The ABCs of Safe Sleep

Ask the Experts by Lacea Zavala, MSW, LMSW

Q: I keep hearing about the ABCs of Safe Sleep. What are they and how can caregivers best protect infants while they sleep?

A: September is Infant Safe Sleep Awareness Month in Michigan, as proclaimed by Gov. Rick Snyder, and first lady Sue Snyder is working to support statewide initiatives to combat the nearly 150 preventable infant deaths annually in the state due to unsafe sleep environments. At that rate, we are losing one baby every three days, and 10 babies every month here in Michigan! These deaths may have previously been categorized as Sudden Infant Death Syndrome (SIDS) and were once believed to be unpreventable.

Today we have a better understanding of infants and data to demonstrate that many of these deaths are due to suffocation from unsafe sleep environments, and therefore are preventable.

The acronym "ABCs" is helpful in remembering how infants should be sleeping.

Babies should sleep ALONE, on his/ her BACK, in a CRIB and in a SMOKE-FREE environment.

Let's take a closer look at each of these. Infants should be alone in their crib, with no other objects, and with a tight-fitting sheet over a firm mattress. There should be no other infants or children, pillows, blankets, loose sheets, bumper pads, stuffed animals or other toys in the crib.

The baby should be put to sleep on their back, not on their side or stomach. It is easier for a baby to choke when lying on the stomach or side rather than on their back.

Babies should be put to sleep in a safety-approved crib, bassinet, or Pack-N-Play. Adult beds, couches, strollers, bouncers and car seats are not safe places for infants to sleep.

Finally, there should never be smoke around a baby. Babies exposed to smoke are five times more likely to be a victim of a sleep-related death. If someone in your home smokes, make sure they smoke outside, change their clothes after smoking, and wash their face and hands before touching a baby.

Other ways to protect an infant include co-sleeping by sharing a room, NOT a bed. The caregiver should sleep close to the infant (usually within an arm's reach), but not share a bed, and this practice can be very dangerous. Infants should not share any other sleeping surfaces with another person (such as a bed, couch, chair, etc.).

Breast milk reduces the risk of infant deaths because it is easier for the baby to digest compared to formula. Therefore the baby sleeps lighter and is woken up more easily if there is trouble breathing or is in a dangerous position.

Tummy time, starting at birth, involves letting a baby play on their stomach so the baby can strengthen their muscles and prevents the "flat head" that many caregivers worry will occur from sleeping on their backs.

Babies sleep most comfortably in 68-72 degrees Fahrenheit. This temperature can be achieved in the winter using a sleep sack, or by sleeping in a basement level room in the summertime if there is no air conditioning.

It is important to remember to bring the safety-approved crib, bassinet, or Pack-N-Play along if moving sleeping locations.

Finally, the safe sleep plan should be shared with other caregivers. When a caregiver talks to others about what and when the baby should eat, what the baby should wear, what the baby can and cannot play with, how the baby should sleep should also be included.

Just as our views of wearing seatbelts has changed over the years, today we know better about infant safe sleep, and so we do better. Our grandparents may have slept with our parents in their beds, and our parents may have put us to sleep on our tummies. Just because we survived, does not mean that it was the safest for us. Please share what you have learned with others so that we can prevent these tragic deaths of our babies!

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Lacea Zavala, MSW, LMSW is a Supervisor at the Kids-TALK Children's Advocacy Center (a program of The Guidance Center) in Detroit and is a Licensed Macro and Clinical Social Worker. She earned her Master of Social Work degree in Community Organizing and Interpersonal Practice from the University of Michigan School of Social Work and teaches part-time at the University of Michigan-Dearborn College of Education, Health and Human Services. Lacea Zavala serves as a Board Member of Child's Hope and the Mayor's Task Force for the Well-Being of Children and Families. She can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 734-785-7705 x7291.

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