October is Safe Sleep and Sudden Infant Death Syndrome Awareness month. Both as a physician and as a dad, I care deeply about this issue.

I have a wonderful 2-year-old daughter and a brand-new baby who arrived last month, so I know the struggle of infant sleep firsthand. I want to share some information and practical tips to help babies sleep more  safely and support the parents, families, and caregivers who care for them. I also want to share some thoughts on what we can all do to make Pierce County a great place for infants.

First, why is safe sleep so important? Sleep-related infant deaths are a significant contributor to infant mortality in Pierce County and the United States. You might have heard the terms Sudden infant death syndrome (SIDS) or sudden unexpected infant deaths (SUID). They’re technical terms for unexpected infant deaths that are often sleep-related.

This is a difficult thing to think about and talk about. Many of these deaths happen when an infant accidentally suffocates because they aren’t sleeping in a safe space—things like an adult bed, couch, or an infant product not designed for safe sleep. Pillows, blankets, cushions, or an adult’s body can cover the infant’s face and prevent them from breathing.

Many of these deaths are preventable. It’s important that we work together as a community to help reduce the risk of infant deaths.

If there are infants in your life (or about to be infants in your life), I encourage you to review the full information from the American Academy of Pediatrics on safe sleep. You can also check out information from the Health Department and Mary Bridge Children’s Hospital. In brief, remember the ABCs of safe sleep:

• Alone—Place your baby on a safe, separate sleep surface. Your baby shouldn’t sleep in an adult bed, on a couch, or on a chair. They should be completely alone—no siblings, pets or stuffed animals—in their bed. Room sharing is recommended for at least the first six months. Put your baby’s crib or bassinet in your room, close to your own bed.
• Back—Every time you put your baby down to sleep, put them on their back. Do not place your baby face down, on their stomach or on their side.
• Crib—A safe crib has a firm, flat surface. Cover the mattress with a fitted sheet and don’t use other bedding or leave other soft items in the crib with your baby.

Examples of safe sleep products include cribs, mini-cribs, bassinets, and portable cribs. Infant swings, loungers, bouncers, couches, and car seats are not safe places for infants to sleep. You might see crib mattresses or other items advertised as “breathable.” This is not an evidence-based designation. For instance, using a mattress advertised as “breathable” does not make it safe to place your infant face down on their stomach.

Some families choose to share an adult bed with their infant (sometimes called co-sleeping). Because bed-sharing increases the risk of sleep-related infant death, we recommend that babies only sleep on a separate surface designed for infants, and still close to their caregivers. For babies born prematurely, a safe, separate sleep space is especially important because they face an even higher risk of sleep-related death.If you do choose to share an adult bed with an infant, there are some steps you can take to decrease the risk:

• Put the baby on their back (not on their stomach or side).
• Keep pillows, blankets, toys, and any other items in the bed away from the baby. Use a sleep sack rather than blankets for the baby.
• Use a firm mattress. Never use a couch, recliner, or other soft surface.
• Avoid smoking, alcohol use, drug use, and any medications that could make you more sleepy or sedated.

We should also think beyond the individual actions of parents and caregivers. I know firsthand that being the parent of an infant is hard and exhausting. I also know many families face more challenging circumstances than mine.

All of us can play a role in making Pierce County and Washington great places for infants to grow up. If you know someone who is having a baby or just had a baby, reach out—see what you can do help them.

At the policy level, we are fortunate to live in a state that offers paid family leave to eligible residents. You can see if you or a loved one qualifies for Paid Family Medical Leave on the state’s website. This pales in comparison to the family leave policies of many of our peer countries. Many of our peer countries have lower infant mortality and more generous policies that support families may be one contributing factor. Other steps we can take include:

• Making sure every family with an infant can access an approved crib, portable crib, or other safe place for their infant to sleep.
• Improving systems and policies to make it easier for people to breastfeed.
• Taking action to decrease smoking rates and other substance use.
• Improving immunization rates.
• Increasing healthcare access for pregnant people, parents, and infants.

Together, we can reduce infant mortality and sleep-related infant deaths in Pierce County—and make Pierce County an even better place for infants to grow up.

Resources

• American Academy of Pediatrics guidance on safe sleep.
• Our safe sleep webpage. Also provides information and resources for people who have experienced the loss of an infant.  
• Mary Bridge Children’s Hospital information on safe sleep
• Visual guide on safe sleep environments.
• National “Safe to Sleep” brochure.