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<pre>
 
 

Policy no.:  D0315 

 
 
 

 
 
 

 
South Australian  

Safe Infant Sleeping  
Standards 

Policy Directive  
 

Version No.: V2.1 
Approval date: 16/10/18  

Best Practice Indicators for 
SA Health,  

Department for Child Protection 
   

 



 
 
 
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Contents  
 
1. Policy Statement .................................................................................................................. 3 
2. Roles and Responsibilities ................................................................................................... 3 
3. Policy Requirements ............................................................................................................ 4 
4. Implementation and Monitoring ..........................................................................................11 
5. National Safety and Quality Health Service Standards .....................................................11 
6. Definitions ..........................................................................................................................12 
7. Associated Policy Directives / Policy Guidelines and resources .......................................12 
8. Document Ownership &amp; History .........................................................................................13 
9. South Australian Safe Infant Sleeping Standards..............................................................15 
10. References .........................................................................................................................53 
  



 
 
 
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South Australian Safe Infant Sleeping Standards  
Policy Directive  

 
1. Policy Statement  
The sudden and unexpected death of infants during sleep has reduced significantly since 
a public health campaign about safe sleeping for infants was conducted in the 1990s. 
However, the sudden and unexpected death of infants during sleep remains a leading 
cause of preventable death for infants between one month and one year of age. 
 
The six standards contained in this policy document provide clarity and direction for staff 
and volunteers working with parents/caregivers and families with infants under 12 months 
of age. This document is intended as a practical resource and outlines essential safe 
infant sleeping practices and environments alongside the respective challenges they pose 
for parents/caregivers and staff. The Standards are informed by the available evidence 
about risk factors in the infant sleeping environment as well as current professional 
practice and consumer needs and apply to all families with infants from birth through to 12 
months of age. 
 
 
2. Roles and Responsibilities 
Staff and volunteers who provide support and advice to parents/caregivers who are able 
to assess an infant s care and sleep environment, identify any of the factors associated 
with sudden unexpected infant death in those environments and take appropriate action 
to reduce the chances of this happening. 

These Standards will do this by helping staff and volunteers to: 

  Assess the risk factors in the infant s care and sleep environments that are 
associated with sudden and unexpected infant death and talk with 
parents/caregivers about those risks 

  Promote and model to families evidence-based safe infant care and sleep 
environments 

  Provide parents/caregivers and families with relevant information about the things 
they can do to make their infant s care and sleep environment as safe as possible 
and the reasons why it is important to do these things 

  Assist parents/caregivers and families to access relevant services, supports or 
referrals, or if necessary engage relevant services, supports or referral on their 
behalf 

  Document discussions and actions taken with the family in the client record. 

Parents/caregivers will make their own decisions about where and how they sleep their 
infant.  Staff and volunteers are responsible for ensuring that parents/caregivers are 
provided with all the information they need to make a choice that minimises the chances 
that their infant will die suddenly and unexpectedly. 
 
The South Australian position is to provide clear messages to all parents/caregivers, 
regardless of their social and life circumstances, in ways that they can understand, and in 
ways that helps them to make informed decisions. This includes: 

  known best practices in relation to safe infant sleeping; 

  reasons why these practices are safest; and 

  the dangers and risks of practices which differ from those being promoted. 



 
 
 
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This approach encourages having conversations with parents/caregivers about risks.  If a 
parent or caregiver does not appear to understand or have the capacity to make changes, 
this should be a case for heightened concern and other ways of supporting those parents 
and or carers to provide a safe infant care and sleep environment, should be actively 
explored (e.g. financial, cultural). 
 
Providing support and appropriate advice to parents and carers can help to reduce the 
chances that their infant will die suddenly and unexpectedly. Such support can come from 
agencies such as, SIDS and Kids, Kidsafe SA, Department for Child Protection, Disability 
SA, mental health services, child care workers, health or welfare agencies and also from 
extended family, general practitioners and child and family health nurses. 
 
 
3. Policy Requirements  

3.1 Scope 
Staff and volunteers who provide support and advice to parents / caregivers with infants 
under 12 months of age. 

