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Sonja Brownlee, MD.
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Last Updated 1/2010
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Sleeping Safety
Sleeping Safety (0-11 months)
Sleeping Safety (1-5 years old)
Sleeping Safety (0-11 months)
Click here for information on SIDS , Sleep Position , and Co-Sleeping .
Your baby will usually be unattended when in his/her crib, so this should be a totally safe environment:
- If you use a new crib or one manufactured after 1990, it should meet current safety standards.
- If you plan to use an older crib , inspect it carefully for the following features:
- Slats should be no more than 2 3/8 inches apart so a child’s head cannot become trapped between them.
- There should be o cutouts in the headboard or footboard, as your child’s head could become trapped in them.
- If the crib has corner posts (or finials), unscrew them or cut them off. Loose clothing can become snagged on these and choke your baby.
- All screws, bolts, and hardware must be tightly in place to prevent the crib from coming apart. A child’s activity can cause the crib to collapse, trapping and suffocating the baby.
- Many older cribs were painted with lead-based pain, which can poison children if they gnaw on the crib rails (it does happen). You must strip the old paint and then repaint with high-quality, new enamel. Let it dry thoroughly in a well-ventilated room. Then place plastic strips (available at most children’s furniture stores) over the top of the side rails.
- If you purchase a new mattress , remove and destroy all plastic wrapping material that comes with it (it can suffocate a child). If you cover the mattress with heavy plastic, be sure the cover fits tightly; zippered covers are best.
- As soon as your baby can sit , lower the mattress of the crib to the level where s/he cannot fall out either by leaning against the side or by pulling him/herself over it.
- Set the mattress at its lowest position by the time your baby learns to stand .
- When fully lowered, the top of the side rail of the crib should be at least 4 inches above the mattress , even when the mattress is set at its highest position. Be sure the locking latch that holds the side up is sturdy and can’t accidentally be released by your baby. Always leave the side up when your child is in the crib.
- The mattress should fit snugly so your child cannot slip into the crack between it and the crib side. If you can insert more than two fingers between the mattress and the sides or ends of the crib, replace the mattress with one that fits snugly.
- Periodically check the crib to be sure there are no rough edges or sharp points on the metal parts, and no splinters or cracks in the wood. If you notice tooth marks on the railing, cover the wood with a plastic strip (available at most children’s furniture stores).
- Use a crib bumper when your child is an infant. Be sure the pad goes all the way around the crib and is secured with at least six straps or ties, to keep the bumper from falling away from the sides. To prevent strangulation, the ties should be no more than six inches long.
- As soon as your baby can pull to a standing position , remove crib bumpers as well as any toys, pillows, or stuffed animals that are large enough to be used as a step for climbing out.
- If you hang a mobile over your child’s crib , be sure it is securely attached to the side rails. Hang it high enough so your baby cannot reach it to pull it down, and remove it when he is able to get up on his hands and knees, or when he reaches five months, whichever comes first.
- Crib gyms should be removed as soon as your baby can get up on all fours . Even though these gyms are designed to withstand a baby’s grabbing and tugging, s/he could fall forward onto the gym and become entangled.
- To prevent the most serious of falls, don’t place a crib --- or any other child’s bed --- beside a window.
Sleeping Safety (1-5 years old)
- Keep the crib away from windows.
- Keep the crib away from drapery and electrical cords.
- Keep the crib mattress at the lowest setting.
- Do not use crib bumpers and do not leave any toys, pillows, or stuffed animals that are large enough to be used as a step for climbing out of the crib.
- If your toddler can climb out of the crib, move him/her to a low bed. This is usually when your child is 35 inches tall, or the height of the side rail is less than ¾ of your child’s height.
- Use a low bed that a 2 year old can easily climb in and out of.
- Do not place a child’s bed beside a window.
- It’s best not to use bunk beds. The child on the top bunk can fall out, and the child on the lower bunk can be injured if the top bunk collapses. The bunk beds might be improperly constructed or assembled, causing dangerous structural flaws. Or a mattress that doesn’t fit properly could entrap your child. If, despite these warnings, you choose to use bunk beds, take the following precautions.
- Place the beds in a corner of the room so there are walls on two sides. This provides extra support and blocks two of the possible four sites for falling out.
- Don’t allow a child under six to sleep in the upper bunk. S/he won’t have the coordination s/he needs to climb safely, or to stop from falling out.
- Be sure the top mattress fits snugly and cannot possibly slip over the edge of the frame. If there’s a gap, your child might get trapped and suffocate.
- Attach a ladder to the top bunk bed. Use a night-light so your child can see the ladder.
- Install a guardrail on the top bunk. The gap between the side rail and the guardrail should be no more than 3 ½ inches. Be sure your child can’t roll under the guardrail when the mattress on the top bunk is compressed by the weight of her body. If her head gets stuck under the guardrail, she may suffocate or be strangled. You may need a thicker mattress to prevent this.
- Check the supports under the upper mattress. Wires or slats should run directly under the mattress and be fastened in place at both ends. A mattress that is supported only by the frame of the bed or unsecured slats could come crashing down.
- If you separate bunks into two individual beds, make sure all dowels or connectors are removed.
- To prevent falls and collapse of the bed, don’t allow children to jump or roughhouse on either bunk.
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