Safe Sleep Essentials: Guidelines for Parents From a Neonatologist 

Published Oct 1, 2024

Bryanne Colvin, MD

As a neonatologist at Washington University in St. Louis, I specialize in the care of both well and ill infants at BJC facilities. My passion lies in promoting safe sleep practices to prevent sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS). Collaborating with national researchers, I focus on helping families implement safe sleep strategies at home, as well as enhancing hospital practices to ensure every baby sleeps safely. One of our achievements has been obtaining Cribs for Kids Hospital Certification at our facilities. 

The ABCDs of Safe Sleep: What Every Parent Needs to Know 

To ensure your baby sleeps safely, remember the ABCDs of safe sleep: 

• A is for Alone: Your baby should sleep alone in their crib or bassinet, without any extra items like blankets, stuffed animals or bumpers. While it’s important for babies to sleep in the same room as their parents, they should not share the bed. The only item permitted in the crib is a pacifier; we do encourage pacifier use, as this can reduce the risk of SUID and SIDS. 
• B is for Back: Always place your baby on their back for every sleep, including naps. We also should remember that awake, supervised tummy time is important to help your baby develop their core muscles, so that when they do roll over the first few times, they can lift themselves up from the mattress to turn their face. 
• C is for Crib: Ensure your baby sleeps on a flat, firm surface like a crib, bassinet or pack ‘n play. Avoid upright sleep spaces like car seats, swings or bouncy seats, as these positions can restrict their breathing. Similarly, avoid soft surfaces like adult beds and thick blankets to prevent improper head and neck positioning. 
• D is for Don’t Smoke: Avoid any exposure to smoke, both before and after your baby’s birth. Smoke exposure significantly increases the risk of SUID and SIDS. 

Understanding SUID and SIDS 

SUID refers to the sudden and unexpected death of an infant under 1 year old, where no immediate cause can be identified. This category includes accidental suffocation, strangulation in bed and SIDS. SIDS is diagnosed when a thorough investigation, including an autopsy, fails to determine the cause of death. In Missouri alone, around 100 babies die each year from SUID, with two-thirds of these deaths occurring when the baby was placed in an adult bed. These tragic deaths are preventable. It’s vital to educate parents that, despite the temptation to co-sleep, placing babies in an adult bed is unsafe. Safe sleep may be hard, but your baby is worth it. 

Resources for Families 

For families struggling to provide a safe sleep environment, numerous resources are available across Missouri. The Missouri Safe Sleep website (safesleep.mo.gov) offers a county-by-county map of programs providing cribs. Additionally, the Safe Cribs for Missouri Program connects families with local resources to obtain cribs at no cost. 

Advice on Co-Sleeping 

Even with the best intentions, adult beds are not designed for infants — they are too soft and often contain unsafe items that can increase the risk of SUID and SIDS. Bed sharing is not safe and places your baby at risk. 

Adhering to safe sleep guidelines is crucial for reducing the risk of SUID and SIDS. Your baby’s safety and well-being are worth every effort to ensure they sleep safely and soundly.