The full text of the AAP recommendations is available here. Follow these guidelines to keep your baby safe:
- Always place your baby on his or her back for every sleep time.
- Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
- The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
- Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.
- Don’t use wedges and sleep positioners.
- Pregnant women should receive regular prenatal care.
- Don’t smoke during pregnancy or after birth.
- Breastfeeding is recommended.
- Offer a pacifier at nap time and bedtime.
- Avoid covering the infant’s head or overheating.
- Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
- Infants should receive all recommended vaccinations.
- Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).
Ohio's Infant Safe Sleep Law
Per ORC 3701.66 and 3701.67 as enacted by Ohio Am. Sub. S.B. 276 of the 130th General Assembly, the Ohio Department of Health (ODH) was required to develop:
- Educational materials on safe sleeping practices for infants (links to resources are below);
- A model screening tool for hospitals to identify expectant and new parents without a safe sleep environment for their baby; and
- Model policies for licensed child care centers, maternity units, pediatric hospitals, and parent/caregiver teaching points.
Effective May 18, 2015, the law also establishes the Safe Sleep Education Program and specifies the following entities distribute infant safe sleep education materials:
- Child birth educators and the staff of obstetricians’ offices, to an expectant parent who uses their services;
- Staff of pediatric physicians’ offices, to an infant’s parent, guardian, or other person responsible for the infant, any of whom uses their services;
- Staff of freestanding birthing centers and certain hospitals, to the infant’s parent, guardian, or other person responsible for the infant, before the infant is discharged from the facility;
- Staff of the existing Help Me Grow program, to an infant’s parent, guardian, or other person responsible for the infant during home-visiting services;
- Each child care facility operating in Ohio, to each of its employees;
- Public children services agency, when the agency has initial contact with an infant’s parent, guardian, or other person responsible for the infant.
The law further specifies that facilities and locations that must participate in the Safe Sleep Education Program and regularly have infants sleeping at them adopt an internal infant safe sleep policy.
Reporting
ORC 3701.67 establishes an infant safe sleep screening procedure for hospitals and birthing centers. Facilities are required to screen new parents and caregivers prior to an infant’s’ discharge home to determine if the infant has a safe sleep environment at his or her residence. If the infant is determined not to have a safe sleep environment, the hospital may do any of the four following activities:
- Obtain a safe crib with its own resources;
- Collaborate with or obtain assistance from persons or government entities that are able to procure a safe crib or provide money to purchase a safe crib;
- Refer the parent, guardian, or other person to a person or government entity described above to obtain a safe crib free of charge from that source;
- If funds are available for the Cribs for Kids Program or a successor program, refer the parent, guardian, or other person to a program site designated by ODH at which a safe crib may be obtained at no charge. (The Cribs for Kids Program, administered by ODH, distributes cribs and infant safe sleep education materials through local and regional health departments to families who meet income eligibility requirements for the Women, Infants, and Children (WIC) program.)
Facilities may also refer to non-ODH supported Cribs for Kids Programs by finding their local partner at https://cribsforkids.org/our-partners/. Facilities are required to report infant safe sleep data to ODH. Facilities with access to the State’s vital statistics records system (IPHIS), must report the data in IPHIS and facilities without IPHIS access should report it using the annual aggregate reporting form (see below for details).
Please contact SafeSleep@odh.ohio.gov with any questions.
Data Collection
In support of ORC 3701.67, a new “Crib” tab was launched on January 1, 2017 in the State’s vital records system (IPHIS) to capture safe sleep screening data. The Ohio Department of Health has provided training for facilities on entering data into the new tab and is providing a recorded presentation, reporting manual, and FAQ document for additional guidance.
Children’s Hospitals
Children’s Hospitals that do not have access to IPHIS are required to report annual aggregate safe sleep screening data by the first Monday in February of each year. The Annual Aggregate Safe Sleep Reporting Form should be submitted by emailing the form to safesleep@odh.ohio.gov.
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