The ISSP meets bimonthly to discuss how to best support families, providers, organizations, and policymakers to increase infant safe sleep practices and address related barriers and disparities through education, practice change, and systems improvement.

Thanks to funding from the Colorado Department of Public Health and Environment, Illuminate Colorado is able to support the work of the ISSP. Members include public health and human services professionals, health care providers, and community organization and nonprofit representatives.

The ISSP focuses on three priority areas: 

Education – Develop culturally-responsive public awareness and educational campaigns collaboratively with families and community-based organizations.

Practice Change – Design and implement Quality Improvement initiatives based in hospitals and provider education opportunities simultaneously.

Systems Improvement – Work in constant partnership with community organizations to address systemic issues that may impact safe sleep practices.

A Peek Inside an ISSP Meeting

ISSP meetings are a place for collaboration, open to anyone who is looking to share or learn about safe sleep practices and how we can best educate families, change hospital practices, and transform systems. Offices such as the Colorado Department of Human Services often join ISSP meetings to share the safe sleep programming they are working on, and ask for feedback and insight from ISSP members.

Ensuring that our youngest Coloradans sleep safely is a complex task that requires input and collaboration from a variety of groups, and the ISSP provides a space where that work can flourish.  

Looking Ahead

The ISSP is gearing up to identify new strategies that will advance their three priority areas. 

Want to be part of the process?

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When all is said and done, having a plan for safe sleep is the best and most important way to keep your little one healthy and thriving!

What Is Safe Sleep?

Safe sleep is a set of practices and guidelines designed to create a secure sleeping environment for infants, minimizing the risk of sudden infant death syndrome (SIDS) and other sleep-related dangers.

The ABCs of Safe Sleep

Safe sleep is a set of practices and guidelines designed to create a secure sleeping environment for infants, minimizing the risk of SIDS and other sleep-related dangers.

A – Alone: Infants should always sleep alone in their own sleep space, like a crib or bassinet, free from pillows, blankets, or toys.

B – Back: Always place your baby on their back to sleep. This position significantly reduces the risk of SIDS.

C – Crib: Ensure that your baby sleeps in a safety-approved crib or bassinet, designed to meet current safety standards.

Planning is Paramount: When ABCs Aren’t an Option

While the safest sleep environment for infants is their own crib or bassinet, there are situations where bed sharing may become a necessity. Caring for a baby is exhausting, and it’s easy for tired parents to fall asleep while holding their baby on the couch or while breastfeeding in bed. Additionally, it’s important to recognize that some cultures and communities intentionally practice bed sharing.

In such cases, it’s vital to take extra precautions:

1. No smoking in the home or outside: This means ensuring a completely smoke-free environment for the baby. Smoke exposure, even indirectly, increases the risk of respiratory problems and SIDS.

2. Sober adults: Caregivers should refrain from consuming alcohol or taking medications that induce drowsiness while responsible for the baby. This ensures they can respond promptly to any needs or emergencies.

3. Breastfeeding day and night: If a parent chooses to bed share, it is recommended that they do so only when breastfeeding. This is because breastfeeding allows for closer supervision and immediate response to the baby’s needs.

4. Only with a healthy baby who is full term: This refers to a baby who is born at full term (between 37 and 42 weeks gestation) and is in good health without any pre-existing medical conditions.

5. Baby should be on their back and face up: Placing the baby on their back for sleep significantly reduces the risk of SIDS. The face-up position allows for clear airways and comfortable breathing.

6. No sweat: Baby is in light clothing and not swaddled. Overheating is a risk factor for SIDS. It’s important to dress the baby in light, breathable clothing and avoid swaddling, especially in warmer environments.

7. Safe surface: No soft mattress, no extra pillows, no toys, no tight or heavy covers. Clear of strings and cords. Gaps firmly filled by rolled towels or baby blankets. The sleep surface should be firm and free from any potential hazards. This includes removing soft bedding, toys, and ensuring that there are no strings or cords nearby.

8. The C-position: The C-position, also known as the “cuddle curl,” is a recommended way to position a baby when bed sharing. In this position, the baby is nestled in a semi-fetal position, with their head near the parent’s chest and knees drawn up. This position can help create a protective barrier and facilitate safe breastfeeding during sleep.

In situations where following the ABCs of safe sleep isn’t feasible, having a well-thought-out plan becomes essential. Always communicate with your partner, family members, or baby’s other caregivers about safe sleep practices, ensuring everyone is on the same page.

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Stay Connected with the Safe Sleep Community

When you join the Infant Safe Sleep Partnership email list, you’ll get updates about upcoming meetings, as well as Illuminate Colorado’s bimonthly safe sleep newsletter, Crib Conversations!

Check out what else Illuminate Colorado has planned for Safe Sleep Awareness Month here.

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This article was published for Crib Conversations, a bimonthly digest of news, resources and updates about infant safe sleep.

August is National Breastfeeding Month, which means that the end of August is a great time to think about how we can support new parents, help them reach their breastfeeding goals, and empower them with consistent information from trusted sources throughout the year.

