babycity® X Safe T Sleep® collaborative blog 

Welcoming a new baby into the world is an exciting time, but it also brings a lot of new responsibilities and things to consider, especially when it comes to ensuring your little one’s safety when sleeping - this is one of the most important aspects of newborn care. In New Zealand alone, between 40-60 babies die each year from Sudden Unexpected Death in Infancy (SUDI) (Plunket, n.d; Environmental Health Indicators New Zealand, 2024). With most happening in the first 6 months of life, and at around 3-4 months being the highest risk period. Fortunately, many of these deaths can be prevented by following safe sleep practices. 

Understanding Sudden Unexpected Death in Infancy (SUDI) 

Sudden Unexpected Death in Infancy (SUDI) is the term which refers to any unexpected death of a baby during sleep. This can happen due to Sudden Infant Death Syndrome (SIDS), where no cause of death can be found, or accidental causes such as suffocation or overheating. While SUDI is rare, the risk is highest when babies are between one and six months old. 

What increases the risk of SUDI? 

Several factors can increase the risk of SUDI, with the most significant factors being an unsafe sleep environment, improper sleeping position especially for ‘young infants’ in the high-risk period and exposure to tobacco smoke during pregnancy or after birth (Environmental Health Indicators New Zealand, 2024; New Zealand College of Midwives, 2016; Plunket. N.d.). Being aware of these risks and taking care when putting your baby to sleep is essential for ensuring their safety.

Safe sleep tips for your baby 

To reduce the risk of SUDI, it’s crucial to create a safe sleep environment for your baby. Here are some essential tips to help: 

• Avoid tobacco smoke
  

  Babies who are exposed to tobacco smoke either during pregnancy or after birth are at a higher risk of SUDI. Eliminating smoking from your baby's environment is one of the most effective ways to protect them. Additionally, though the risks are still unknown, it’s important to be cautious about vaping, as the chemicals in vape and e-cigarettes may also pose a risk to your baby’s health. 

• Always place your ‘young’ baby on their back to sleep

  Back sleeping for young babies (under 9months) is the safest position during the high-risk period for SUDI. Once your baby is older and can roll from back to tummy and back again, they can sleep in their preferred position as long as the sleep space is free of loose items or choking hazards nearby. Be mindful of known risks such as pillows, soft toys, blind cords and low-hanging mobiles, which can be dangerous if within reach. 

• Place your baby in their own sleep space in the same room as you

  For the first six months, it’s recommended that your baby sleeps in their own bassinet or cot in the same room as you. While some parents choose to share their bed with their baby for cultural or maternal reasons, it’s important to note that bed-sharing increases the risk of SUDI by x5 times, particularly if you have been drinking, taking drugs or smoking. Using soft bedding or pillows in your sleep space also poses a high risk. If you wish to keep your baby close and co-sleep, we highly recommend a co-sleeper bassinet, like the Snuzpod4, phil&teds Traveller 4n1 travel cot or ORIGIN Morepork Co-Sleeper which are designed to provide a safe sleep space within arm’s reach and allow baby to have their own safe sleep space. 

• Use a firm and flat mattress

  Your baby’s mattress should be firm and flat, fitting snugly in their cot or bassinet. Soft sleep surfaces like waterbeds, sofas, beanbags, or overly soft mattresses can increase the risk of suffocation.

• Preventing Flat Head Syndrome (Positional Plagiocephaly)
  

