Having a safe sleep policy can help your program maintain a safe sleep environment, which can reduce the risk of Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Infant Death (SUID) in infants less than one year of age.


SIDS is the sudden and unexplained death of an apparently healthy infant younger than one year of age that remains unexplained after a thorough case investigation which includes performing a complete autopsy, examining the death scene and reviewing the clinical history. 


SUID is the sudden and unexpected death of an infant in which the manner and cause of death are not immediately obvious prior to investigation. Causes could include, but are not limited to, metabolic disorders, hypothermia, hyperthermia, neglect, poisoning and accidental suffocation.

Reduce the Risk

SIDS is not preventable; however there are many ways for parents and caregivers to reduce the risk of SIDS and other sleep-related causes of infant death.  Following risk reduction recommendations will give all infants the best chance for safe sleep. These risk reduction recommendations should be included in a safe sleep policy.

Benefits of Safe Sleep Policy

  • It may help save babies' lives
  • Shows parents that their children's health and safety is a top priority
  • Can further educate parents and other staff in your program about safe sleep
  • Empowers caregivers to follow proper standards of care

Contents of Safe Sleep Policy

  • Infants will always be placed to sleep flat on their back
    •  Swings, car seats, bouncy seats, rock’n plays, boppy pillows, infant slings, strollers and other containment devices should not be used for sleep - neither should couches or adult beds.
  • Use of safety approved cribs and firm mattresses with a tightly fitted sheet
  • Obtaining a physician’s note for non-back sleepers
    • An alternative sleep position requires a written and signed physician’s note which identifies the medical reason why the infant is sleeping in a position other than on their back. The physician’s note should be reviewed periodically, have an expiration date and be signed by the pediatrician or family doctor that is listed on the infant’s enrollment physical.
    • A physician’s note for alternative sleep positions should only be used when the risk of the medical condition is greater than the risk of SIDS.
  • Nothing in the crib with the infant other than a tight fitted sheet
    • No toys, stuffed animals, pillows, bumper pads, blankets, soft bedding, etc. should be used.
    • Infant positioners and wedges should not be used. Research has found no evidence these devices are safe and their use could increase risk of suffocation or overheating.
  • Sleeping only one infant per crib
  • Room temperature is comfortable for a lightly clothed adult
    • A sleeper or other sleep clothing can be used as an alternative to blankets to keep baby warm and safe during sleep.
  • Pacifiers can be used for sleeping
    • Pacifiers cannot be attached to the infant’s clothing in any way.
  • Child Care Environments must be smoke free
    • 1st, 2nd and 3rd hand smoke put infants at a higher risk.
  • Sleeping infants will be monitored
    • Infants should be actively observed by sight and sound.
  • Supervised tummy time for infants while they are awake
  • How all staff are educated about safe sleep policy and practices
  • Parents given a copy of safe sleep policy

On average, 40-45 infants in Iowa die each year due to sleep related deaths, some of which happen while the infant is in the care of someone other than their parents. It’s important you as the caregiver know how to follow safe sleep policies and implement them in your program. Healthy Child Care Iowa offers an example of a safe sleep policy which can be used as a guide in creating your own safe sleep policy.

A helpful resource regarding Safe Sleep can be found on the Iowa CCR&R website here

More information about Safe Sleep Policies can also be found on the Caring for Our Children website here.

If you need assistance creating, enhancing or implementing your safe sleep policy, or if you have questions about safe sleep, contact your local CCR&R Child Care Consultant. Our mission is to provide resources, education and advocacy to support quality child care. CCR&R is committed to ensure that Iowa’s vision is met: All children, beginning at birth, will be healthy and successful.

Eunice Kennedy Shriver National Institute of Child Health and Human Development
Iowa Department of Public Health, Healthy Child Care Iowa
Safe Sleep 2015, SIDS Education Training


Tags: Safe Sleep, SIDS, SUID

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