Hospital Policies and Practice Guidelines for Infant Sleep

Healthcare providers including hospital staff must role model implementation of safe sleep guidelines. 
Multiple studies have demonstrated that hospital staff members - including Neonatal Intensive Care Unit (NICU) and post partum nurses - often give inconsistent and sometimes inaccurate information to new parents regarding safe sleep for infants. In fact, studies have found that NICU staff consistently identify non-supine (prone or side-lying) positions as preferable or safer for preterm, hospitalized infants.
Premature babies are already at increased risk of SIDS. Their risk is further increased when they continue to be placed in prone position by their parents after discharge due to modeling of behavior from the hospital. It may be particularly difficult for parents to put infants in supine position even if they know and understand this to be the safest position for infant because the infant has become used to prone position at hospital. An important part of discharge planning for infants who have been placed to sleep in prone position in the NICU should be a transition to supine sleeping position as soon as possible. 
It is essential that hospitals that provide care to mothers and infants institute strategies for education of hospital personnel and policies and procedures that promote safe infant sleep practices.
Birthing hospitals and hospitals with Neonatal Intensive Care Units should evaluate their in-house policies, practices and parent education with the goal of implementing (or strengthening) infant safe sleep practices and education.  Safe sleep policies should mandate:

  • Provision of standardized patient education, including written instructions on safe sleep and safe bedding;
  • Consistent use of role modeling of safe sleep practices; and,  
  • Referrals to resources for obtaining a safe sleeping surface and/or a sleeping sack.

Sample hospital policies are included here. 
Model Behavior- Sample Policy and Procedures: Safe Sleep Practices for the NICU- From First Candle
Model Hospital Policy and Tool Kit – From Pennsylvania Chapter of AAP
These are meant to serve as examples of guidelines that hospitals/practices can review and customize. Prior to implementation of such policies/guidelines, hospitals should ensure that recommendations are up-to-date and consistent with other hospital guidelines and policies and in-line with recommendations from guidelines from professional organizations/associations such as those from the American Academy of Pediatrics.
American Academy of Pediatrics (AAP) Policy Statement: The Changing Concept of Sudden Infant Death Syndrome