Safe sleep for babies and toddlers

In this fact sheet Remember, the information on Sleeping position this fact sheet should not be used or relied on as an alternative to Wrapping babies professional care. If you have a Buying a cot particular problem, see your health care professional. • may place things in their mouths or Portable cots around their necks and choke. Where to put a cot There are steps that can be taken to make sleep environments safer for babies. Cot and restraints There are many different kinds of cots U-shaped pillows and bedding on the market for babies. Play pillows Babies don't care about how smart their beds look, but what is important is that they are safe. Sofa (lounge chair) Rocking Sleeping position

Bassinettes Babies should always sleep on Prams and strollers their backs. Baby • Many babies can roll from their sides onto their tummies, so they should Bean bags not be put to sleep on their sides. Changing from a cot to a bed Put babies into the cot with their feet Bunk beds at the end of the cot. Toys and pets • Put your baby's feet at the bottom of the cot, then cover him so that he Sleeping with others cannot wriggle under the bedding. Smoking • Make up the cot so that the bedclothes just come up to the baby's Dummies shoulders and the baby's head cannot References go down under the bedclothes. • Click here to view a diagram of a safe cot. While babies are asleep they may get • be strangled on cords and ribbons. into dangerous situations. They may: The reasons for this are that they: Wrapping babies • suffocate under bedding • are not able to control their own • choke on toys or other objects sleeping situations Some babies sleep better when they are wrapped. • be caught between the cot side • cannot understand danger and • may not be able to move out of a dangerous situation

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Buying a cot • If your baby needs to be wrapped to Portable cots go to sleep, use a sheet over Children have died in accidents related light clothing and place the baby The main concerns with portable cots to cots. Young babies are at risk of on his back. is that they could be dangerous if they suffocating or choking. Toddlers are at • Doonas, thick or heavy collapse. The collapsed side could trap a risk of injury from falling while trying to may cause your baby to over heat and child, or the child's head may get caught climb out of a cot. are not recommended for this reason. between the mattress and the sides of There is also a pamphlet published by the • Make sure that baby’s face and head the cot (these may be stretchable). remains uncovered (avoid sheep's ACCC which has a picture that shows the Where to put a cot features of a safe cot: 'Safety alert - cots' skins, quilts, pillows, cot bumpers and soft toys). Cot bumpers are not Cots need to be well maintained Mattresses needed to protect your baby. Babies (making sure that all bolts and screws have been found with their faces are tight for example), and the cot Mattresses need to fit a cot well so pressed against bumpers. This can needs to be in a safe place in the house. cause breathing problems. there is no risk of the child becoming Cot and bed restraints trapped between the mattress and the • Do not use pillows in a cot. Babies do You can get cot and bed restraints which side of the cot. Also some mattresses not need pillows to sleep. are meant to stop babies rolling over onto are not safe for babies.. It is not safe to use a hot water bottle their tummies. These may not be safe. or electric for babies or young Bedding children because of the risk of burns. Heat packs can also cause burns and U-shaped pillows Make sure that your baby's face and should not be used with babies and very head are not covered when she is asleep. young children. Babies should not be left on adult The best way to do this is to use a baby sized u-shaped pillows while they are which is made so that the Pillows sleeping, or left alone there while they baby cannot slip inside the bag and are awake. become completely covered. • Pillows could be dangerous for babies. • There have been a number of −− They can cause suffocation, either • The sleeping bag should have fitted deaths associated with accidental by the baby turning face down and neck and arm holes and should not asphyxiation (smothering) in infants burying his face in the or by have a hood. who had been left unattended on getting his head under the pillow. adult size U-shaped pillow. In some • Make sure that your baby has enough This is rare. of those cases, the pillows were clothes on under the sleeping bag so −− Babies do not need a pillow to considered to be part of the cause that you do not need to use any other sleep comfortably. of death, because they blocked the bedding (no sheets or blankets). • Do not use pillows until the child infants’ airways. If you need to use sheets or blankets moves from the cot into a normal • U-shaped pillows are unsafe for use • Use only light bedding that can be bed, usually at 2 to 3 years. Even then as babies may accidentally suffocate tucked in firmly. pillows are not essential, but children if trapped between the two arms, • Dress your baby in clothing that will usually want to have one to be like or under the pillow.The use of such keep him warm enough so he does everyone else. Once our shoulders pillows to maintain the body position not need much bedding. Then it does are wider than our heads, most of us of sleeping infants can be unsafe. not matter if he wriggles out from sleep more comfortably with a pillow. • They are also not recommended under a blanket. • Young children should start with a for use when babies are awake. • To avoid your baby being strangled, flattish and fairly firm pillow. Older If U-shaped pillows are used for make sure that clothing does not children usually choose the type and playtime, babies should not be left have any long strings, ribbons or size they prefer. The type of filling in them by themselves if you need to cords. If you use a cord or ribbon to does not matter unless there is an move away. Lift your baby out and attach a dummy to clothing, make allergy problem. place her on the floor, or other safe sure that it is less than 10 cm long. surface, or take her with you.

