Safe sleep

Safe sleep is a difficult topic for infants that have additional needs. Firstly, it is important for all health care professionals to be understand and keep up to date with safe sleep advice.  Understanding the reasons why this advice is given and evidence supporting it, will ensure there is a consistent message.  

Secondly, it is important to note that families who spend time on a neonatal unit are less likely to follow safe sleep guidance (people will often model what they see, rather than follow advice).  This paper below is a helpful guide to topics often difficult to discuss with families around safe sleep.

Thirdly, there are a very small number of infants for whom sleeping on their back may pose more of a risk than alternative sleeping positions.  This is rare and is usually secondary to neurological impairment and difficulty managing their own airway (for example some infants with severe Hypoxic Ischaemic Encephalopathy).  In these circumstances, planning for discharge home is very challenging, and all health care professionals involved in the child's care should discuss risks of recommending safe sleep advice as well as risks of alternative individualised recommendations.  If there is any advice given that does not fit with standardised safe sleep advice it is important that there is agreement across the team, honest and transparent conversations with families and consistent information shared with family and community teams.  These conversations should be documented clearly in the medical record alongside clinical reasoning supporting the decision, and agreement from the multi-disciplinary team.

The following resources will help to support a consistent message across your unit, and into community services.