 
3.2 Principles 

  Taking a preventative, proactive and participatory approach to infant health 

  Valuing and embracing the opinions and views of parents, guardians or carers 

  Being sensitive to and focused on the protection of infants  

  Taking action to protect infants from unsafe practices 

  Providing parents, guardians or carers with evidence of infant safe sleeping 
environments and practices  

  Having culturally inclusive practices which nurture and affirm parents, guardians 
or carers in their role. 

  Having information that uses clear, straightforward, and inclusive language 
appropriate for the client, that is available in other languages and modes of 
communication. 

3.3 Background 

The SA Safe Infant Sleeping Standards were developed by a core group of experts from 
Government and non-Government sectors in South Australia under the direction of the 
South Australian Safe Sleeping Advisory Committee. They were the result of extensive 
consultations and conversations, not only with members of the Committee, but also with 
local and interstate experts outside the Committee including consumers, retailers, staff 
within SA Health, Families SA, Disability SA, Department for Education and Children s 
Services (DECS) Early Childhood, Queensland Health and the Victorian Child Safety 
Commissioner. 

 
The Standards were written to guide staff and increase family and community awareness 
of the key infant care practices associated with reducing the risk of infants dying while 
asleep. The Standards provide information consistent with the safe sleeping 
recommendations being promoted in many parts of the world and were informed by 
current Australian and international research.  

 
The Committee took into account all available evidence and arrived at an approach which 
it believed best supported the interests of public health. The safety of infants was given 
the highest priority in formulating these recommendations1. 



 
 
 
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The standards have now been reviewed by a workgroup facilitated by the SA Child Health 
Clinical Network (CHCN) bringing together former members of the Advisory Committee, 
SA Health and other relevant stakeholders for the purpose of updating the Policy Directive 
to incorporate new evidence, coroners  recommendations and current best practice. 

3.4 Incidence 

In Australia, infant deaths attributed to SIDS have fallen substantially during the last 20 
years2. Evidence suggests that the marked reduction in SIDS can be attributed to the 
Australian public health campaigns which promoted safe sleeping practices, particularly 
advice to parents/caregivers to place infants on their back to sleep3. 

 
The number of infant deaths attributed to SIDS has also fallen in South Australia during 
the past decades; from 2.1 per 1,000 live births in 1986 to 0.3 per 1000 live births in 
20134,5. This is mostly attributable to the success of the SIDS and Kids Reducing the Risk 
of SIDS Campaign, but also to changing trends in classification. However, annually over 
the past few years there have been approximately 10 sudden unexpected deaths in 
infancy associated with unsafe sleeping environments (Figure 1). Tragic in themselves, 
each of these deaths prompts us to consider how we can help parents/caregivers to 
provide the safest possible care and sleep environment for their infant. 

 
Figure 1: Infant death rates per 1,000 live birth for three subcategories of SUDI (SIDS, 
accidental asphyxia and undetermined cause of death), South Australia 2003-2013 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Source:  
- 2003-2012 Data collected in the Pregnancy Outcome Unit and reviewed by the Maternal, Perinatal  

and Infant Mortality Committee  
- 2013 Data collected and reviewed by the Child Death and Serious Injury Review Committee  

 

3.5 Risk factors for SUDI, SIDS and fatal sleeping incidents 

In research studies undertaken about SUDI, SIDS and fatal sleeping incidents, a 
significant number of factors have been identified that have been associated with sudden 
unexpected infant death. The level of risk increases significantly when several of these 
factors are clustered in the infant s care or sleep environment 6 11. Some of these factors 



 
 
 
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are about infants themselves, some are about their environment and some are about 
parents/caregivers and their ability to provide for an infant.  

 
Some of the factors associated with infants and sudden unexpected death include:  

  Infants who are born prematurely (&lt;37 weeks) 

  Infants of low birth weight (&lt;2,500g) 

  Multiple births 

  Male and first born infants 

  Infants who have problems after birth including a history of minor viral respiratory 
infections and/or gastrointestinal illness. 

