As a registered home provider, you are required to place children under the age of one year on their backs to sleep (Iowa Administrative Code). A physician may prescribe a different sleep position for children with special needs. The National Standards state that all infants must be placed on their backs to sleep unless a physician has prescribed a different sleep position. For naps and nighttime sleeping, infants should:

Infants who sleep on their backs on a firm surface have a reduced risk of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden and unexpected death of a seemingly healthy infant. SIDS usually occurs between the ages of three weeks and five months. Physicians are still not certain what causes SIDS.  Sleep position and exposure to secondhand smoke are related to SIDS deaths. When infants can easily turn over from their backs to their "tummies," they should be put down to sleep on their backs but allowed to choose which sleeping position they prefer.

REASON:

Placing infants to sleep on their backs instead of their stomachs has been associated with a dramatic decrease in deaths from SIDS. When infants develop the motor skills to move from their backs to their sides or stomachs, it is safe to put them to sleep on their backs and allow them to change to whatever position makes them comfortable. Once the child has learned to turn over easily from back to stomach, it is not recommended that you move sleeping infants onto their backs. If a child has an illness or a disability that leads to airway obstruction in the back sleeping position, parents should give you a physician’s note telling you the need for stomach sleeping and any other special arrangements required

for that child.

COMMENTS:

Infants who are back-sleepers at home but are put to sleep on their tummies in child care have a higher risk of SIDS. "Tummy time" when the child is awake and observed helps muscle development. It also reduces the tendency for back positioning to flatten the back of the head.  Alternatives to blankets include sleepers or other sleep clothes.