Frequently asked questions

About Safe Sleeping

What are the Safe Sleeping recommendations?

Since the Safe Sleeping recommendations were introduced in the early 1990s, the incidence of SIDS has reduced by approximately 85% in Australia.

The principles of safe sleeping are encapsulated in the BACK model, which is:

  • Sleep baby on the BACK on a clean, flat and firm mattress in his/her own safe sleep place from birth
  • Ensure AIRWAYS are kept clear – keep the sleep place free
    ALWAYS sleep your baby with head and face uncovered
  • Baby should sleep in his/her own safe COT in your room for the first six to twelve months.
  • KEEP baby smoke-free, before and after birth.

Other recommendations research has found to reduce the risk of SIDS and other fatal sleeping accidents include:

  • Breastfeeding baby as it offers the best form of nutrition and many other benefits for mother and baby
  • Using a cot that meets current Australian and NZ mandatory standards
  • Ensuring your baby’s sleeping place is FREE from soft toys, padded bedding, loose blankets, doonas or sheets, sheepskins or underlays, accessories such as pillows, bumpers, sleep nests or positioners
  • Using sleep wear, e.g. sleeping bag, that is the correct size for your baby and has fitted neck and armholes (or sleeves) and no hood, and no head coverings such as beanies or bonnets (especially with ties)
  • NEVER put baby on a sofa, armchair, beanbag, sleep nest or positioner, sling or cushion to sleep – these are not safe
  • Car capsules should only be used when travelling in a car, and baby placed in a cot at the end of the journey if asleep. Regular supervision when travelling is important



Why is BACK so important to infant safe sleeping?

Baby is safer sleeping on the BACK, not side or tummy. A baby placed on the side to sleep can be unstable and roll onto the tummy. A baby placed on the tummy to sleep does not have the upper body strength to turn his/her head so may suffocate. There is also the risk of re-breathing CO2, especially if he/she rolls against soft or padded items in the cot.



Won’t sleeping baby on the BACK increase the risk of choking?

Research[1] has shown that by placing baby to sleep on the back (supine), anatomically the food pipe lies below the windpipe and the little reserves (piriform fossae) provide a temporary reservoir for any regurgitation while baby is sleeping. Babies also tend to swallow more frequently on their back during sleep if posseting occurs. By tilting or elevating your baby, other risks can arise.

The recommendations are the safest way to sleep baby is on the BACK on clean, firm, flat surface with no toys, bumpers, soft comforters, loose bedding or accessories. Ensure baby’s head and face are uncovered. Keep baby smoke-free as parental smoking may also be a cause of GOR in babies[2]. Research has discovered breastfeeding reduces GOR[3]. After feeding, holding your baby before placing in a sleep environment for thirty minutes can help.

  1. Jeffery HE, Ius D, Page M. The role of swallowing during active sleep in the clearance of reflux in term and preterm infants. The Journal of Pediatrics. 2000;137(4):545-8.
  2. Alaswad B, Toubas PL, Grunow JE. Environmental tobacco smoke exposure and gastroesophageal reflux in infants with apparent life-threatening events. The Journal of the Oklahoma State Medical Association. 1996;89(7):233-7.
  3. Heacock HJ, Jeffery HE, Baker JL, Page M. Influence of breast versus formula milk on physiological gastroesophageal reflux in healthy, newborn infants. Journal of Pediatric Gastroenterology and Nutrition. 1992;14(1):41-6.



Doesn’t sleeping baby on the BACK cause ‘flat head syndrome’?

When baby is slept on the BACK and then also placed in the same position (back) on a rug to play, because baby’s head is also very soft and malleable at this early age, it increases the possibility of baby’s head becoming misshapen (also called positional plagiocephaly[1] if baby is put down in the same position every time. For the majority of babies, a “flat head” can be prevented or treated simply by changing baby’s head position when placed to sleep, and increasing appropriate forms of supervised tummy play time from birth.

Simply by popping baby down to sleep with the head in alternate positions (facing to the left for one sleep, to the right for the next), the risk can be minimised. Another strategy is to put baby at different ends of the cot or move the cot around the nursery so when they wake, they are looking at another view.