Factors about the environment, parents/caregivers and families and their ability to provide 
for an infant, that have been associated with sudden unexpected death include: 

  Young parental age 

  Mental health problems or cognitive difficulties experienced by parents/caregivers  

  Domestic violence occurring in households 

  Transient lifestyle, with lack of access to a stable home. 

There were 55 infants born in South Australia between 2007 and 2012 that died suddenly 
and unexpectedly at a time when they were expected to be sleeping12. All of these infants 
were over 28 days old.  A review of the care and sleep environment of these infants 
confirmed some of the well-known factors that can be modified or changed in ways that 
will reduce the chances of sudden and unexpected death, including: 

  Unsafe cot and bedding 

  Parental smoking (before and after birth) 

  Use of alcohol and other drugs, including prescription medication, that makes the 
parent/caregiver  drowsy  and less responsive to infant cues 

  Infants in a prone (face down, tummy) sleeping position 

  Infants and parents/caregivers sharing the same sleep surface (such as bed, 
couch, sofa, chair etc.). 

In addition, there are other factors that have been shown to reduce the chance that an 
infant will die suddenly and unexpectedly.  These include: 

  Sleeping an infant in the same room as the parents/caregiver 

  Ensuring that an infant is fully immunised 

  Using a pacifier (once breastfeeding has been established) 

  Breastfeeding. 

3.6 The South Australian approach to sharing a sleep surface with infants 

The issue of an infant sharing the same sleep surface with an adult or child is complex. 
Unfortunately there is currently no evidence available that clearly shows that 
parents/caregivers can safely share a sleep surface with an infant whether this is by 
modifying the bedding or their own behaviour.  

 



 
 
 
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Earlier studies suggested that the risk of SIDS was only increased when infants shared a 
sleep surface and their parents smoked, used sedating drugs, were fatigued, the infant 
was born prematurely or low birthweight, or was not being breastfed.  

 
The National Institute for Health and Care Excellence (NICE) recently reviewed the 
research about the risks of infants sharing a sleep surface and concluded that:  

 there is an association between co-sleeping and SIDS, that the association 
between co-sleeping and SIDS is likely to be greater when they or their partner 
smokes, and that the association between co-sleeping and SIDS may be greater 
with parental or carer recent alcohol consumption, drug use or the infant is of low 
birthweight or premature 13. 

These findings were incorporated in NICE s Addendum to Clinical Guideline 37, Postnatal 
Care14. In this report the term  co-sleeping  was defined as sharing of a bed, or other 
sleep surface, such as a sofa or a chair to sleep. 
 
Other research has more definitively demonstrated that sharing a sleep surface can 
pose a risk to all infants regardless of these additional risk factors. For example the 
recently published Literature Review and Recommendations for Safe Infant Sleeping15 
(Monash University) have sought to identify the risks associated with infants sharing a 
sleep surface.  This research concluded that: 

 sharing a sleep surface increases the risk for SIDS for all infants under three 
months of age. The risk of SIDS when sharing a sleep surface is further 
increased with maternal smoking, alcohol or drug use and sharing a sofa or couch 
with an infant significantly increases the risk for SIDS 16. 

Based on these studies, the SA Health Standard considers that parents need to be 
informed about the risk factors that have been frequently associated with increasing the 
likelihood of an infant dying suddenly and unexpectedly when they are sharing a sleep 
surface. Some of these factors are about infants themselves, some are about their 
environment, and some are about parents/caregivers and their ability to provide for an 
infant:  

  Sharing a couch or sofa carries the highest risk of fatal sleeping incidents17.  

  Adult sleeping environments contain hazards that can be fatal for infants18. 
These hazards include overlaying of the infant by another individual; entrapment 
or wedging between the mattress and another object such as a wall; head 
entrapment in bed railings, and suffocation from pillows and blankets19.  

  Infants most at risk of fatal sleep incidents whilst sharing a sleep surface are 
those who are born preterm or small for gestational age20. 

  Infants younger than three months of age are at greater risk of fatal sleep 
incidents when sharing a sleep surface21,22. 

