Safe sleeping

Upcoming changes for this guidance

This content will be strengthened so it more completely reflects our commitment to practice framed by te Tiriti o Waitangi, based on a mana-enhancing paradigm for practice, and drawing from ​Te Ao Māori principles of oranga to support mana tamaiti, whakapapa and whanaungatanga. We each need to consider how we can apply these principles to our practice when reading this guidance. The following resources provide support:
Practice for working effectively with Māori
Our practice shift

Sharing information about SUDI

We share information about Sudden Unexpected Death in Infancy (SUDI) with whānau or family and caregivers.

Most SUDI is explainable and happens when pēpi has an unsafe sleeping environment. Common causes are suffocation by bedding or accidental smothering by an adult or tamaiti who is co-sleeping with pēpi.

SUDI can occur at any time between 1 week and 1 year of age, with the highest concentration between 2 months and 4 months of age.

Hāpai — SUDI Prevention Coordination Service

SIDS and Kids

Risk factors for SUDI

When completing an assessment with a whānau or family or caregiver, we support them to address any SUDI risk factors. Pēpi are more vulnerable to SUDI when they:

• are born before 36 weeks
• have a low birth weight (under 2500 grams or 5.5 pounds)
• co-sleep with adults or tamariki
• are not breastfed
• are born to a mother who smoked during pregnancy
• are born to a young mother
• were exposed to drug or alcohol use during pregnancy
• are born to a mother who received late or no prenatal care
• have health issues
• are placed in unsafe sleeping situations (for example, an unsafe position, loose covers or soft bedding).

Keeping pēpi safe during sleep

We talk with whānau or family and caregivers about the importance of pēpi:

• having their own bed
• sleeping on their back with their face up
• sleeping with their face clear.

Own bed

Ideally, pēpi should sleep in the same room as their parents or caregivers for their first 6 months, but in their own bassinet, cot or other baby bed – like a wahakura and pēpi-pod®. (A wahakura or pēpi-pod® can also reduce the risk of suffocation if it’s used when pēpi is sharing a bed with adults or other tamariki.)

For tamariki in care, we ensure they have safe sleep equipment and where necessary a pēpi-pod®.

Pepi-Pod® sleep space programme

A safe bed for pēpi has:

• a firm and flat mattress to keep their airways open
• no gaps between the bed frame and the mattress that could trap or wedge pēpi
• cot bars that are around 50mm apart (the gap should be no more than 95mm).

Pēpi should also have their feet close to the end of the bed so they can’t burrow under the blankets.

Avoid soft or loose bedding, soft mattresses, pillows, sheepskins, bumper pads, and stuffed toys, as well as adult beds, couches, chairs, beanbags and waterbeds, and any position where their head can drop forward and block their airway – for this reason, pēpi shouldn’t be left to sleep in car seats. Also avoid amber beads and ‘teething’ necklaces while pēpi is sleeping.

Pēpi should be put back in their own bed after feeding.

Face up

Pēpi are designed to sleep face up (on their back). This will keep their airways clear.

A built-in alarm reminds them to breathe, and strong gag and swallow reflexes protect their airway if they vomit.

A doctor may recommend a different sleep position for pēpi with special needs.

Face clear

Keeping their face clear helps pēpi breathe freely and not get too hot.

Avoiding too many layers will also help keep pēpi from overheating, as will using clothing and bedding made from natural fibres. The room temperature should be around 20°C. An easy way to check their temperature is by feeling the back of their neck or their tummy (under the clothes) – they should feel warm, but not hot or cold.

Other ways to help protect pēpi from SUDI

We encourage homes and cars to be smoke free. All smoking harms pēpi (including during pregnancy). Smoking takes oxygen and weakens vital systems as pēpi develop. When born, these pēpi need extra protection.

We remind whānau or family and caregivers about:

• handling pēpi gently to protect their brain
• having someone look after pēpi who is alert to their needs and free from alcohol or drugs.