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March 7, 2019

Signs of Safe Sleep in Child Care

Baby in crib

Safe sleep environments protect children from harm. Here’s what you need to know about what child care providers should be doing to keep your tiny dreamer safe and sound.

We’ve come a long way since safe sleep rules were first introduced in the 1990s to families and child care providers. Since then, infant deaths have declined sharply. Sadly, the stats still show that we can do better. There are about 3,500 sleep-related deaths among babies each year in the United States. As parents, we do our research and know what to do at home.

But we also need to make sure that our babies are safe when they sleep away from home. Because of everything we know about safe sleep, there are many signs you can look for!

What families can look for in provider settings:

Is the program licensed or registered?

All programs working with infants that are licensed and registered have to comply with safe sleep practices, and they get oversight from the state to make sure they do. Family child care homes that care for five or fewer children don’t have to be regulated or licensed. If a program is not licensed, they aren’t getting visits from external parties to check on their practices. Illegally operating facilities are less likely to practice safe sleep. The vast majority of infant deaths in child care happen in those unregulated settings.

Did you know documentation of health and safety orientation training is required for all caregivers including teachers, directors in child care centers, child care homes licensees, volunteer caregivers, and anyone else included in the child-staff ratio? Click here to learn more about identifying quality care in Indiana.

Does the program have a safe sleep policy?

Licensed and registered providers are required to have a safe sleep policy that is part of both their family handbook and their staff handbook. One way to know if your provider’s safe sleep policy is a good one is by comparing it to the American Academy of Pediatrics (AAP) recommendations and guidelines for safe sleep.

Is the staff safe sleep trained?

Safe sleep training is now required for all staff in child care programs that work or might work with infants, and there should be a Safe Sleep Certificate in their files. At safe sleep training, child care and early education staff learn what SIDS (sudden infant death syndrome) is and also what accidental suffocation is. Staff learns how to avoid situations where an infant would die of SIDS or accidental suffocation. They learn of risk factors associated with SIDS and about the aspiration myth: the idea that if an infant sleeps on their back they are more likely to choke when they throw up — that idea is not true.

New views on swaddling via the National Resource Center For Health and Safety in Child Care and Early Education.

What do the cribs look like?

Are the cribs in good condition? Are the sheets fitted and tight? Soft surfaces like cushy mattresses or sofas are not safe places for a baby to sleep. Make sure the sheets are not loose and are fit tightly on the mattress. Observe there are no items, toys or blankets in or on the cribs. All cribs should be completely clear of anything. Some cribs have signs attached to them, to help providers remember information about the baby. Those signs do comply with safe sleep practices.

Infants should never sleep in a car seat, swings or bouncers. According to the AAP, allowing an infant to sleep in a bucket car seat that’s been placed on the floor is a safety hazard, as the baby’s head can fall forward and cut off her airway.

While you are doing the tour: Watch an infant get laid to sleep and observe that they’re laid back on their back.

What does safe sleep at home look like?

  1. Baby lays on his or her back for all sleep times-naps and at night.
  2. Sleep happens on a firm sleep surface, such as a mattress, in a safety-approved crib.
  3. No soft bedding such as blankets, pillows, or bumper pads is in the crib. No toys or soft items should be in the baby’s sleep area.
  4. Sharing your room and not your bed with your baby.

Ask about tummy time.

Tummy time is essential for many developmental reasons. Ask your provider how they support children in tummy time. Because infants should be put to sleep on their backs, they need to spend significant awake time on their stomachs. Their muscles will develop differently if they don’t get enough tummy time. Providers need to make sure that they’re getting time on their stomachs every day.

Indiana has many kinds of child care programs. So, you have a lot of options when choosing the right place for your child and family. Understanding those options helps you have a successful selection process. Click here to see a safety comparison chart based on types of care.

Look around and make sure the room has a space for infants to play on the floor.

Observe and look for a space where infants are able to play on the floor. Make sure babies are not spending long periods of time on restraining or entrapment devices, like infant swings, bouncy seats, sleep positioners or wedges, high chairs or walkers. When infants can play on clean, open floor space, they are getting the muscle development that they need. They are also in an environment that reduces risks.

Care providers have lots of resources! If your care provider is having difficulties practicing safe sleep, share this provider-facing post with them. If you are concerned about safe sleep practices in your child’s program, you can also reach out to Brighter Futures Indiana’s team.

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