  If a parent/carer smokes, then the risk of a fatal sleep incident is highest for 
infants, particularly for infants less than 12 weeks old23. 

  If a parent/carer has used drugs/alcohol then the risk is likely to be greater if the 
infant is of low birthweight or premature24. 

  Lastly, when there is more than one risk factor   the chances of an infant dying 
suddenly and unexpected are even higher25.  

 
 
 

In these Standards, the term  bed sharing  has been used to describe taking a 
baby to bed for feeding, cuddling and playing, when there is no intention of 
sleeping with the infant. There appears to be no increased risk of a fatal sleep 
incident if parents/caregivers return the infant to its own safe sleeping surface 
prior to the parent or carer going to sleep. 



 
 
 
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Bed-sharing and room-sharing 

The Standards promote the benefits of room sharing (placing an infant for sleep in an 
Australian Standards compliant cot in the same room as the parents/caregiver) for the first 
six to twelve months as this is known to reduce the risk of SIDS26,27. Several studies have 
demonstrated that infants who sleep in close proximity to their mothers also have better 
outcomes relating to successful initiation and duration of breastfeeding28. 
 

3.7 About the standards of practice 

These Standards apply: 

  To all SA Health, Families SA, and Department for Education and Child 
Development Early Childhood Services staff; carers, and volunteers whose work 
brings them in contact with parents/caregivers and families with infants under 12 
months of age. 

  To all settings across clinical, acute care and the community. 

  In all circumstances, unless medically indicated reasons state otherwise. 

These Standards aim: 

  To ensure staff and volunteers in all facilities both public and private sectors (i.e. 
antenatal, birthing, postnatal, paediatric, child health, childcare, community and 
general practice settings) promote and model safe infant care practices and 
environments consistent with the Standards. 

  To ensure staff and volunteers provide parents/caregivers with consistent and 
accurate information that take into consideration the needs of the infant and the 
family and the opportunity to observe recommended safe sleeping practices. 

  To support ongoing training and/or professional development activities that builds 
the capacity of staff and volunteers to model and promote safe sleeping best-
practice. 

These Standards support staff and volunteers to effectively promote and model 
the six safe infant care practices which ensure a safe sleeping environment. It is 
expected that all staff and volunteers will comply with these Standards unless 
medically indicated reasons state otherwise. 
 

Standard 1 
All staff will place well infants under 12 months on their back to sleep from birth, 
never on their front (tummy) or side, unless there are medically indicated reasons. 

Standard 2 
All staff will be fully informed about the risks of sharing the same sleep surface 
with an infant and promote the placing of infants for sleep in an Australian 
Standards compliant cot (AS/NZS 2172)29 in the same room as the parents for the 
first six to 12 months. 

Standard 3 
All staff will consider the social, cultural and life circumstances of each family when 
promoting safe sleeping practices and ensure the information is provided in ways 
that are culturally accessible and can be easily understood by that family. 

Standard 4 



 
 
 
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All staff will ensure that expectant and new parents are made aware of the strong 
association between smoking and the increased risk of SIDS and are supported 
and referred to smoking cessation or reduction programs. 

Standard 5 
All staff will provide parents, caregivers and families, with accurate information 
about a safe cot, with a safe mattress, safe bedding and in a safe environment. 

Standard 6 
All staff will ensure that expectant and new parents are made aware of the benefits 
of breastfeeding as a protective factor in reducing the risk of SIDS and are later 
given support to breastfeed. 

 

 

 

 

 

3.8 The six safe infant care practices 

The following key infant care practices ensure a safe sleeping environment for 
infants up to 12 months of age: 

1. Sleep infants on their back from birth for every sleep period (night and 
day), never on their front (tummy) or side. 

2. Sleep infants with: 

? feet at the foot of the cot, 
? appropriate bedclothes or sleeping bag which are the correct weight for 

the season to provide adequate warmth whilst avoiding overheating, 

? head and face uncovered, 
? bedclothes tucked in securely so bedding is not loose, or in a sleeping 

bag which is the correct size for the infant with fitted neck and arm 
holes and no hood, and 

? without quilts, doonas, duvets, pillows, cot bumpers, sheep skins, soft 
toys or any other soft item which could pose an asphyxiation risk. 

