Safe Sleeping
AMENDMENT
Additional information was added to this chapter in November 2023.1. Introduction
This chapter aims to provide advice, guidance and support to practitioners to enable them to provide a consistent message to parents and carers regarding safe sleeping arrangements for children.
Every year in the UK 300 babies die suddenly and unexpectedly in their sleep. While there is no advice which can guarantee the prevention of sudden and unexpected death in infancy (SUDI), also referred to as sudden infant death syndrome (SIDS), there are a number of things that can be done to reduce the risk, both at nap time and bedtime.
National advice on reducing the risk of SIDS and other fatal sleep accidents has been clear and consistent over many years. A national review into SUDI in families where the children are considered at risk of significant harm noted that while there is no evidence that this advice is not given routinely, it is not, for whatever reason, clearly received or acted on by some of those families most at risk (National Child Safeguarding Practice Review Panel, 2020). It is important therefore to reflect on how safer sleep messages are communicated to families.
Evidence shows that interventions are most effective when they are personalised, culturally sensitive, enabling, empowering, relationship building, interactive, accepting of parental perspective, non-judgemental and are delivered over time (National Child Safeguarding Practice Review Panel, 2020).
The Lullaby Trust identifies the following principles that should be applied when discussing safer sleep with families. These principles are also reflected in the NICE guidance on behaviour change:
Be open and non-judgemental
Creating an environment where families can discuss their situations and concerns without fear of judgement is crucial.
Focus on assessing needs rather than making assumptions. For example, breastfeeding families are not automatically 'safer' co-sleepers and neither are formula fed babies always at a much higher risk. Both groups need guidance that's tailored to their needs.
Shock messages that increase fear do not work. For example, shocking messages that imply that all/any co-sleeping leads to death are not helpful. They do not reflect the evidence, and they frighten parents and staff, induce guilt and limit honest conversations (UNICEF, 2019).
Explore
A relationship-based approach – developing supportive yet challenging relationships – can facilitate more effective safer sleep conversations. Parents are more likely to act on advice from someone they trust and believe.
Safer sleep conversations and advice should be tailored to each family's needs. Take time to understand the family's experiences and circumstances. What is influencing the family's sleep practices?
Conversations should combine empathy and support with appropriate challenge. Do not be afraid to tell families if their circumstances mean their baby is at higher risk.
Remember that it isn't helpful to tell parents what they must or mustn't do; instead, listen carefully and offer information appropriate to their needs (UNICEF, 2019).
Plan
It may be necessary to focus safer sleep conversations and information on risky situations, and to initiate 'what if' discussions about arrangements to ensure a safer sleep environment. Every family needs a plan to avoid potentially hazardous sleep situations on those occasions when something different happens.
For example, questions could include: what's happening tonight? Having a drink? Going on holiday or staying with friends? Letting your partner sleep? What's the family's plan if baby is unwell?
Explain
We know from research and discussions with parents that they are much more likely to follow advice if they understand the reason.
It might be helpful to some families to explain normal baby behaviour and discuss expectations. Acknowledge that young babies wake and feed frequently in the night and that this is normal and not modifiable, as young babies are not capable of 'learning' to defer their needs. Accepting this reality can be helpful, as parents are reassured that their baby is normal and they aren't doing anything wrong. It can also relieve the pressure to find 'solutions' (UNICEF, 2019).
Give clear advice
Information must be provided in such a manner that it is understood by the baby's carer. For those babies' whose carers do not understand English, an approved interpreter should be used where possible and appropriate. Families with other language and communication needs, including learning disabilities, should be offered information in such a way to aid understanding.
National Information
Local Information
Safer Sleeping Week Presentation
Note: this Presentation is also available on request from STSCSAP@southtyneside.gov.uk
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