How to Keep Bedtime Safe for Babies

In Hillsborough County and around the country, babies continue to die in unsafe sleeping environments. These tragedies are preventable, and Rebecca Bacon, executive director of the Children’s Board of Hillsborough County, wants parents and caregivers to know the rights and wrongs of safe sleep.

“As a community, we need to make sure that every parent understands the importance of these guidelines to ensure safe sleep for babies and to make sure they have access to safe sleep environments,” says Bacon. “The Children’s Board is committed to ensuring that every family has the knowledge and resources to provide their babies with a safe sleep environment.”

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First, let’s talk about what we have seen locally when it comes to infant deaths due to unsafe sleep practices.

Rebecca Bacon: First and foremost, our hearts go out to families affected by these tragedies. In Hillsborough County, we’ve seen a number of infant unsafe sleep deaths that could have been prevented. Bed-sharing is one of the biggest risks, and too often, parents are not using the resources available to them, like pack ‘n plays or cribs.

Our focus is on educating families and caregivers about safe sleep practices. It’s crucial to remember that infants should always sleep alone, on their backs, and in a crib or pack and play with no loose bedding or toys.

What were the circumstances of these deaths?

Rebecca Bacon: A major risk is placing babies to sleep in the prone, or face-down, position. This obstructs their airway. Co-sleeping with adults, children or even pets also presents a grave danger. Babies can accidentally be rolled on, or become trapped in bedding, which can lead to suffocation. Despite the emotional desire to have your baby close, the safest sleep environment is always in their own crib or pack ‘n play.

We also see risks when babies are placed in cribs with pillows, soft bedding, stuffed animals or unsafe items like Boppy pillows or Dock-a-Tots. These can create a smothering hazard if the baby’s face becomes covered or if they roll into them. A crib should be free of all objects except a firm mattress and a fitted sheet.

Are sleep sacks a safe alternative to blankets in the crib?

Rebecca Bacon: Yes, regular, not weighted, sleep sacks are a safe and highly recommended alternative to blankets in the crib. One of the key principles of safe sleep is to keep the baby’s sleep environment free of loose items, including blankets, which can pose a suffocation risk. Sleep sacks, also known as wearable blankets, provide warmth and comfort without the dangers associated with loose bedding.

Unlike traditional blankets, sleep sacks are designed to fit snugly around the baby’s body, leaving the arms and head free, ensuring the airway remains open and the baby can move freely. This minimizes the risk of the blanket covering the baby’s face or getting tangled. Pediatricians and the American Academy of Pediatrics (AAP) support sleep sacks as a safer choice for keeping babies warm at night.

Why is it best for babies to sleep on their backs?

Rebecca Bacon: The safest sleep position for babies is on their backs, as recommended by the American Academy of Pediatrics (AAP). This guidance is based on extensive research showing that placing infants on their backs significantly reduces the risk of suffocation, which is one of the leading causes of death in infants under 1 year.

When babies sleep on their stomachs or sides, their airways can become obstructed, making it harder for them to breathe. Sleeping on the back keeps the airway open and reduces the chances of suffocation or rebreathing carbon dioxide trapped in bedding, which can occur in other sleep positions. The back-sleeping position also lowers the risk of overheating, which has been linked to unsafe sleep deaths.

Our goal is to educate parents and caregivers on this life-saving practice. It’s a simple yet powerful way to protect the youngest members of our community.

Are there resources for families who cannot afford a safe sleep crib for their baby?

Rebecca Bacon: Yes; I encourage families to join one of our seven Children’s Board Family Resource enters where there are a number  of supports provided for parents and caregivers with infants.  Please visit familysupporthc.org for more information and to become a member, which is free for all Hillsborough County residents.

What should a parent tell their child’s caregiver/childcare provider when it comes to safe sleep?

Rebecca Bacon: Parents should be very clear and direct when discussing safe sleep practices with their child’s caregiver or childcare provider. This is an essential conversation that can help prevent tragic accidents. They should explain that their baby must always be placed on their back to sleep. This is the safest sleep position, as recommended by the AAP, and it greatly reduces the risk of unsafe sleep.

Why is it unsafe to leave an infant asleep in a car seat when I carry it outside of the car?

Rebecca Bacon: Car seats are designed to keep infants in a semi-upright position, which is ideal for travel, but not for prolonged sleep outside the car. In this position, an infant’s head can tilt forward, potentially causing their airway to become obstructed, making it harder for them to breathe. This condition is sometimes referred to as “positional asphyxia”.

When a car seat is placed on a soft or uneven surface, it can tip over or cause the infant to slump further into an unsafe position, increasing the risk of suffocation. Car seats are designed to be secured in a car, not to function as a stable sleep environment outside of it.

Anything else we missed that you’d like to add?

Rebecca Bacon: We encourage all parents and caregivers to take the pledge to practice safe sleep, which can be found at www.childrensboard.org.  Additionally, please check out the Family Guide found on the home page, for all the wonderful programs and resources funded by your Children’s Board.

*Presented by the Children’s Board of Hillsborough County | Originally published in the October 2024 issue of Tampa Bay Parenting Magazine.