As a group who supports a shift in the way families manage this time in their lives and seek to move beyond sleep training, any talk of Safe Sleep simply must include the biologically normal way for babies to sleep throughout human history- with their mothers on a shared surface.

This does not mean that this is the ONLY way Safe Sleep can / will be found. What it does do is give us is a base understanding about why so many families struggle with sleep.

This base understanding acknowledges that the idea of a solitary sleeping human infant in a cot in their own room is a social and cultural construct, not a given, and most certainly not ‘normal’ from a biological, and anthropological standpoint.

This is important for how we frame our view of infant sleep and what is/ isn’t a ‘problem’ and why normal infant behaviour can seem to be problematic for families.

When we recognise our babies all start with an intense need for care and closeness by day and night we can work with their natural needs to make it work for our families.

SIDS AND SUDI are real risks we face as parents and there are factors that have been recognised to increase risk of it occurring.
Life is all about ***risk management*** and the best risk management can be achieved when we are fully informed about the risks so we can make decisions based on our unique situation. No activity will ever be risk free.
No sleep set up is entirely risk free.
*Risk reductio*n is the name of the game.

**Prepare to Share**
Sharing sleep (co-sleeping) with your baby is really common whether you intend to sleep your baby separately (eg. in a cot) or not.
It’s important for all parents and caregivers to know the basics of making shared sleep safer.
Key message: ***If it is easy to breathe, it’s safer to sleep.***
Babies need their head and airways clear.
Here are the things to do to prepare to share:
You will need:
A firm, flat mattress, large enough to fit you and baby comfortably
Clear of heavy bedding, keep pillows and blankets away from baby and consider using a sleep sack for baby
Position baby on their back at breast/ chest height NOT up near your face and pillows
Make sure all adults in bed know baby is sharing
Make sure an adult is with baby if they are on an adult mattress
If rolling/ falling is a worry, consider placing the mattress on the floor and away from walls to reduce height, do not place pillows around baby.
If you have other children, make sure an adult sleeps between them and the baby
No pets on the bed
Couches, recliners and nursing chairs are NOT safe surfaces to share sleep.

There is an extra risk of Sudden Unexpected Death in Infancy SUDI (including Sudden Infant Death Syndrome SIDS and fatal sleep accidents) in shared sleep settings if you have some additional factors to consider:

If baby is

under 3 months of age
exposed to smoking during pregnancy or after being born
born prematurely or low-birthweight
not breastfed

If the parent/ caregiver/ or anyone in the bed

smokes
is not sober (drugs or alcohol)
is on medication that induces sleep or drowsiness

If this is you, still prepare to share while also creating safer separate sleep spaces to use whenever you can.

Examples:

Bassinet
Bedside / side- car sleeper
Cot
Pepi-pod

Keep baby in the same room as you for the first 6-12 months as this reduces the risk of SUDI. Roomsharing also supports the breastfeeding relationship and makes night time care much easier for most families.

If you are feeling tired, moving to the firm, flat clear mattress you have prepared is safer than falling asleep accidentally on the couch or nursing chair.

Breastfeeding is protective against SIDS and night nursing is part of this.

If I can’t / don’t want to safely bedshare, what else can I do?

• Articles- https://www.basisonline.org.uk/room-sharing/

• http://evolutionaryparenting.com/b edsharing-and-formula-feeding/

• https://www.basisonline.org.uk/parents-bed/

• https://www.basisonline.org.uk/side-car-cribs-bedside-cots-and-co-sleepers/

• https://www.breastfeeding.asn.au/blog /simonecasey/boobies-bed

We encourage parents to place their babies on their backs to sleep until their baby is strong enough to turn themselves over, this is what the evidence suggests is the lowest risk way to put your baby to sleep.

Please note, that a baby who really struggles to sleep unless they are on their tummy may be experiencing symptoms of discomfort and this could be a sign that something else is at play and it is worth looking in to.

Sleeping on a parent’s chest is often a fabulous way to settle an unsettled baby, particularly little people who have reflux and other discomfort. It must be acknowledged however, that there is risk attached to chest sleeping. Prone positioning (on their tummy) reduces baby’s arousal mechanism, which is protective of baby’s airway. Baby’s nose or mouth could become obstructed by clothing or their parent’s body, and an unsupervised baby could become positioned with their chin to their chest, which obstructs their airway.

There is additional information on chest sleeping available in the book Sweet Sleep by La Leche League International for those interested to know more.

We will share up to date research articles on this topic and highlight gaps in the current research (formula feeding and bedsharing is one such example where more research is needed- see this article by Dr Tracy Cassels- http://evolutionaryparenting.com/bedsharing-and-formula-feeding/ ).

Other gaps in advice currently include-

Twins– safe bedsharing and co-sleeping options and risk reduction
Siblings– sleeping arrangements to keep both infants and older children safe while co-sleeping/ bedsharing
Dealing with gaps and edges in co-sleeping and bedsharing arrangements
Side car cots – no current risk reduction advice other than to say there are no product standards in many countries
Premature babies– what age is it safe to share a surface with a baby born preemie?

We will continue to work to see that these gaps are remedied.

Further advice we do have:

There is information about the elvated risks associated with the use of baby sleep positioners and wedges- read more here- https://www.lullabytrust.org.uk/are-sleep-pos itioners-safe-for-babies/

Baby nests and pods (small, portable beds for an infant that have padded or soft sides), such as Dock-A-Tot/Sleepyhead and the many other names used for these items, do not meet Safe Sleep Standards for most countries including- Australia, UK and Canada.

There are ‘boxes’ that may be used in co-sleeping arrangements such as the Finnish Baby Boxes, Wahakura and Pēpi Pod, these have been specifically designed to create a low risk sleep space for baby.

This is BASIS’s advice regarding Baby Hammocks and Swings–https://www.basisonline.org.uk/baby-hammocks-swings/

Above all, we will advocate for families to keep responding to their little one in the night. What could possibly be safer than attending to your child day/night?

Each family ultimately takes responsibility for deciding what is acceptable or unacceptable in their unique setting. We are not here to tell you what to do. We will share up to date advice and empower you to make an informed decision.

This quote from Professor James McKenna explains this beautifully-

“Aside from never letting an infant sleep outside the presence of a committed adult, i.e. separate-surface cosleeping which is safe for all infants, I do not recommend to any parents any particular type of sleeping arrangement since I do not know the circumstances within which particular parents live. What I do recommend is to consider all of the possible choices and to become as informed as is possible matching what you learn with what you think can work the best for you and your family.”

Here are some of our go to articles and sites on all things Safe Sleep-

https://www.basisonline.org.uk/basis-information-sheets/

https://www.basisonline.org.uk/sleep-health-safety/

https://kellymom.com/parenting/nightt ime/cosleeping/

http://www.llli.org/sweetsleep book/thesafesleepseven

http://cosleeping.nd.edu/safe-co-sl eeping-guidelines/

https://www.bellybelly.com.au/baby-sleep/4-unsafe-pla ces-for-baby-sleep/