  While back sleeping is safest for reducing SUDI risk, it’s important to also be mindful of the risk of flat head syndrome (positional plagiocephaly). This condition can occur when a baby’s soft head rests in the same position too often, which can cause a misshapen head and forehead, which in severe cases, may require medical intervention such as helmet therapy or surgery may be needed (Argenta et al., 1996; Turk et al., 1996). Early awareness can help ensure normal brain development and a nicely shaped head.
  Here’s some tips to reduce the likelihood of flat head syndrome: 
  • Use the Safe T Sleep HEADwedge: The little HEADwedge together with the Safe T Sleep Sleepwrap® helps prevent a flat/deformed head and encourages a nice head shape. It must be used in conjunction with the Safe T Sleep Sleepwrap®, as it tucks well underneath the Sleepwrap® to ensure it is not a ‘loose’ item in the bassinet or cot. 
  • Alternate your baby’s head position: Gently turn your baby’s head from left to right at each sleep to avoid constant pressure on one side. 
  • Encourage tummy time: When your baby is awake, offer tummy time to strengthen their neck muscles and relieve pressure on just one side or back of the head. 
  • Provide time off their back: Give your baby breaks from lying or sitting against the back of the head by holding them in different positions and engage them in upright play. 

• Keep the sleep area clear

  Be aware that babies have their own individual rolling and creeping capacities into awkward and potentially dangerous positions. Remove all pillows, loose bedding, toys and any other objects that could cover your baby’s face and cause suffocation. Loose or fluffy, non-breathable bedding and clothing can pose a significant risk also.

• Prevent overheating

  Dress your baby appropriately for the room temperature - use light, breathable clothing and avoid overdressing or using too many blankets. The Safe T Sleep Sleepwrap® has a specific fabric weve which is highly breathable with a 0.27 TOG rating and simply goes over whatever baby wears to bed. Common signs of overheating are sweating, damp hair, flushed cheeks or rapid breathing. To check your baby’s temperature, feel their core temperature (chest or back of the neck) with two fingers – these areas give you a more accurate indication than their hands and feet. If they feel as though they are overheating, adjust the number of layers immediately.

The Safe T Sleep® Sleepwrap® and little HEADwedge: A helping hand 

For additional peace of mind, consider using products like the Safe T Sleep® Sleepwrap®. Designed in New Zealand in 1976 and hospital clinically proven, the Sleepwrap® allows necessary body movements at each stage of development, including hip and limb movements. Sleepwraps are suitable for use with cots, bassinets, co-sleepers and beds and are widely recommended by hundreds of thousands of parents including medical health professionals worldwide. So easy to use, the Sleepwrap® simply goes over any modern or traditional swaddle, baby sleeping bags and any kind of sleepwear baby wears to bed. In addition to the safety and comfort benefits, the Sleepwrap® is also a highly practical, convenient, compact, lightweight and economical solution, fitting beds worldwide making it perfect for travel, holidays, and visits with your baby.

Using the Sleepwrap® and little HEADwedge together helps keep your baby’s face and head clear of any potential suffocation hazards, significantly reducing the risk of SUDI, whilst remaining in a comfortable position for a cosy and safe sleep. The little HEADwedge also ensures baby has a normal brain development and develops a nicely shaped head. The little HEADwedge tucks well underneath the Sleepwrap® and is therefore also not a ‘loose’ item.

References used to write this blog

Argenta, L., David, L. R., & Wilson, J. (1996). An increase in infant cranial deformity with supine sleeping position. Journal of Craniofacial Surgery, 7(1), 5-8.  

Environmental Health Indicators New Zealand. (2024). Sudden unexpected death in infancy (SUDI) report. https://www.ehinz.ac.nz/assets/Surveillance-reports/Released_2024/SUDI_released052024.pdf 

New Zealand College of Midwives. (2016). Safe sleeping for baby [PDF]. https://www.midwife.org.nz/wp-content/uploads/2019/05/Safe-Sleeping-for-Baby.pdf 

Plunket. (n.d.). SUDI - Sudden infant death. Plunket. https://www.plunket.org.nz/caring-for-your-child/safe-sleep/sudi-sudden-infant-death/ (Accessed 2 September 2024). 

Turk, A. E., McCarthy, J. G., Thorne, C. H., & Wisoff, J. H. (1996). The "back to sleep campaign" and deformational plagiocephaly: Is there cause for concern? Journal of Craniofacial Surgery, 7(1), 12-18. https://doi.org/10.1097/00001665-199601000-00006.