Safe Sleep & Breastfeeding

Resources to support safe infant sleep

Welcome to NICHQ’s official guide to ensuring safe infant sleep! Here you’ll find strategies and interactive resources to promote safe infant sleep recommendations, along with lessons learned to empower health professionals, community advocates, and families across the country to be champions of safe sleep.

Close Up Of Mother Cuddling Sleeping Baby Daughter At Home

Equity & Safe sleep

Help ALL families create safe infant sleep environments

cute Black little baby with curly brown hair in white bed for sleeping

While sudden unexpected infant death (SUID) and breastfeeding are public health issues across population groups, significant disparities exist across race, ethnicity, and geography. SUID rates for American Indians, Alaskan Natives, and Non-Hispanic Black babies are more than twice those of white babies. These statistics represent real families who suffer unimaginable loss—a loss that stems from the persistent effects of systemic racism on the health of families from historically marginalized communities.

Every new person who learns about safe infant sleep is one more person who can promote safe infant sleep recommendations. We’re providing you with the tools and knowledge to work toward eliminating SIDS and other sleep-related deaths.

Help build collective knowledge across the country by sharing safe infant sleep information using these resources.

NICHQ INitiatives

Our Safe Sleep and Breastfeeding Work

The use of a health equity lens is imperative in the work of making breastfeeding and chestfeeding a national norm. We’re grateful to have insight from a diverse team of experts on these project-related safe sleep and breastfeeding initiatives.

National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN)

NAPPSS-IIN is an initiative to make infant safe sleep and breastfeeding the national norm by aligning stakeholders to test safety bundles in multiple care settings to improve the likelihood that infant caregivers and families receive consistent, evidence-based instruction about safe sleep and breastfeeding.

Learn more about this project

Safe Sleep Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality

An initiative to decrease the instances of sudden unexpected infant death (SUID) rates and reduce racial disparities in sleep-related deaths.

Learn more about this project

Partner Resources

AAP Safe Sleep Resources

The American Academy of Pediatrics (AAP) has assembled a collection of tools and resources to help pediatricians and healthcare professionals provide education and guidance to parents and caregivers on infant safe sleep.

Safe Sleep Resources

Be a champion of infant safe sleep

View the Resources

Publications

Community infant safe sleep and breastfeeding promotion

A mixed-methods study to improve population-level health outcomes

Though breastfeeding is a protective factor against sudden unexpected infant death, motivations to breastfeed often couple with unsafe infant sleep practices. Racial/ethnic disparities are present in sudden unexpected infant death, accidental suffocation and strangulation in bed, and breastfeeding. The study aimed to investigate the relationship between community-level strategies and associated state-level outcomes for infant safe sleep and breastfeeding.

Findings

We identified two mixed insights: gaps in promotion and outcomes, and persistent disparities between infant safe sleep and breastfeeding promotion and outcomes. Findings indicate conversational approaches could improve infant safe sleep and breastfeeding promotion, outcomes, and relative disparities. Community collaboration is needed to address organizational capacity limitations in promoting infant safe sleep and breastfeeding.

View Publication

Save the Date

Weekly Observances

Five distinct weeks are celebrated during Breastfeeding Awareness Month.

August 1-7: World Breastfeeding Week
August 8-14: Indigenous Milk Medicine WeekAugust 8-14
August 15-21: Asian American Native Hawaiian and Pacific Islander Breastfeeding Week
August 25-31: Black Breastfeeding Week
September 5-11: Semana de la Lactancia Latina

NICHQ Insights

Safe Sleep Reading List

At NICHQ, we are committed to making infant safe sleep the national norm. Check out our insights to learn how you can support this initiative.

View all insights

3 Lessons from Centering Community Voices: Safe Sleep and Breastfeeding Using a Quality Improvement Framework

Quality improvement (QI) work is driven by an interest in implementing changes that lead to improvements. In breastfeeding and safe sleep work, this can be challenging. It can be difficult to fully and accurately understand the source of maternal and child health inequities. Ultimately, professionals do not yet have a clear idea of which strategies…

Addressing Historic Trauma to Improve Breastfeeding and Safe Sleep Among Indigenous Families

Kim Moore-Salas, IBCLC, enrolled member/citizen of Navajo Nation Shawn Meyer, RN, BSN, CLC, member of Turtle Mountain Band of Chippewa Please note, we use the terms Indigenous People and Native Americans to reflect the preference of our interviewees. “Breastfeeding is a cultural tradition,”…

Applying an Equity Lens to Safe Sleep and Breastfeeding Efforts

Black families are twice as likely as white families to have their baby die in the first year of life. In Ohio and Wisconsin, they are three times as likely. These statistics are more than numbers; they represent real families who suffer unimaginable loss—loss that stems from the persistent effects of systemic racism on the…

Boxing Out Unsafe Sleep Practices for Babies

Despite only being 2 feet long, 1.5 feet wide and less than a foot tall, Finland’s baby boxes have had a dramatic impact on the country’s infant mortality rate. In the 1930s, Finland’s infant mortality rate reached 65 deaths per 1,000 live births, leading to the 1938 introduction of baby boxes—kits that include a mattress, bedding, diapers,…

Breastfeeding in 2019: Safe Sleep, Bias, Gender Equitable Norms, and Paid Leave

In 2010, the U.S. made breastfeeding a national health improvement priority by identifying eight key breastfeeding objectives in the Healthy People 2020 goals, a ten-year agenda for promoting national health. And while we’ve made significant improvements as a nation (surpassing five of the eight breastfeeding objectives), there is still considerable progress needed to help more…