A wonderful opportunity to build baby’s muscles and create some bonding time with your baby is to give him/her lots of supervised tummy time.

  1. Bialocerkowski AE, Vladusic SL, Wei Ng C. Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Developmental Medicine & Child Neurology. 2008;50(8):577-86.
    Bialocerkowski AE, Vladusic SL, Howell SM. Conservative interventions for positional plagiocephaly: a systematic review. Developmental Medicine & Child Neurology. 2005;47(8):563-70.



If I tilt my baby’s cot, won’t that help with reflux?

We need to remember that babies are not little adults and understand they not only breathe differently to us, they also have a different anatomy.[1] Babies have large heads and short necks.

When an infant falls asleep propped up or tilted at an incline – even a very slight incline, their head can bend forwards, pushing the chin down towards the chest leading to their airway becoming restricted and reducing airflow.

Try this exercise for yourself: Bend a straw slowly until it is completely bent and try to suck your drink. Baby’s airways are tiny and narrow, and it does not take much to restrict or block their breathing.

Any product that is tilted or accessories such as wedges or pillows and head and neck accessories are unsafe to use as baby’s head can be tilted into the dangerous “chin to chest” position, causing what is known as ‘positional asphyxia’. All pillows or accessories marketed to support an infant’s head and neck are deemed unsafe and should not be used.

[1] http://www.changeforourchildren.nz/files/docs/safesleepforbabies.pdf

About Education

What experience/expertise do the presenter[s] have?

Our principals possess a very strong background in developing safe sleeping guidelines based on scientific evidence-based information, in collaboration with researchers and other key players in this field.

Between them, they have over thirty years of safe sleeping knowledge and with qualifications in nursing to underpin this knowledge, they have been instrumental in developing policy which is embedded into maternal child health practice and other national standards.

They are influential in developing resources for professionals and families, advocating for changes in policy and practice, in both the safe sleeping and bereavement support spheres.



Do I get a certificate that I attended the workshop?

Yes, each participant is presented with a certificate of attendance and is asked to complete a questionnaire, both pre and post workshop, to evaluate their understanding of the topics discussed.



Is there any follow up after the workshop to assess if I have understood the topics discussed?

Yes, the questionnaire completed pre and post illustrates whether a participant has comprehended the recommended safe sleeping information and where gaps in their knowledge are identified, our presenter contacts them within 2-3 weeks to help them understand and implement best safe sleeping practice.



I have booked a workshop/ education session but need to cancel. Do you have a cancellation policy?

Yes, full refunds will be given for any cancellations made one week prior to the Workshops. Cancellations made less than one week but more than 24 hours prior to the Workshops will attract a 50% penalty. Cancellations made less than 24 hours prior to the Workshops will attract the full 100% attendance fee.

You can also transfer your registration to another participant or workshop. Please advise us as soon as possible so we can update our records and ensure the correct details on the certificate of attendance.



If we have an in-service education session, do we pay for travel?

Travel costs are inclusive for any service within a 25 kms radius of the CBD; outside this metropolitan area, travel is charged at standard ATO/RACV rates.



Do you evaluate in-service education sessions and provide reports?

Yes, all sessions are evaluated to ascertain that participants have comprehended the information. Where gaps are identified in participants’ knowledge, the presenter will follow up with the Service to offer feedback. A comprehensive report can be provided at a nominal fee.



Why should I undertake the Policy workshop?

With the recent changes to the National Quality Framework (NQF) Regulation 168, it is mandatory that all Services have a current safe sleeping policy. However, experience has demonstrated that policy is often developed but not incorporated into daily operations, or it is poorly written and does not provide sufficient guidance to stakeholders to ensure all parties understand their obligations. Attending the policy workshop offer participants the opportunity to review their policy objectively and ensure it provides strong, clear and concise direction.



If I am unable to pay using a credit card, can I get an invoice?

Yes, an invoice can be issued; however, payment must be made prior to commencement of the workshop/education session. Contact education@soteriasafesleepingadvice.com.au to request an invoice.



Does this workshop go towards any study I may be undertaking?

Our workshops and education sessions are not currently accredited; however, we are investigating this via a Registered Training Organisation.