Safe Sleep Revisited

Posted in Development and Learning Early Childhood  |  Tagged ,

by Sydney Carlson, Jamika Acevedo, Samantha Daugherty (GU CEI ’23)

The American Academy of Pediatrics recently released updated recommendations on safe sleep (2022). The guidelines were updated to reduce sleep-related infant deaths, which were showing an increased rate of sudden unexpected infant deaths (SUIDs). Safe sleep recommendations include:

  • putting babies on their back to sleep,
  • using a firm and flat sleep surface,
  • room sharing rather than bed sharing with a sleeping baby,
  • removing loose items or bedding, and
  • avoiding overheating.

The American Academy of Pediatrics emphasized other behaviors that reduce risk as well, such as using a pacifier, feeding the baby breastmilk, engaging in tummy time, and avoiding substance use around the baby (Moon, 2022). In order to understand these guidelines, it is important to explore the influence of  individual differences in the implementation of the recommendations, the delivery of this information to families, and the potential role of early intervention providers in this process.

Just like many other topics in this field, understanding the lived experience of supporting sleep in early childhood provided valuable context for understanding the science and recommendations. Interviewing two individuals, both of whom are parents and service providers who have worked closely with families, revealed valuable insight. For one, safe sleep recommendations, while very useful, may not be trauma-informed or take into account the underlying factors impacting sleep. Many children have spent time in the NICU or have had many medical appointments at a young age which may be stressful or traumatic experiences for the child and family which may affect sleep habits once they are home.

One parent also discussed the many barriers families face when trying to discuss sleep with a pediatrician or medical professional, such as time restrictions during appointments, feelings of shame or embarrassment, and the focus of well-child visits leaning towards developmental milestones. Both parents emphasized the potential benefit of early intervention service providers working with families on this topic, given their ability to discuss these routines in depth in a nonjudgmental and supportive manner.

To complement this interview, it was helpful to learn from another professional who is very involved in promoting safe sleep practices. Suzanne Bronheim, PhD, a psychologist at Georgetown University discussed the Conversations Approach, which is part of “Building on Campaigns with Conversations” created by the National Center for Education in Maternal and Child Health. The campaign provides families and caregivers with information and resources to support safe sleep in their children. The Conversations Approach emphasizes the importance of approaching safe sleep through the lens of individualized support, education, and risk reduction.

Key to safe sleep and following the recommendations are:

  1. There is no one-size-fits-all strategy to support sleep. Each child and family come with their own experiences, culture, and needs, all impacting the child’s sleep practices.
  2. Sleep is a very personal experience that can require dedicated, nonjudgmental support from service providers.
  3. Because as Bonuck (2012) states that “young children with developmental delays experience sleep problems at a higher rate than do typically developing children” , early interventionists must should have “safe sleep conversations”.


Bonuck, K., & Grant, R. (2012). Sleep problems and early developmental delay: implications for early intervention programs. Intellectual and developmental disabilities, 50(1), 41–52.

Bronheim, S. (2017). Building on campaigns with conversations: An individualized approach to helping families embrace safe sleep and breastfeeding. Washington, DC: National Center for Education in Maternal and Child Health. Retrieved from:

Moon, R. Y., Carlin, R. F. & Hand, I. (2022). Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 150 (1).