SAFE SLEEP FOR INFANTS POLICY PROCEDURE

SAFE SLEEP FOR INFANTS
POLICY
At BC Women’s Hospital frequent skin to skin care is encouraged as there are significant benefits to the
newborn. However, in order to maintain safe sleeping practices parents are instructed to place their
infants in their basinettes when they feel tired and need rest. Parents are advised against sleeping with
their infant in their bed or hospital chair also known as “bed sharing”.
Applicability: Safe sleeping practices are encouraged in the Maternal Gyne and Neonatal Programs.
PROCEDURE
Registered Nurse
1.1.1
Information and Education
Bed Sharing refers to a sleeping arrangement where the infant sleeps with another person, often the
mother on the same bed or sleep surface. This does not include times that the infant shares the same
surface for breastfeeding, bonding or cuddling while the mother or partner is awake. Some literature has
found bed sharing to be associated with Sudden Infant Death Syndrome (SIDS) and Sudden Unexplained
Death in Infancy (SUDI).
Definitions
Sudden Infant Death Syndrome -The death of an infant under one year of age which is sudden and
unexpected without a clear cause.
Sudden Unexplained Death in Infancy -The sudden unexplained and unexpected death of and infant
where external risk factors are noted as possibly contributing to the death.
Many of the risk factors for SIDS and SUDI are related to the infant’s physical environment such as sleep
position, unsafe sleep surfaces, hazards in the sleep environment, overheating, exposure to tobacco, bed
sharing, and lack of breastfeeding. It is important to provide care givers with information on how to support
safe infant sleep.

Provide the following information:
o When parents are tired or planning to sleep place the infant in the bassinette
o Always put the infant on their back to sleep
o Keep the basinette flat and do not use positional props (unless medically indicated)
o Place the bassinette in close proximity to the mother so that the infant can be easily reached for
breastfeeding and other care needs.
o Keep the basinette free of soft materials or objects (e.g. bumper pads, extra blankets, toys)
o The matress should be firm with a tight fitting sheet; waterbeds, pillow-top mattress, couches,
recliners and sheepskins are not firm enough for the infant to sleep safely
o Ensure the crib, cradle, bassinet, or other sleep equipment meets Canadian Crib and Cradle
Regulations (http://laws-lois.justice.gc.ca/eng/regulations/SOR-2010-261/page-1.html#docCont)
 Many surfaces are not designed for sleep (e.g. car seats, slings, soft carriers, bouncy
chairs, strollers); care providers should avoid intentionally placing infants to sleep on
these surfaces.
o Ensure the infant does not overheat while sleeping, do not use touques, thick blankets,
overdress or overwrap the infant. Keep the room less than 20°C
o Never cover the infant’s face
WW.07.15A
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-JUN-2014
Page 1 of 4
Disclaimer Message
Refer to online version – Print copy may not be current – Discard after use
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 25, 2016 09:32
Anonymous
SAFE SLEEP FOR INFANTS
o
A “blanket sleeper” (warm sleeping garment) can replace the use of a blanket
 This can reduce the incidence of turning from back to front during sleep and prevents
the risk of bedding covering the infants head
o
If a blanket is used it should be tucked firmly underneath the end of the crib mattress and only
reach the infants chest.
Always place the infant at the bottom of the basinette to prevent them from sliding under their
blanket
Ensure a smoke free environment
Breastfeeding is reccomended as it is a protective measure against SIDS
The baby can be given tummy time while awake and being watched. This helps develop their
muscles and prevents the back of their head from becoming flat.
o
o
o
o

1.2
Review the safe sleeping poster with parents
Bed Sharing
If parents are found sleeping with the newborn in their bed or armchair
 Move the infant to their bassinette
 Reinforce safe sleep education
If parents continue to “bed share” despite receiving safe sleep education
 Check infant status every time the infant is found “bed sharing”
 Document their informed choice
 Ensure parents are aware of the safe sleep principles listed above as well as the following safe care
practices:
o Choose a firm surface without any adjacent spaces that could allow the infant to fall out of bed
or become trapped between the mattress and the wall or bed frame.
 Consider using a futon or mattress on the floor.
o The infants sleeping area should be free from heavy pillows and blankets (including duvets)
o Other adults in the bed are aware the infant is in the bed
o The infant is never left alone in the bed
o Other children and pets are not in the bed
o No recent parental consumption of alcohol
o No illicit drug use
o Parents are not excessively tired
WW.07.15A
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-JUN-2014
Page 2 of 4
Disclaimer Message
Refer to online version – Print copy may not be current – Discard after use
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 25, 2016 09:32
Anonymous
SAFE SLEEP FOR INFANTS
DOCUMENTATION


Interprofessional Progress Notes
Newborn Clinical Path
REFERENCES
Public Health Agency of Canada (2012). Joint Statement on Safe Sleep. Retrieved from: http://www.phacaspc.gc.ca/hp-ps/dca-dea/stages-etapes/childhood-enfance_0-2/sids/jsss-ecss-eng.php
Canadian Paedeatric Society (2004) Recommendations for safe sleeping environments for infants and
children. Pediatrics and Child Health, 9(9) 659-663. Retrieved from:
http://www.cps.ca/english/statements/CP/cp04-02.htm
Government of Canada (2014). Cribs, Cradles, Bassinettes Regulation Retrieved from: http://lawslois.justice.gc.ca/eng/regulations/SOR-2010-261/page-1.html#docCont
Mason, B., Ahlers-Schmidt, C., & Schunn, C. (n.d). Improving Safe Sleep Environments for Well Newborns
in the Hospital Setting. Clinical Pediatrics, 52(10), 969-975.
Meadows-Oliver, M., & Hendrie, J. (2013). Expanded Back to Sleep Guidelines. Pediatric Nursing, 39(1),
40-49.
Moon, Rachel Y. "SIDS and other sleep-related infant deaths: expansion of recommendations for a safe
infant sleeping environment." Pediatrics 128.5 (2011): e1341-e1367.
Perinatal Services BC (2011). Safe Sleep Environment Guideline for Infants 0 to 12 Months of Age.
Retrieved from: http://www.perinatalservicesbc.ca/NR/rdonlyres/D799441C-3E00-49EE-BDF72A3196B971F0/0/HPGuidelinesSafeSleep1.pdf
Shaefer, S., Herman, S., Frank, S., Adkins, M., & Terhaar, M. (2010). Translating Infant Safe Sleep
Evidence Into Nursing Practice. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 39(6),
618-626.
APPENDIX
Appendix D
WW.07.15A
Safe Sleep Poster
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-JUN-2014
Page 3 of 4
Disclaimer Message
Refer to online version – Print copy may not be current – Discard after use
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 25, 2016 09:32
Anonymous
SAFE SLEEP FOR INFANTS
WW.07.15A
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-JUN-2014
Page 4 of 4
Disclaimer Message
Refer to online version – Print copy may not be current – Discard after use
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 25, 2016 09:32
Anonymous