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www.healthdirect.org.au/pbb Safe sleep for babies and toddlers – continued

Play pillows in the angle between the back and the Prams and strollers seat, making it difficult for your baby Play pillows are small horse-shoe to breathe. It is also not safe for you • Before you buy a pram or stroller shaped that can be used to to sleep with your baby on the sofa or check that the pram or stroller meets support young babies during play and lounge chair. the Australian Standard AS/NZS 2088. to help hold babies in a comfortable • Make sure it is strong, stable and that position for breastfeeding. These Rocking cradle it does not collapse until the lock is pillows may also be called play donuts released. or play rings. • Make sure the rocking cradle cannot • A baby in a pram or stroller should tilt while the baby is asleep. not be left unattended - as the pram • Make sure the cradle has a tilt or stroller may tip over. Also a baby in limiter so that it won't tilt more a stroller may slide down and become than 10 degrees. tangled in the stroller straps. • Make sure the locking pin/bolt is in • Always use the safety harness when place when you leave the baby and that your baby is in the pram. Even young a baby or another child can't take it out. babies can move. • Make sure that you use the tether Bassinettes strap so that you retain control of the pram when using it. Some parents use bassinettes for the Also for more information about pram early weeks. It is not necessary to have and stroller safety, see "Prams and a bassinette - they are an extra expense Strollers" section in "Keeping baby and babies usually settle well in a cot safe" from the Ministerial Council on even when they are very small. Consumer Affairs http://www.consumer.gov.au/html/ There have not been any reports of • They have the advantage that they pdf/baby.pdf deaths of babies left in play pillows but don't take up a lot of space and you it seems wise to use them with care. We can wheel them from room to room. advise parents that babies should not • Bassinettes can be rocked with a Baby hammocks be left in play pillows for sleep, and they head-to-toe movement which some should not be left in them unsupervised babies like. Baby hammocks may not be safe while they are awake. for babies. • On the other hand babies are not in them for very long because once Waterbeds the baby grows too long for the Bean bags bassinette, or starts to roll over or pull Waterbeds are not safe for babies and up on things, they are no longer safe. Do not put a baby on a bean bag. young children. There are no safety standards for • They are soft, so it is much easier for bassinettes but here are some things to Changing from a cot a child to roll over, and babies will not check. to a bed be able to lift their head so they can • Make sure the bassinette has a breathe. sturdy, wide based stand that will not • Children over 2 years are generally • Babies and young children need firm tip easily. old enough to sleep on a mattress mattresses. • Make sure the mattress fits well. on the floor or in a regular bed with guard rails. • Many bassinettes are made of • They will be safer if the mattress is on Sofa (lounge chair) wicker or cane. Make sure that the the floor and they can climb in (and wicker has not dried out and become out) easily. Do not let your baby sleep on a sofa as brittle as pieces could break off and your baby might roll and get trapped stick into your baby or choke her. • When a young child is moved out of a cot onto a bed, make sure that there

