SIDS and Child Care Providers

Child Care and SIDS

Child care providers should be aware of and follow current recommendations concerning infant care.  Twenty percent of SIDS deaths occur in child care settings.   Many of these deaths occur during the first week of child care.  Why this happens remains unclear, but child care related studies suggest unaccustomed tummy sleeping as a preventable risk factor, either by being placed on the tummy or by rolling over onto the tummy when this is not a usual sleep position.

One of the most effective strategies in reducing SIDS and accidental suffocations is to promote a safe sleep environment.  Following the recommendations and promoting safe sleep can prevent deaths due to accidental suffocations, overlays and entrapment.

What Can A Child Care Provider Do to Help Prevent SIDS and Promote Safe Sleep?

1. Always place the baby on his or her back to sleep in a safety-approved crib, for both bed time and nap time (unless otherwise specified by the baby’s physician).  Side sleeping is not recommended as a safe alternative to back sleeping.
2. Remove all extra bedding (i.e., blankets, pillows, quilts, etc.) and toys from the crib.
3. Crib slats should be no more than 2 3/8” apart (the width of a soda can).
4. Sleep one baby per crib.
5. Do not overheat the baby, and do not cover the baby’s head or face.
6. Do not allow smoking near the baby.  If a child care provider does smoke, he or she should do so outside while wearing a jacket.  Before the provider touches or picks up the baby, the provider should remove the jacket and wash hands and face.
7. Discuss pacifier use with the parents.  Pacifiers are now recommended by the American Academy of Pediatrics for infants 1 month to 1 year of age.
8. Share safe sleep policies with other staff.

What Should Not be Allowed in the Crib?

1. Soft bedding (i.e., blankets, pillows, quilts, comforters, etc.)
2. Bumpers
3. Stuffed toys
4. Positioning devices (without a doctor’s approval)
5. Pets

What if Parents Request the Baby Sleep on its Tummy?

In this case, child care providers must obtain written instructions from the baby’s physician before the baby can be placed in any position, other than on its back.  The doctor must provide instructions on the medical condition and how the baby should be positioned, or if any positioning devices must be used. 

Licensing Standards for Child Care Centers