Despite the concerns of parents,
infants are not at increased risk for choking if placed on their
back. Some infants may require being positioned on their
stomachs due to a birth defect; a chronic problem of spitting up
following eating; or a heart, lung or breathing problem. In this
case, the child’s physician should provide instructions on the
child’s physical examination report or provide a specific written
Should a parent request that a child
not be placed on their back for health considerations, you should
have the parent sign a statement indicating their preference. If the
request is due to due to a physician’s order, you should place a
copy of the order in the child’s file. If such a request or order is
made, you may
want to place a note or "alert" over
the crib used by the child, so that all staff are aware of the
Another SIDS prevention step that you
can do is to make sure the crib mattress is firm. Cribs should not
be equipped with "fluffy" comforters or blankets, nor should an
infant be allowed to sleep on a pillow, sheepskin, or other soft
material. Soft stuffed toys or pillows should not be placed in the
crib, as some infants have smothered with these items. You can also
ensure the infant is not overheated while sleeping.
Contact the child care health
consultant if you have further questions or would like additional
training onSIDS prevention.
The Consumer Product Safety Commission
has had crib safety standards since 1974. These were developed in
part because of the high incidence of infant strangulation. Many
children have strangled because their shoulders or necks became
caught in crib openings, their heads became wedged between the
mattress and the crib side, or their clothing became entangled on
Therefore, slats or any other opening
on a crib should not be more than 2 3/8 inches apart. Mattresses
should fit snugly in the crib and allow for no more than two fingers
to fit between the mattress and the crib side. The top of the
mattress to the top of the crib rail should be at least 36 inches.
have no corner post that exceeds 1/16
of an inch, and the headboard should have no cutouts. While many
manufactures have ceased to make cribs with corner posts, you may
have older cribs still in use.
Cribs should be sturdy and have secure
latching devices. Cribs on wheels are helpful in the event of a fire
or tornado or other need for immediate evacuation. Cribs should have
sufficient spacing between them, recommended by NHSPS to be at least
three feet. A divider may be used to separate the cribs, as
long as it does not obstruct staff’s
view of the infant.
Cribs should not be placed end to end,
as this still allows for children to reach over the "wall" into
another child’s space, risking the likelihood of the transmission of
illness. If the child care consultant approve the placement of cribs
end to end for exceptional spacing considerations, the cribs
should be used only for infants who are not yet able to pull
themselves to a standing position. Staff must still have full access
to a child located anywhere in the crib.
You must provide a crib and bedding for
each child under two. The rule requires a crib or crib-like
furniture for all children under two, if developmentally
appropriate. If the child nearing age two is developmentally ready,
you may substitute a cot or mat for the crib.
All cribs should have a waterproof
plastic mattress cover, a sheet over the cover, and bedding that
allows the infant to be comfortable and warm. Infants should never
be placed directly on a plastic mattress cover, and the cover should
be thick and taut enough so as not to pose a suffocation hazard.
All bedding and coverings should be washed at least weekly, when
another infant is going to use the bed, or immediately if the
material becomes soiled or wet. Crib frames should be wiped down and
sanitized on a weekly basis.
Frequent and consistent procedures for
cleaning and disinfecting may help to prevent the transmission of
lice, ringworm, and scabies, three of the most infectious disease
that plague child care centers. In addition, illness caused by fecal
contamination or respiratory secretion will be reduced by frequent
laundering of bedding.
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