Safe sleep practices to follow for your children.

Infants and Babies

Because babies spend much of their time sleeping, the nursery – or their sleeping environment –  should be the safest area in the house.

According to the Centers for Disease Control and Prevention (CDC), there are about 3,500 sudden unexpected infant deaths (SUID) in the United States. These deaths occur among infants younger than one. Two main causes include sudden infant death syndrome (SIDS) and accidental strangulation or suffocation in bed.

SIDS is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. Though the exact cause of SIDs is unknown, research shows parents and caregivers can help reduce its risk and that of other sleep-related deaths.

If you just had a baby, are expecting, or are taking care of a young infant it’s important to implementing safe sleep practices including:  

• Placing a baby on its back to sleep – Infants should be placed for sleep on their back for every sleep by every caregiver until the child reaches one year of age. Side and stomach sleeping is not safe and is not advised. Infants should never be left to sleep on sofas, armchairs, or in sitting devices.

• Removing suffocation hazards – A firm mattress and fitted sheet are all you need for your baby’s crib. Remove soft bedding, blankets, pillows, toys, crib bumper pads, pacifier clips, or any other items that could obstruct infant breathing or cause overheating should be in the bed.

• Avoiding bed sharing – Infants should sleep in the parents’ room, close to the parents’ bed but on a separate surface (room sharing). The infant’s crib, portable crib, play yard or bassinet should be placed in the parent’s bedroom for at least 6 months but preferably a year. The Consumer Product Safety Commission (CPSC) offers safety standards for bedside sleepers. There are no safety standards for in-bed sleepers.

Toddlers and Young Children

The move from a crib to a bed doesn’t come at the same time for everyone. If a child is comfortable in a crib, there’s no need for a move, but some children are ready sooner than others. Here are some safety considerations to make before your child graduates from a crib to a toddler bed or kid-sized bed:

• Does your child climb out of the crib? Ideally, babies would remain in their cribs closer to pre-k age, but the switch should happen before a child begins to climb out of the crib and possibly hurt themselves. Most toddlers have the ability to climb out of a crib when they are 35 inches tall. Keep the crib mattress on the lowest setting to make it harder to climb out.
• Is the bed safety certified? Keep it low to the ground and make sure it comes equipped with guardrails to keep your child from falling out. Check for a sticker from the Juvenile Products Manufacturers Association (JPMA) on the bed and any portable rails you purchase.
• Remove all hazards from the child’s room and the rest of the home. Once the crib bars are removed, your child is no longer confined to a small space. They’re given a newfound freedom to explore their bedroom – and the whole house, for that matter.
• A big kid bed should be positioned in the center of the room, if possible, or at least a few feet away from a wall. Even at this older age, there is still a risk of suffocation if they become trapped between the wall and the bed.
• Ensure that window blind cords or electronics cords like baby monitors, which can be strangulation hazards, are out of reach. Watch for items that your toddler might be able to pull into bed, like picture frames, lamps, etc.
• Secure the stairs with gates at the top and bottom, bolt bookshelves and televisions to the wall, and put safety latches on dresser drawers so they can’t pull them out and use them to climb.
• Consider using a monitor or attach bells to the door so you know when your child leaves the bedroom.

Car seat use reduces the risk for injury in crashes by 71% to 82%.

Choosing the Right Car Seat for Your Child

Car crashes are a leading cause of injury or death for children. The CDC states that car seat use reduces the risk for injury in crashes by 71% to 82% for children when compared with seat belt use alone. Did you know that more than half of car seats are not used or installed correctly?

The best way to keep your child safe every time you get in a vehicle is to ensure that you’re using the right car seat and that you’re using it the correct way. It can be overwhelming and intimidating, so parents, expectant parents, caregivers should take the time to research available options and find the seat that is appropriate for your child’s age, weight, and height (as well as your car model). 

There are a variety of car seat options available for parents, and one size does not fit all. Here’s a look at some of the options available:

• Infant Carriers (rear-facing)
• Convertible Car Seats (rear-facing and forward-facing)
• 3-in-1 Seats (rear-facing, forward-facing, and booster)
• Booster Seats 

Car seats come with a user manual with detailed instructions for installing and buckling your child. The National Highway Traffic Safety Administration also maintains a directory of many car seat inspection stations. More detailed information can be found in the Resources section.

Staying Safe in the Seat

Choosing and installing a car seat is definitely a large part of the process to keep your child safe in the car, but it doesn’t stop there. Each time you leave the house in a vehicle, you need to check that your child is strapped in correctly and external factors do not impact the efficacy of the seat. 

Here are some things to consider: 

• Bulky clothing, including winter coats and snowsuits, can compress in a crash and leave the straps too loose to restrain your child, leading to increased risk of injury. Ideally, dress your baby in thinner layers and wrap a coat or blanket around your baby over the buckled harness straps if needed.​ Car seat safe coats also are popping up on the market. Learn more Winter Car Seat Safety Tips from the American Academy of Pediatrics and Pennsylvania’s Promise for Children.
• Do not place padding under or behind your child or use any sort of car safety seat insert unless it came with the seat or was made by the manufacturer for use with that specific seat. When you add comfort items (like custom car seat covers, head supports, strap covers and winter inserts), you’re changing the way the seat fits and protects your child. 
• Be wary of toys in the car. Choose toys that are soft and will not hurt your child in a crash. Secure any loose objects in the car
• Never leave your child alone in the car. 
• Allow time for snacking before you get in the car. It’s hard to attend to a child who is choking when you are driving, so it’s best not to give food in the car. If a child needs to eat during a long trip, stop or offer a liquid or a pouch in the car to reduce the risk of choking. 
• Do not use seats that have been in a moderate or severe crash. Seats that were in a minor crash may still be safe to use, but some car safety seat manufacturers recommend replacing the seat after any crash, even a minor one. The NHTSA considers a crash minor if all the following situations are true:
  • The vehicle could be driven away from the crash.
  • The vehicle door closest to the car safety seat was not damaged.
  • No one in the vehicle was injured.
  • The airbags did not go off.
  • You can’t see any damage to the car safety seat.

Safety on Public Transportation

Travel with children isn’t always limited to cars. Parents and caregivers might have to take their young children on other forms of transportation such as airplanes, buses, or trains. The following resources outline safe guidelines:

• Airplane Travel
  • The Federal Aviation Administration – Flying with Children 
  • The American Academy of Pediatrics – Family Friendly Flying
  • The National Transportation Safety Board – Child Passenger Safety on an Aircraft
• School Bus Safety
  • National Highway Traffic Safety Administration – School Bus Safety
  • Safe Kids Worldwide – Pre-school and school age children on school buses
• Public Transportation
  • Everything You Need to Know About Using a Car Seat on Public Transportation