The Pregnancy, Birth & Baby Helpline is a service provided by the National Health Call Centre Network, operating ashealthdirect Australia.

www.healthdirect.org.au/pbb Safe sleep for babies and toddlers – continued

are no gaps between the mattress which cause them to sleep working party involving the Women's and the wall, or bed head, or rails, etc, more heavily. and Children's Hospital, Child and Youth where the child's head may be trapped. −− See the topic 'Sleeping with your Health, Kidsafe and SIDS and Kids baby' for more information. Bunk beds Other references and resources Australian Competition and Consumer • Bunk beds are not safe for children Smoking Commission (ACCC) 'Cots' under 9 years. • No-one should smoke in the same Kidsafe - Child Safety Australia: • While some falls occur during sleep, room as your baby or child because http://www.kidsafe.com.au/ there is also a danger of falling when they also inhale the smoke. It is now Ministerial Council on Consumer Affairs. children play on the . illegal in South Australia to smoke in a (Australia). 'Keeping baby safe - A guide vehicle with a baby or child. Toys and pets to nursery furniture': Dummies SIDS and KIDS (Australia): • Toys and pets can smother a baby. http://www.sidsandkids.org/ • It is best to remove toys while a There is some evidence that using a Sids and Kids 'Information statement - baby sleeps. dummy during sleep may protect a child Pacifier/dummy use' December 2005 from SIDS. The evidence is not yet clear • Make sure that pets cannot climb into http://www.sidsandkids.org/ enough for 'Sids and Kids' to make any the cot or bassinette. documents/05Pacifiers2.pdf • Do not let your pet sleep in the cot recommendations about use of a dummy. Sids and Kids 'Sudden unexpected or bassinette even when your baby is • When babies are learning to breastfeed Death in Infancy (SUDI) -Frequently not in there, as the pet may want to (in the first 6 or so weeks), dummies Asked Questions 2009 sleep there when the baby is there. may interfere with this learning. • Do not use mobiles or toys with • Dummies are often used in the early stretch or elastic cords in cots. weeks for bottle fed babies. The information contained in, or • By the age when a child may want a • If you use a cord or ribbon to attach a accessed through, this Website teddy or some other toy for comfort dummy to clothing, make sure that it is is for your general information (usually over 1 year), there is little or less than 10 cm long. and use only and is not intended no risk, but it is not recommended • Always check that the dummy is not to be used as medical advice and before this age. worn or damaged before you give it to should not be used to diagnose, your baby. Small pieces can break off. treat, cure or prevent any medical Sleeping with others If your baby or child has a dummy it may condition, nor should it be used become something which helps your for therapeutic purposes. • When babies sleep in their parents' child to feel relaxed at sleep time. It is The information is not a room the risk of SIDS is lower, and best not to take the dummy away until substitute for independent they often sleep better. The safest the child is ready, usually about 3 years professional advice and should place for a baby to sleep is in a of age. For more information about not be used as an alternative separate cot or bassinette next to this have a look at the topic 'Dummies, to professional health care. If their parents' bed. It seems wise to thumbs and other '. you have a particular medical do this at least until the baby is one For more information about dummies problem, please consult a year of age, after which the risk of and safety have a look at the ACCC healthcare professional. SIDS is very small. pamphlet 'Babies dummies - keep baby • But there is a risk if babies sleep in safe, safety alert' The content of this fact sheet was provided by the the same bed with an adult or child. South Australian Government’s Children, Youth The main way this happens is that the References and Women’s Health Service. The South Australian baby gets under the bed clothes or Government does not accept responsibility for the accuracy of this reproduction. a pillow. Some information in this topic was −− The risk is higher if parents smoke, based on the 'Safe Sleeping for Under have drunk alcohol or used drugs 2's' pamphlet, released by a joint

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