Safe sleep

Sudden Unexpected Death in Infancy (SUDI) includes:

• deaths that can be explained (for example, suffocation or accidental choking) and
• deaths that cannot be explained (for example Sudden Infant Death Syndrome (SIDS) or cot death).

Most SUDI is explainable and happens when a baby is asleep in an unsafe sleeping environment. Common causes are suffocation by bedding or accidental smothering by an adult or child who is sleeping with the baby.

In New Zealand about 60 babies per year die suddenly and unexpectedly in their sleep, and most of these deaths are preventable. SUDI can occur at any time between one week and one year of age, however most deaths occur before the age of six months with the highest concentration occurring between two months and four months of age.

Babies 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 other children
• are not breastfed
• are born to a mother who smoked during pregnancy
• are born to a young mother
• were exposed to drug and/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 (unsafe positioning, loose covers, soft bedding).

The key message is: make sure that baby is safe for every sleep in every place.

This means:

• Own bed
• Face up
• Face clear
• Smoke free

Own bed

Babies need a firm flat surface, with no soft bedding, pillows, sheepskins or stuffed toys. Babies should never sleep on a soft mattress, couch, beanbag, or waterbed. Wahakura and pēpi-pods® are two options for providing a safe sleep surface for baby.

Hāpai — SUDI Prevention Coordination Service

Pepi-Pod® sleep space programme

Face up

Babies are designed to sleep face up (on the back). Their drive to breathe works best in this position and their airway is also safer. A built-in alarm reminds them to breathe, and strong gag and swallow reflexes protect their airway if they spill. There will always be babies with special needs, and a different sleep position may be part of their care for a time. Your baby's doctor can advise you.

Face clear

Babies are designed to sleep with a clear face. This helps them breathe freely and not get too hot. How babies are put to sleep can help ensure their face stays clear.

Smoke free

Babies are designed to grow and develop smoke free. All smoking harms babies, especially in pregnancy. Smoking takes oxygen and weakens vital systems as babies develop. When born, such babies need extra protection.

• Keep baby close by. Research has shown that sleeping baby in the same room, but not in the same bed, in the first six months of life is protective.
• Avoid overheating baby. Natural fabrics are best for baby's bedding to avoid overheating.
• Babies should never be left to sleep in a position where their head can drop forward and block their airway, such as in car seats.
• Handle baby gently (to protect their brain).

A number of babies that come into Oranga Tamariki care will carry with them characteristics that make them more vulnerable to SUDI. This may include having a low birth weight, a young mother, a mother who smoked during the pregnancy or other health issues. Additionally, Māori and Pacific Island babies are at more risk.

When completing an assessment with a family/whānau it is important to be mindful of SUDI risk factors in order to support the family/whānau or caregiver to find ways in which they can be addressed. This includes ensuring they have safe sleep equipment and where necessary arranging provision of a pēpi-pod®.

If the baby is in care it is important that the caregiver follows the policy about safe sleep and smoke free to ensure the baby has a safe sleeping and smoke free environment and is aware of how to address any concerns.

Change for Our Children

Change for Our Children delivers safe sleep information and the Pepi-Pod® sleep space programme. Pepi-Pod® sleep spaces started as emergency beds for vulnerable babies in Christchurch, following the 2011 earthquakes. Now some regions of New Zealand are making these available to local babies most at risk of sudden infant death.

Phone: 03 379 6686

Change for our children

Hāpai — SUDI Prevention Coordination Service

Hāpai is responsible for coordinating a national, integrated approach to SUDI prevention in Aotearoa. Their whakapapa as a Māori public health organisation over 20 years drives their philosophy which places health and wellbeing of tamariki, mokopuna and whānau at the centre of everything they do.

Their goal is to reduce the incidence of SUDI in Aotearoa across all our communities. To achieve this they work with local coordinators and national experts to coordinate evidence based, best practice solutions with the purpose of assisting whānau, health professionals and communities to reduce the incidence of SUDI.

Phone: 09 520 4796

Hāpai — SUDI Prevention Coordination Service

SIDS and Kids

SIDS and Kids