3. Avoid exposing babies to tobacco smoke before and after birth. 

4. Sleep baby in their own cot in the same room as the parents for the first six 
to 12 months. 

5. Provide a safe sleeping place night and day in a cot that is compliant with 
the Australian Standards for Household Cots (AS/NZS 2172)30 and 
positioned away from blind cords and other hazards. 

6. Breast feed baby if you can. 

 

This document lists Standards common to all staff and volunteers. Additional 
indicators apply to SA Health, Families SA and DECD Early Childhood Services 
staff.  See Appendices 1, 2 and 3 for those additional indicators relevant to your 
organisation. 
 



 
 
 
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Image courtesy of SIDS and Kids 

  



 
 
 
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It is always important to consider an infant or child s ability to move, lift and turn 
their head to breathe when choosing the most appropriate sleeping situation, cot, 
bed, bedding and temperature control. 

Although the current definitions and classifications presented in this document 
refer to an age limit of up to 12 months and relate to the immediate sleeping 
environment (e.g. sleep positioning, cot), other items in or around the sleeping 
environment, such as blind cords or electrical cords, can pose a risk of 
strangulation for children of any age. These and other risks become more 
hazardous as infants become more mobile and capable of exploring their 
environment. For this reason it is important that parents continue to remain alert to 
risks in the sleeping environment throughout their child s developmental stages. 

Parents and carers of children with identified developmental delay or special 
needs are encouraged to consult with their child health specialist (i.e. doctor, 
nurse, allied health worker) regarding the safest sleep practices for their child. 
Staff should consider referring parents/caregivers to their child health specialist 
(i.e. doctor/nurse/allied health worker) for further information regarding infant 
safety issues as well as information in relation to the infant s overall health, 
development and wellbeing. 

 
 
 
 
 
 
 
 
4. Implementation and Monitoring  
SA Health Local Health Networks continue to undertake Client Case Record Audits 
 
 
5. National Safety and Quality Health Service Standards 
 
 

The National Standards below will be implemented from 1 January 2019. 
 

  

 
 

National Standard 
1 
 

Clinical 
Governance 

 
 

National 
Standard 2 

 
Partnering 

with 
Consumers 

 
 
 

 
 

National 
Standard 3 

 
Preventing &amp; 
Controlling 
Healthcare- 
Associated 
Infection 

 
 

National 
Standard 4 

 
Medication 

Safety 
 
 
 
 

 
 

National 
Standard 5 

 
Comprehensiv

e Care 
 
 

 
 

National 
Standard 6 

 
Communica

ting for 
Safety 

 
 
 
 

 
 

National 
Standard 7 

 
Blood 

Management 

 
 

National 
Standard 8 

 
Recognising &amp; 
Responding to 

Acute 
Deterioration 

 
 

? ? ? ? ? ? ? ? 

The safe infant care practices referred to in these Standards apply in all 
circumstances unless medically indicated reasons dictate otherwise. These 
Standards do not replace specific agency guidelines, protocols or procedures. 



















































 
 
 
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6. Definitions  
In the context of this document: 
 

  The term  adult sharing the same sleep surface with an infant  is used in place 
of the term  co sleeping  to encompass all surfaces that might be shared including 
a bed, couch, chair, sofa etc. 
 

  the definition of sudden unexpected death in infancy (SUDI) used is based on 
the definition proposed by Fleming and others31. 
 
