The elusive infant sleep. It’s normal for new parents to feel anxious about their baby’s safety while sleeping; parents have been so bombarded with safe sleep campaigns and what not to do that it can feel so scary putting the baby down for a nap. And if their babies are anything like mine and refuse to follow any of those great safety guidelines anyways, parents might be feeling at their wits’ end.

Often in childbirth classes, we cover the safe sleep guidelines of being alone in a crib on their back in a smoke-free environment. It can be helpful to introduce the safe sleep guidelines as the gold standard for infant sleep while acknowledging that the majority of newborns do not want to be alone on their back in a crib. In reality, these are learned skills that take some time for babies to get right.

Image sourced from Win Network Detroit.

So, what are some ways to promote safe sleep in our childbirth classes while also acknowledging the difficulties of realistically implementing the guidelines?

Here are four simple ways to boost your safe sleep content in ways that will actually help:

1. Teach strategies for encouraging newborns to actually sleep alone on their backs.

Learning to sleep alone on their back is a learned skill for babies. Educators can help parents feel more prepared by covering specific skills and techniques to teach newborns how to sleep independently on their back. These can include tricks like using a heating pad to warm up the crib or bassinet before placing the baby in it or placing an article of clothing that smells like baby’s parent flat in the bassinet (or, even better, having a parent sleep with the crib sheet to get their smell on it before placing it on the crib). Educators can also suggest ideas for naptime or bedtime routines that get babies cued into when it is time to sleep, like taking a bath or reading a book; going into a quiet, dark space; putting on white noise or making the shushing sound while bouncing them; drinking some milk; or offering a pacifier before going down to sleep. Whatever the process includes, the consistent routine can help train babies to sleep. Some parents find that using a stroller, rocker, sling, or tying the baby to a caregiver’s back to rock the baby to sleep before transferring them into the crib can also help.

2. Normalize that there are many different safe sleep locations.

While being in a crib or bassinet is the ideal, not everyone has the means or desire to use these sleep locations. Research shows that more than 60% of new parents share a bed with their infant at least once during their infancy. Given this statistic, educators should include strategies to reduce harm to babies while co-sleeping, such as the Safe Sleep 7.

Image sourced from Birth Partner.

Additionally, parents who do not have the resources to access a new crib or a room large enough to fit a crib often feel guilty that their child is at risk for unsafe sleep. However, parents can use something as simple as an empty wardrobe drawer placed on the ground with a single towel laid down in the bottom as a safe sleep location. Or if the parent(s) has a tiny apartment and the baby’s crib doesn’t fit in the parents’ room, it’s OK for the baby’s crib to be right outside the room within hearing distance. Even having the baby fall asleep on their parent or caregiver is OK as long as the parent, or another adult nearby, is awake to prevent the baby from rolling off. Many parents safely monitor their baby’s sleep by placing them in a wearable carrier, sling, or cloth around the parent’s back and allowing baby to sleep while the parent walks around and works. Normalizing different safe sleep locations can help reduce new parent guilt and fear while their baby is sleeping.

3. Discuss the actual risk of SIDS (sudden infant death syndrome).

It is easy for new parents to feel alarmed when they hear their educators and healthcare providers say their baby is at an “increased risk” for SIDS (sudden infant death syndrome, or when the baby dies unexpectedly while sleeping) if the parents don’t follow the safe sleep guidelines. However, parents take risks every day with their babies. Just driving the baby in a car to the doctor’s office puts them at risk, so it’s important to help parents consider the “actual” risk of SIDS and how much risk they are OK with.

Studies (see here and here as well as Emily Oster’s book “Cribsheet”) have found that SIDS risk during bed sharing is actually much lower for babies who are considered “low risk” (not born prematurely and have an average birth weight) to parents who don’t smoke cigarettes or drink more than two servings of alcohol per day. And this risk is significantly lower than the risk of being killed in a car accident or drowning. The risk for SIDS increases when the baby is considered “high risk” (born prematurely and/or have low birth weight) and when the parents smoke cigarettes and/or drink more than two servings of alcohol per day. Helping parents understand the actual risk of SIDS, and factors that can increase or decrease that risk, can help parents make informed decisions about safe sleep options for their baby and reduce guilt and fear.

Image sourced from NPR.

4. Affirm parents in their choices.

New parents are often overwhelmed by the newness of caring for a newborn, sleep deprivation, and the sheer number of decisions they have to make. It is so easy for new parents to feel guilty, anxious, or downright panicky that they aren’t doing something right, especially when it comes to safe sleep. Educators have an important role of reminding parents of their inner strengths, compassion, and ability to best care for their child(ren). By normalizing the variety of safe sleep options and meeting parents where they are, educators can help lessen parent anxiety and promote safe sleep that actually works for parents.

Leslie Massicotte, M.Ed., LCCE, is a childbirth and women's health educator in North Carolina. She's been working with young people and families for over 10 years, ensuring that everyone has access to evidence-based, inclusive, and comprehensive information about their health and their bodies.

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