Caregiver TIPS
Reducing the Risk of SIDS
and Unintentional Death in the Sleep Environment

What is SIDS?  SIDS is a term used to describe the sudden, unexplained death of an infant under one year of age. SIDS stands for Sudden Infant Death Syndrome.  Here are some tips to help reduce the likelihood of an infant dying while in child care.


  • Develop and follow a policy regarding sleep position in your child care setting
  • Discuss your policy with parents before enrollment
  • Require a written medical statement  from a doctor for babies that require an alternate sleep position
  • Place babies on their backs to sleep for every nap and at nighttime for the first year
  • Use a crib that meets current safety standards. For guidelines on current crib safety standards please visit the Consumer Product Safety Commission at:
  • Use a firm mattress with a snug-fitting sheet in the crib
  • Dress the child in clothing appropriate for temperature  
  • Require a physician’s recommendation (kept on file) for the very small percentage of babies who tummy sleep because of a physical condition
  • Require a general physical and up-to-date immunizations in your admission procedures
  • Consider use of a sleep sack for infants (wearable blanket) instead of loose blankets
  • Consider pacifier use after discussing with parents


  • Don’t smoke around infants or care for infants in areas where smoking occurs
  • Don’t place babies on soft surfaces such as waterbeds, pillows, or beanbag chairs
  • Don’t place soft materials in the crib (stuffed animals, quilts, bumper pads, pillows)
  • Don’t use positioning or propping devices
  • Don’t leave an infant sleeping in a car seat or swing
  • Don’t overheat the sleeping area or overdress an infant
  • Don’t force a pacifier on an infant
  •  Don’t put baby to sleep wearing a bib


Choose a safety-approved crib that meets current Consumer Product Safety Commission (CPSC) and American Society for Testing and Material International (AMST) standards.

• If you purchased a crib prior to the June 28, 2011 effective date and you are unsure if it meets the new federal standard, CPSC recommends that you verify that the crib meets the standard by asking for proof.

Ask the manufacturer, retailer, importer, or distributor to show a Certificate of Compliance. The document must provide the following information:
•    Description of the product
•    The name, full mailing address, and telephone number for importer or domestic manufacturer
•    Identification of the rule for which it complies (16 CFR 1219 or 1220)
•    The name, full mailing address, e-mail address, and telephone number for the records keeper and location of testing lab
•    The date and location of manufacture and testing

The crib must also have a label attached with the date of manufacture.

For mesh-sided cribs or playpens, look for:
•    Mesh less than ¼ inch in size; smaller than the tiny buttons on a baby's clothing
•    Mesh with no tears, holes, or loose threads that could entangle a baby
•    Mesh securely attached to top rail and floor plate
•    Top rail cover with no tears or hole
•    If staples are used, they are not missing, loose, or exposed

Check the website to make sure the equipment has not been recalled.

Note:  A three-year study on infant sleeping positions in child care settings showed that the overriding risk factor for SIDS was placing a baby on its tummy during naptime when the baby normally slept on its back (Mitchell, Thach, Thompson & Williams, 1999). Always place an infant on his or her back to sleep.

If you need assistance, please call the Infant Toddler Specialist at your local Child Care Resource and Referral agency.  To locate your specialist, visit and find your CCR&R or contact the Indiana Association for Child Care Resource and Referral at 800-299-1627.

Mitchell, E. A., Thach, B. T., Thompson, J. M., & Williams, S. (1999) Changing infants’ sleep position increases risk of sudden infant death syndrome: New Zealand cot death study. Archives of Pediatric & Adolescent Medicine; 153(11):1136–1141.