This definition includes infants under one year of age whose deaths: 

  were unexpected and unexplained at autopsy; 
 

  occurred in the course of an acute illness that was not recognised by 
parents/carers and/or health professionals as potentially life-threatening; 

 
  arose from a pre-existing condition that had not been previously 

recognised by health professionals; or 
 

  resulted from any form of accident, trauma or poisoning. 

sudden unexpected death in infancy could be described as an umbrella term with 
Sudden Infant Death Syndrome (SIDS) a subset of SUDI. The definition for SIDS 
currently accepted in Australia and by many experts internationally, is the San Diego 
definition proposed by Krous and others32. 
 

 the sudden and unexpected death of an infant under one year of age, with onset 
of the lethal episode apparently occurring during sleep, that remains unexplained 
after a thorough investigation including performance of a complete autopsy and 
review of the circumstances of death and the clinical history . 
 

  The current definition of SIDS has become more stringent, such that some deaths 
which were attributed to SIDS in earlier years would now be classified as SUDIs in 
the  unexplained  group. 

SUDIs fall into one of two categories: 
  explained deaths of infants which incorporate criteria 2 to 4 of the above definition; 

or 
 

  unexplained deaths of infants accounted for by criteria 1 and incorporating the San 
Diego definition of SIDS proposed by Krous and others 

 
 
7. Associated Policy Directives / Policy Guidelines and resources 
All references, Resources and Related Documents are provided throughout the 
Standards themselves. 
 
 
 
 
 
 
 
 
 



 
 
 
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8. Document Ownership &amp; History  
 
Document developed by:  Child Health Strategy, Women s and Children s Health Network 
File / Objective No.: eA891217    DHA2015-06350/1 
Next review due:   31/07/2021  
Policy history: Is this a new policy?  N 
 Does this policy amend or update an existing policy version?   Y  
 If so, which version?  V2.0 
 Does this policy replace another policy with a different title?  N 
 If so, which policy (title)? 
 
ISBN No.:                             978-1-76083-079-3 
 
 
 
 

 

Approval 
Date Version 

Who approved New /  
Revised Version Reason for Change 

16/10/18  V2.1 Interim Director Health Informatics, Performance, Planning &amp; Outcomes Minor changes in line with Legislation 

03/10/16  V2.0 Approved at Portfolio Executive 

Formally reviewed in line with 1-5 year 
scheduled timeline for review.  
 
Section 5.4 and references updated to 
reflect current research and populated into 
policy template.  

14/02/11  V1.0 Approved at Portfolio Executive Original Portfolio Executive approved version. 



 
 
 
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Standards 
 
 

 
South Australian 

Safe Infant Sleeping Standards 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

  



 
 
 
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9. South Australian Safe Infant Sleeping Standards 
 
 
 
 
 
 
 
Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Describe to parents with infants under 12 months of age how to place the infant on 
their back from birth for every sleep period (night and day): 

  with feet at the foot of the cot, 

  with appropriate bedclothes or sleeping bag which are the correct weight for the 
season to provide adequate warmth whilst avoiding overheating, 

  with head and face uncovered, 

  with bedclothes tucked in securely so bedding is not loose, or in a sleeping bag 
which is the correct size for the infant with fitted neck and arm holes and no hood, 

  without quilts, doonas, duvets, pillows, cot bumpers, sheep skins, soft toys or any 
other soft item which could pose an asphyxiation risk, 

  provide parents and caregivers with evidence about the risks associated with side 
and front (tummy) sleep positions (illustrated below). 

2. Provide parents and caregivers with advice about the importance of a firm sleeping 
surface (mattress) and offer to view. 

3. Recognise when lack of appropriate sleep and settling strategies are contributing to 
unsafe sleeping practices and make relevant referrals based on the specific needs of 
the infant and the family circumstances. 

4. Explain to parents and caregivers the importance of supervised tummy time when the 
infant is awake (i.e. to strengthen infant neck muscles and prevent a  flat head ). 

5. Explain to parents and caregivers the dangers of positional aids, devices and rolls 
which are marketed to maintain infants in certain sleep positions in the sleep 
environment (such devices could pose an asphyxiation risk). 

6. Recognise when referrals, supports and information are necessary to better support 
the parent or caregiver to provide a safe sleeping environment for their infant  
(see pages 32 34). 

 
 
 
 
 
 
 
 
 
 
 

                                                                                                                    Image courtesy of SIDS and Kids ACT  

Standard 1 

All staff will place well infants under 12 months on their back to sleep from birth, never on the 
front (tummy) or side, unless there are medically indicated reasons.  

