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2.2.43 Reducing the Risks to Babies


Postnatal care up to 8 weeks after birth - NICE Guidelines CG37

NICE has published updated guidance which includes recommendations on co-sleeping with babies. The guidelines advises healthcare professionals to inform parents that the risk of sudden infant death syndrome (SIDS) is greatest during co-sleeping when the parents smoke or have recently consumed alcohol or drugs, or the infant was premature or had a low birth weight.


The link to Nice Guidance CG37 was updated in October 2016.

More than 300 babies die suddenly and unexpectedly every year in the UK. Since parents and carers have been following the risk reduction advice, the number of babies dying has fallen by over 70%.

All professionals that work with families that have young children and have access to family homes should be aware of the risk indicators associated with sudden infant death syndrome (SIDS) and safer sleeping advice.

Whenever an assessment is completed by any professionals working with a family within the family home (or in the community), especially when there are babies, reference should be made to children’s sleeping arrangements and any safer sleeping/safe baby advice that has been given.

Professionals should directly challenge / advise parents / carers, when the risk factors associated with Sudden Infant Death Syndrome (SIDS) / Sudden Unexpected Death in Infancy (SUDI) are present.

These include:

  • Babies sleeping in a room on their own (under the age of 6 months);
  • Babies being put to sleep on their front or side;
  • Babies sleeping in adult beds or on sofas;
  • People smoking around the baby or in the baby’s room;
  • Parents co-sleeping with babies. This is especially important when the parent smokes, has been drinking or using other substances, is taking medication and/or the baby is premature (before 37 weeks) and had a low birth weight (less than 2.5kg or 5 1/2lb);
  • Duvets lining cots and/or the use of “cot bumpers”;
  • Babies sweating in their bedclothes or being put to bed in restrictive clothing;
  • Cots being placed next to radiators or in direct sunlight.

Any advice given to parent/families by professionals concerning safer sleeping guidelines should be recorded.

Midwives should aim to give parents safer sleeping advice in the antenatal and postnatal period. Health visitors should reinforce this message along with advice to help keep babies safe and healthy.

This advice should include:

  • The safest place for babies to sleep is in their own age-appropriate bed in the same room as their parents, for at least the first six months;
  • Never sleep with their baby on a sofa or armchair;
  • Babies should be put on their back to sleep;
  • Babies should be placed in their cots with their feet to the foot of the cot;
  • Blankets and not duvets should be used in their cots;
  • Bedclothes should be firmly tucked in and no higher than a babies shoulder;
  • A baby’s mattress should be firm and fit the baby’s cot without any gaps (or less than 3cm from the cot edge);
  • A baby’s head should not be covered;
  • Avoid exposing babies (and children) to any cigarette smoke and do not smoke in the room they sleep in;
  • The use of a room thermometer is recommended and the room should be between 16 and 18 degrees centigrade;
  • The use of a dummy reduces the risk of cot death. If breastfeeding this should be delayed until the baby is one month old and weaning off should be between 6 months to a year;
  • Breastfeeding has associated health benefits for babies;
  • That a baby’s immunisations should be up to date and they should be taken for checkups;
  • Babies need time to have supervised play on their front (“Tummy Time”) to ensure muscles develop properly and to avoid the risk of misshapen heads.