For Your Health: Safe sleep for infants

Megan Horstman
Megan Horstman


At the Cole County Health Department, we have a motto of "prevent, promote, protect." The health department is involved with many different aspects of public health, including the promotion of safe sleep for infants. By educating the community about safe sleep practices, the health department is playing a vital role in preventing sleep-related infant deaths and protecting the lives of babies.

The Safe to Sleep campaign originally began in 1994, and its emphasis was on educating the public that babies should be placed to sleep on their back. This continues to be the recommendation today, and is an essential component of safe sleep education. The "ABC's of safe sleep" is an acronym that has become widely used to simplify the basics of safe sleep for babies:

(A) Alone -- Babies should always sleep alone. Co-sleeping has been linked to increased risk of suffocation, strangulation, and Sudden Infant Death Syndrome (SIDS). However, it is encouraged that the baby's crib share a room with the parents until the first birthday.

(B) Back -- Babies should sleep flat on their back. Putting a baby to sleep on its back is the number one thing that a parent can do to reduce the risk of SIDS. Stomach sleeping has been linked to overheating and rebreathing exhaled air, which can lead to decreased oxygen levels and increased levels of carbon dioxide. The American Academy of Pediatrics (AAP) does not support the use of positioner pillows or wedges that incline infants, even those with reflux.

(C) Crib -- Babies should sleep in a crib every time they sleep. The crib should contain only a tightly fitted crib sheet. Loose items such as blankets, pillows, stuffed animals, or crib bumpers pose a risk of suffocation and should not be in the crib. Zip up or Velcro sleep sacks are a safer alternative to loose blankets, because babies cannot easily get these over their face. Experts also caution parents to not overdress babies, because if they get too hot while sleeping it increases the risk of SIDS.

There's an abundance of evidence to support that when the ABC's of safe sleep are followed, the risk of sleep-related injury and death is greatly reduced. However, we also know that there are several obstacles that the community faces when it comes to safe sleep. The first challenge is a lack of knowledge. Some families do not receive this information during prenatal care visits, while other families may struggle getting access to healthcare during pregnancy due to transportation or financial challenges. Other barriers that exist include cultural practices and traditions and parental anxiety.

The health department recognizes these obstacles and works with the Safe Cribs for Missouri Program to help families create safe sleeping environments. This is a grant funded program that provides portable cribs to low-income families in Missouri. For families located in Cole County with transportation challenges, home visits are offered. To qualify for the program, an applicant must meet the following requirements:

Client must be a Missouri resident who is between 34 weeks gestation, and 6 months postpartum.

Client must be eligible for WIC, Medicaid, or have an income below 185 percent of the federal poverty level.

Client does not own a crib, and has no other means of obtaining one.

Client must agree to participate in two short safe sleep education sessions.

If you are a Missouri resident and would like more information on the Safe Cribs for Missouri Program offered at the Cole County Health Department, please reach out to Megan at [email protected] or 573-636-2181 ext. 3121.

Megan Horstman is a Registered Nurse at the Cole County Health Department. Megan has been a nurse since 2015, and has been with the Cole County Health Department for more than two years serving as the Child Care Health Consultant and Maternal Child Health nurse.