Pediatrician Marianne Neifert, MD, is a member of the Infant Safe Sleep Partnership. Below, she provides information about the relationship between breastfeeding and safe sleep, and she encourages us all to be a part of the conversation to increase breastfeeding and infant safe sleep practices.

Q & A with Pediatrician Marianne Neifert, MD

Q: What were some of the key takeaways from the updated 2022 AAP Breastfeeding Policy?

Neifert: Traditionally the AAP has recommended exclusive breastfeeding for about six months, with continued breastfeeding through 12 months and beyond, as mutually desired by mother and baby, and as solid foods are added. In the 2022 policy, the AAP, consistent with the World Health Organization (WHO), supports continued breastfeeding for two years or beyond, acknowledging that mothers who decide to breastfeed beyond the first year often feel alienated and unsupported in their choice. Yet, human milk during the second year of life continues to be an important source of nutrients and immunologic factors for toddlers. Research emphasizes the importance of nutrition during “the first 1000 days” (conception to two years of age) on neurodevelopment and lifelong health. Breastfeeding beyond 12 months also continues to have a positive impact on maternal health, decreasing the risk of diabetes mellitus, hypertension, and breast and ovarian cancer.

A major emphasis of the 2022 AAP Breastfeeding Policy Statement and accompanying Technical Report was an extensive review of the documented improved infant and maternal health outcomes linked with breastfeeding, including breastfeeding beyond one year. The 2022 policy statement also repeated past recommendations that birthing facilities implement maternity care practices that promote and support breastfeeding, such as WHO’s Ten Steps to Successful Breastfeeding, including early skin-to-skin contact, frequent breastfeeding, and skilled lactation support. 

The AAP again acknowledged the importance of supporting breastfeeding and the use of human milk in reducing short- and long-term morbidities among very low birth weight infants. When a mother’s own milk is not available for these vulnerable infants, the AAP recommends pasteurized donor human milk.

The updated breastfeeding policy also re-emphasized that pediatricians need to be knowledgeable about breastfeeding benefits, management, and the provision of culturally congruent breastfeeding care; partner with community resources to improve breastfeeding support; and address inequities in the delivery of care to eliminate breastfeeding disparities. The AAP addressed the significant breastfeeding inequity issue that predominantly impacts the non-Hispanic Black population and acknowledged that breastfeeding-supportive hospital practices and peer support interventions for women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been shown to reduce breastfeeding disparities. The full policy statement and technical report can be downloaded below.

Q: Why do lactation care providers make ideal partners in promoting safe infant sleep?

Neifert: I view breastfeeding and safe infant sleep as dual aligned public health priorities and consider safe sleep proponents and breastfeeding advocates as ideal partners in safeguarding infant wellbeing. Lactation consultants and other lactation care providers are deeply committed to the welfare of infants and mothers and to reducing health disparities. They recognize the importance of breastfeeding in improving maternal-child health, including reducing sleep-related infant deaths. Lactation care providers develop quality client relationships within which empowering health information can be shared, and they work in maternity, pediatric, and public health settings. In addition, lactation care professionals are committed to lifelong learning and the use of evidence-based practices. 

Lactation care providers who work with expectant and new mothers have the opportunity and ethical responsibility to help prevent sleep-related infant deaths. The postpartum hospital stay provides a convenient early opportunity for hospital-based lactation consultants to teach and model safe infant sleep practices as part of their education about safe skin-to-skin care. 

Q: Can collaboration between safe sleep proponents and breastfeeding advocates more effectively promote safe infant sleep?

Neifert: In 2015, the National Action Partnership to Promote Safe Sleep and Breastfeeding Improvement and Innovation Network (NAPPSS-IIN) was launched to create a national coordinated strategy to engage the full set of partners to make safe infant sleep and breastfeeding the national norm. 

Some of us may have only one-time or limited contact with expectant or new parents—such as at a prenatal class—where we can offer conversation starters concerning the topic of safe infant sleep and elicit questions and concerns. Others will have ongoing interactions over a limited time period—such as during the postpartum hospital stay—where nurses and lactation consultants can facilitate safe sleep conversation deepeners. Still others—such as visiting nurses, WIC staff, or primary care providers–will engage with families through continuing interactions that permit ongoing dialogues. What’s important to remember is that compliance with safe infant sleep recommendations is increased when clients hear consistent information from multiple trusted sources and multiple times! 

Q: What if parents won’t commit to implementing the AAP recommendations?

Neifert: Despite our passion about safe infant sleep practices, we have to recognize that parents and other caretakers are the ultimate decision-makers about where and how their babies sleep. We must begin by meeting families where they are and conducting individualized, open, culturally appropriate, and non-judgmental conversations about their infant sleep practices. We can seek to understand personal, cultural, and community values and families’ life realities. And, we can learn to shift our attitude about our role as “experts” who make recommendations to being “resources” who support families to make their own decisions.

Other strategies to increase compliance with safe sleep recommendations include:

1. provide families who do not have a safe sleep space for their infant with information about low-cost or free cribs/play yards;
2. integrate safe sleep messaging with other health messaging, such as prevention of infant falls; and
3. introduce safe sleep recommendations in school curricula to educate older siblings and teen babysitters about safe infant sleep practices.

Together we can do great things and save infant lives!

Get Involved

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