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Safe Sleep Standard Operating Procedure (SOP)

Purpose

To ensure the safety of infants during sleep and rest periods by following evidence-based safe sleep practices in compliance with state regulations and the American Academy of Pediatrics (AAP) recommendations, as referenced in Caring for Our Children: Basics Health and Safety Foundations for Early Care and Education.

Scope

This SOP applies to all staff members who care for infants in the childcare facility.

Responsibility

  • All infant caregivers are responsible for implementing and maintaining safe sleep practices at all times.

  • Directors and supervisors are responsible for training, monitoring, and enforcing compliance with this SOP.

Procedure

Step 1: Approved Sleep Environment

  1. Only approved cribs, playpens, or play yards designed for infant sleep may be used.

  2. All sleep equipment must:

    • Have a firm mattress

    • Be fitted with a tight-fitting sheet

  3. No excess bedding or items are permitted in the sleep environment, including but not limited to:

    • Bumper pads

    • Hanging mobiles

    • Quilts or comforters

    • Receiving blankets

    • Pillows

    • Stuffed animals

    • Cushions

Step 2: Infant Sleep Positioning

  1. Infants who are not able to roll over independently must always be placed:

    • On their backs

    • On a firm sleep surface

  2. This positioning must be followed to reduce the risk of Sudden Infant Death Syndrome (SIDS).

Step 3: Exceptions for Alternate Sleep Position

  1. An infant may be placed in an alternate sleep position only if:

    • A written physician’s authorization is provided.

  2. Physician documentation must be kept on file at the facility and include:

    • Child’s full name

    • Child’s date of birth

    • Required sleep position

    • Instructions for any equipment used

    • Length of time the authorization is valid

  3. Staff must follow the physician’s instructions exactly as written.

Step 4: Use of Sleep Sacks and Swaddling

  1. Sleep sacks may be used if they:

    • Fit according to manufacturer instructions

    • Do not restrict the infant’s arms

    • Do not slide up over the infant’s face

  2. Swaddling is prohibited unless:

    • Authorized in writing by a physician

    • Documentation is on file and current

Step 5: Prohibited Items During Sleep

  1. Infants must never be placed in cribs, playpens, play yards, or sleep areas with:

    • Any item that could pose a suffocation or strangulation risk

  2. This includes loose items worn on the child or placed in the sleep space.

Step 6: Safe Placement of Sleep Equipment

  1. All cribs, playpens, play yards, and sleep bedding must be positioned:

    • A minimum of 18 inches away from:

      • Window blinds

      • Draperies

      • Cords

      • Any window coverings or treatments that pose a strangulation hazard

Monitoring and Compliance

  • Staff must conduct visual sleep checks according to facility policy.

  • Supervisors will conduct routine audits to ensure:

    • Proper sleep positioning

    • Safe sleep environment compliance

    • Required documentation is current and accessible

Training Requirement

  • All staff caring for infants must receive safe sleep training:

    • Upon hire

    • Annually

    • Whenever regulations or best practices are updated

Documentation

  • Physician authorizations must be:

    • Reviewed regularly

    • Stored in the child’s file

    • Accessible to all staff caring for the infant