  Back Side
 

Tummy
 



 
 
 
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Image courtesy of SIDS and Kids ACT 

Safest place for baby to sleep 
is in a safe cot next to parents  
bed 

 
 
 
 
 
 
Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Explain the risk factors (see page 6) which contribute to the deaths of infants, 
particularly the risks of sharing the same sleep surface with infants. 

2. Describe to parents of infants aged under 12 months the benefits of room sharing 
(see below). 

3. Describe to parents the risks of sharing the same sleep surface with infants whilst still 
encouraging breastfeeding, bonding33 and closeness before returning the infant to its 
own cot beside the bed. 

If parents choose to share a sleep surface with a baby, use of the SIDS and Kids 
Information Statement on  Sharing a sleep surface with a baby  may be appropriate.  

Review of this article highlights that caution be taken when considering the benefit 
listed as  Higher Self-esteem, better social skills and emotional outcomes as young 
people and adults . None of the articles show that bed or room sharing causes 
improvements in the above area, only that it does not cause problems.  

4. Work in partnership with parents and caregivers to develop settling and sleep 
strategies which work best for the family or ensure a referral is made to Child and 
Family Health staff for assistance with this. Suggested strategies must take into 
account the family s social, cultural and life circumstances. 

5. Link families with appropriate supports and resources, making referrals as necessary 
and documenting these in the client record (see pages 34 38). 

These are definitions of the terms used in this Standard: 

 
Room sharing (RECOMMENDED) 
 
Room sharing is defined as an infant sleeping in an 
Australian Standards compliant cot (AS/NZS 2172)34 
in the same room as their parents. This is 
recommended for the first six to 12 months of life.  

 Bed sharing  is defined as taking a baby to bed for 
feeding, cuddling and playing, when there is no 
intention of sleeping with the infant. There 
appears to be no increased risk of a fatal sleep 
incident if parents/caregivers return the infant to its 
own safe sleeping surface prior to the parent or carer 
going to sleep. 

  

Standard 2 

All staff will be fully informed about the risks of sharing the same sleep surface with infants and 
promote the placing of infants for sleep in an Australian Standards compliant cot in the same 
room as the parents for the first six to 12 months. 



 
 
 
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Sharing the same sleep surface with infants 
(NOT RECOMMENDED) 
Sharing the same sleep surface with infants commonly referred to as  co-sleeping  refers 
to mothers/partners (or any other person) sleeping on any surface (bed, sofa, couch, chair 
or mattress but not limited to) with an infant, whether with the intention to fall asleep or 
not. 

Please note that these definitions differ slightly from those proposed by UNICEF35 
because of the evidence regarding the protective effect of room sharing and because in 
the SA context we wish to make clear distinctions between sharing the same sleep 
surface and sharing the bed when awake with an infant to feed or cuddle (bed sharing). 
 

 
 
 
 
 
 
 
Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Demonstrate they are able to promote the safe infant care practices recommended 
by SIDS and Kids in the format most appropriate for the individual family and 
caregiver. 

2. Facilitate access to further evidence-based culturally appropriate information, 
services and resources related to safe infant sleeping particularly for  high needs  and 
vulnerable clients, including pregnant women, young parents and families from 
Aboriginal and Torres Strait Islander and other  diverse cultural communities. 

3. Work in partnership with families to identify any specific resources, information and 
services that may be required to meet the unique needs of the infant or the family 
circumstances. 

4. Make referrals as appropriate, particularly where there is reason to believe the 
parent/caregiver is unable to understand the risks inherent in the sleep environment 
(e.g. due to language difficulties, intellectual disability or mental health issues). 

5. When necessary, engage culturally appropriate supports: such as a person or service 
that has credibility with the family and is able to translate or convey the evidence-
based safe infant care practices in the language or manner that is most suitable for 
that family (see pages 39 41). 

