Back to Sleep
Always place your baby on his/her back for sleep times, both naps and at night. Back sleeping has been shown to reduce the risk of sudden infant death syndrome (SIDS), the sudden, unexplained death of a baby younger than 1 year of age. SIDS is the leading cause of death in babies 1 month to 1 year of age, with most SIDS deaths happening between 1 – 4 months of age (See safetosleep.nichd.nih.gov). Babies who sleep on their backs are much less likely to die of SIDS than are babies who sleep on their stomachs or sides.
A Safe Sleep Surface
The sleep surface (crib/bassinet) that your baby sleeps on should be firm and should not have any bumpers, pillows, blankets quilts, sheepskins, loose bedding or soft toys in it. Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you or with anyone else. If you bring your baby into your bed to feed, make sure to put him or her back in a separate sleep area, such as a safety-approved crib or bassinet. For information on crib safety, contact the Consumer Product Safety Commission.
Sleep-related causes of infant death are those linked to how or where a baby slept. They are due to accidental causes, such as:
- Entrapment, when baby gets trapped between 2 objects, such as mattress and wall and can’t breathe
- Strangulation, when something presses on or wraps around baby’s neck, blocking a baby’s airway.
Keeping your baby’s sleep area in the same room where you sleep has been found to reduce the risk of SIDS and other sleep-related causes of infant death.
Sleep Patterns/States of Arousal
Preterm babies sleep longer than full-term babies. Their sleep is characterized by much motor activity. On average, preterm babies spend approximately 80% of their sleeping time in the more disorganized state of active sleep compared with full-term babies, who spend 50% of their overall sleeping time in quiet sleep (deep sleep). Periods of quiet alertness are brief and sporadic in preterm babies. The ability to maintain periods of quiet alertness is a high-level task for premature babies. Good quality alertness increases closer to term.
Babies continually transition from state to state. They have a range of six levels of alertness: quiet sleep, active sleep (preemies spend most of their time in this state), drowsy, crying/fuss, quiet alert and active alert. Your baby may signal changing states by crying or going from sleep to drowsy to quiet alert.
When responded to, your baby can calm down, organize himself, and be able to engage with his caregiver and maybe enjoy a meal. After the baby has eaten enough or he can’t focus anymore, he moves back to a drowsy state or moves to active alert state and may need help (soothing, holding, sucking) to transition back to sleep. Encourage sucking, which helps babies:
- Regulate themselves
- Transition between states