Closing the Gaps in Safe Sleep Education in Underserved Populations

This series focuses on how states are reaching underserved populations as part of the Collaborative Improvement and Innovation Network to Reduce Infant Mortality. While the country’s rate of sudden infant death syndrome (SIDS) has dropped by more than 50 percent over the past two decades, SIDS continues to claim the lives of about 1,500 U.S. infants each…

Continuing Conversations Around Breastfeeding and Safe Sleep Promotion

In the U.S., significant racial/ethnic and geographic disparities exist among sudden unexpected infant deaths (SUID) and breastfeeding practices. Combining infant safe sleep (ISS) and breastfeeding promotion on the community level presents opportunities to address these racial/ethnic disparities and associated socioeconomic, cultural, and psychosocial influences. Join NICHQ for an upcoming webinar, “Their stories are so…

Creating a Safe Sleep City

In 2016 in Mississippi, more than 30 healthy babies died in their sleep from accidental suffocation or strangulation. These numbers reflected an increase from the previous year, despite the promising fact that overall infant mortality rates decreased in the state. “Understanding infant safe sleep practices isn’t always easy; that’s why we need to do more…

Are Your Hospital’s Website Images Safe-Sleep Friendly?

Creating a safe sleep environment for an infant can be confusing to families, especially when they don’t hear consistent information from their peers or health providers. Moreover, pictures of infants sleeping in unsafe positions are all over the internet and social media platforms, which adds to the mixed messaging. Considering that approximately 3,500 babies die…

Bedsharing, Breastfeeding and Babies Dying: A Conversation Worth Having

Bedsharing can lead to longer breastfeeding duration. It also leads to more infant deaths. These opposing facts represent a major dilemma for those working to improve infant health. It becomes even trickier when we dive a little deeper. Breastfeeding also correlates with lower sudden infant death syndrome (SIDS) rates, the most common cause of post-neonatal…

Better Sleep for Breastfeeding Mothers, Safer Sleep for Babies

When a mother or birthing person breastfeeds/chestfeeds, they release oxytocin, a hormone that soothes anxieties and helps induce a unique emotional connection to their newborn baby. Oxytocin, also known as “the love hormone,” packs a powerful punch that, while supporting healthy breastfeeding/chestfeeding, has one potentially dangerous side-effect: it can make people tired. “New mothers are sleep-deprived…

Doula Support Improves Maternal and Child Health Outcomes, Patient and Family Engagement

In honor of World Doula Week, celebrated annually March 22-28, The National Institute for Children’s Health Quality (NICHQ) held a conversation with LaToshia Rouse, CD/PCD(DONA), owner of Birth Sisters Doula Services. Rouse currently serves as the Patient and Family Engagement Co-Chair of the National Network for Perinatal Quality Collaboratives Executive Committee and joined NICHQ’s Board…

Eliminating Safe Sleep Fatalities Starts by Identifying What Causes Them

Understanding what causes fetal, infant, and child deaths gives states and communities the information they need to identify focused, effective solutions. This makes infant mortality data—data that reveals the causes and contributors to death and system barriers—irreplaceable assets for any infant health improvement effort. And that makes the National Center for Fatality Review and Prevention…

Exploring NAPPSS-IIN Project Insights and Future Visions: A Conversation About Safe Sleep and Breastfeeding

Domonique Davis: On this month’s episode of Before Birth & Beyond, we’re excited to be joined by summer 2023 NICHQ Communications and Digital Strategy interns Amalia Hirschhorn-Martinez and Katie McCormick. They will be speaking with members of the NICHQ team about our upcoming webinar, focused on infant safe sleep and breastfeeding messaging, and NICHQ’s continued…

How Do We Address Safe Sleep Disparities? Start by Building Trust

Every day across the country, families wake up to an unimaginable heartbreak. The healthy baby that they put to bed passed away during the night. Healthy babies shouldn’t die in their sleep. But, despite decades of trying to reduce the number of sudden unexpected infant deaths (SUID) they still persist. And most often, their persistence affects…

Ignoring Safe Sleep Progress Risks Increasing Safe Sleep Deaths

The American Academy of Pediatrics (AAP) recently released a journal article and commentary focused on national and state trends in sudden unexpected infant deaths (SUIDs). The study concluded that national SUID rates have stagnated and this is an opportunity for states to re-examine their efforts to improve safe-sleep practices. At the National Institute for Children’s Health Quality (NICHQ),…

It’s Past Time to Prevent SIDS and Sleep-Related Infant Deaths

In the U.S., Sudden Infant Death Syndrome (SIDS), suffocation and other sleep-related causes claim approximately 3,600 babies every year. That number translates to nearly 165 unfilled kindergarten classrooms. And while research shows that many of these deaths are preventable, they still persist. Doing better by American families starts by identifying what’s working and outlining opportunities…

Putting Unsafe Sleep Marketing to Bed

Last week I was sharing some of the exciting work happening in my NICHQ projects with my family and they asked (jokingly) what my boss had against me. You see, I’m expecting my first child in July and they couldn’t imagine how I could enjoy working on projects related to infant mortality. My take is…

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Additional Safe Sleep Resources

Safe Sleep FAQ for Child-Care Providers

This handout is designed to empower child-care providers to always protect children in their care by creating a safe sleep environment and spreading the safe sleep message among the families they serve.

Download Handout

Safe Infant Sleep Baby Registry Product Guide

There is no shortage of gear marketed to parents of babies, and products may promise to solve all your sleep problems. Use this registry guide to help sort through the options.

View the Guide

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