Protect Your Child: Know the ABC’s of Safe Sleep


Dr. Thomas Spence, McLeod Pediatric Associates of Florence

Despite continuing progress in reducing infant mortality and Sudden Infant Death (SIDs) in South Carolina, sleep-related infant deaths continue to be a significant problem.

Following a 1992 recommendation by the American Academy of Pediatrics to place babies on their backs to sleep, deaths from SIDS began to drop. Unfortunately, the number of South Carolina infant deaths due to sleep-related suffocation or entrapment in the beds doubled in a six-year period beginning in 2004.

Safe Kids Worldwide reports that nearly 75% of suffocation infant deaths are due to choking or strangulation in bed. For children under age one, unintentional suffocation is the leading cause of injury-related deaths. Babies aged two to four months are most at risk.

Statewide efforts promoting Safe Sleep have started making inroads into sleep-related deaths.

To keep those numbers going in the right direction and your baby healthy, follow these ABC’s of safe sleep. Your baby should sleep Alone on her/his Back in a Crib.

Your baby should NOT sleep in your bed (also called co-sleeping or co-bedding). Your baby is not strong enough to hold his/her head flat on an adult bed. As a result, your baby is at an increased risk of bending their neck, which blocks their windpipe. In addition, an adult in deep sleep can roll over on the baby, causing suffocation. 

The same holds true for sleeping on a chair or couch – DON’T SLEEP WITH THE BABY. Instead, put the baby’s crib nearby or in your bedroom (also called room sharing or co-rooming). 

Remove pillows, stuffed animals, bumpers, wedges, quilts, comforters and blankets from the crib. Also, make sure there are no light or blind cords within reach of the crib that could tangle or choke the baby.

Since 1992, we’ve known that babies should sleep on their backs, avoiding chances for their mouths and noses becoming buried in bedding. They can get plenty of “tummy time” when awake, playful and monitored by an adult or a trained sitter.

Again, NO adult beds, chairs or couches for baby sleep time. A safety-approved crib with a firm mattress and tight fitting sheet is recommended. A bassinet or pack-n-play are also approved sleeping furniture. Keep in mind that the bassinet should be discontinued once the baby can attempt to roll over.

Always place your baby on his/her back for every sleep time – during the day and at night.

Remove all loose bedding, blankets, stuffed animals, bumper pads, wedges, and pillows from your baby’s crib to maintain an uncluttered sleeping area. Also, avoid overheating by keeping the room temperature at a comfortable setting for you.

A sleepsack – or wearable blanket – is a good option if you’re concerned about your baby getting cold. In any case, use light sleep clothing with the tags, ties and strings removed from the sleepwear, nighties or pajamas.

Spread the Word
Share this simple message with everyone who cares for your baby or for any baby under one year of age to help reduce the risk of SIDS and other sleep-related causes of infant death. Help family members, babysitters, child care workers, and everyone you know ensure a safe sleeping environment for your baby.

For more helpful information on Safe Sleep, please visit

Sources include: McLeod Health, American Academy of Pediatrics, Safe Kids Worldwide, Cribs for Kids, March of Dimes, SC Dept. of Health & Environmental Control, Children’s Trust of SC, Eunice Kennedy Shriver National Institute of Child Health and Human Development

Dr. Thomas Spence cares for children at McLeod Pediatric Associates of Florence. Dr. Spence attended medical school at the University of Texas Medical School at Houston in Houston, Texas, where he also completed a residency in Pediatrics. To make an appointment with Dr. Spence, please call (843) 777-5065 or 777-7602.