6. Document in the client record any risks identified and referrals made. 

 
 
 
 
 
  

Standard 3 

All staff will consider the social, cultural and life circumstances of each family when promoting 
safe sleeping practices and ensure that information is provided in ways that are culturally 
accessible and can be easily understood by that family. 

The Translating and Interpreting Service provides professional translating services  
24 hours a day, 7 days a week   phone 131 450 and quote your service s client number. 
 
See page 41 for services available to Aboriginal families. 



 
 
 
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Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Explain to expectant and new parents the harmful effects to the infant of smoking 
during pregnancy and second-hand smoke after birth. 

2. Describe to families the importance of ensuring a smoke-free zone around pregnant 
women, infants and children to avoid them being exposed to tobacco smoke before 
and after birth. This includes the parent s bedroom when room sharing occurs. 

3. Work in partnership with individuals to increase smoking disclosure and support them 
to stop or reduce smoking (e.g. the 5A s approach: Ask, Advise, Assess, Assist, 
Arrange). 

4. Provide pregnant women who smoke with Quit SA resources and referral information 
as appropriate to assist them to cease or reduce smoking (see pages 42 and 43). 

All community facilities will promote smoke-free displays and smoking cessation 
resources (e.g. antenatal and maternity outpatient clinics, postnatal wards, neonatal units, 
child care centres, etc.). 

All agencies will ensure educational messages relating to smoking are available to 
secondary care providers including day care and child care providers, grandparents, 
foster parents and babysitters.  

 

 

 

 

 

 

 

 

 

 

 

 
                                Image courtesy of SIDS and Kids ACT 

  

Standard 4 

All staff will ensure that expectant and new parents are made aware of the strong association 
between smoking and the increased risk of fatal infant sleep incidents and that they are 
supported and referred to smoking cessation or reduction programs. 



 
 
 
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Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Describe the dangers associated with a cot that doesn t comply with the Australian 
Standards for Household Cots (AS/NZS 2172)36 or is in poor condition, broken or 
damaged with missing slats. This includes: 

  where the spacing between the bars may be too wide and trap a child s head or 
too narrow and trap a child s arms or legs, 

  where the corner posts of the cot may be higher than the sides and ends creating 
a strangulation hazard if clothes get caught on any corner post, 

  when the mattress does not fit snugly to within 20mm of the sides and ends, and 
when pillows, toys and other items are not removed to prevent asphyxiation.  

 
 

 
Image sourced from and reproduced with permission by the 
Australian Competition and Consumer Commission. 

 

2. Explain, particularly to expectant parents and families with young infants, the 
Australian Standards for Household Cots and the importance of positioning the cot 
away from blind cords and other hazards. 

3. Provide information about safe infant care practices and safe sleeping environments 
to parents and caregivers of infants under 12 months. 

4. Consistently model safe sleeping environments in community settings and offer to 
view environment, bed and bedding. 

5. Link families with appropriate supports and resources   make referrals as necessary 
and document this in client records (see pages 44 and 45). 

 
  

Standard 5 

All staff will provide families and caregivers with accurate information about a safe cot, with a 
safe mattress, safe bedding and in a safe environment. 



 
 
 
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Household cots  
 
 
The following Information is courtesy of SIDS and Kids: Frequently Asked Questions 
 What to look for in Household Cots . 
 
 
A safe cot is one that meets the Australian Standard for cots. All new and second-hand 
cots sold in Australia must meet the Australian Standard for Cots (AS 2172)20 and will 
carry a label to say so. The standard includes: 

  the mattress must be firm, flat, in good condition and fit snugly to within 20mm of 
sides and ends 

  with the mattress base set in the lower position, the cot sides or end need to be at 
least 500mm higher than the mattress 

  the spacing between the bars or panels in the cot sides and ends needs to be 
between 50mm and 95mm gaps wider than 95mm can trap a child s head. If the 
bars or panels are made from flexible material, the maximum spacing between 
the bars or panels should be less than 95mm 

  no small holes or openings between 5mm and 12mm wide in which small fingers 
can be caught 

  no spaces between 30mm and 50mm that could trap a child s arms or legs 

  no fittings (including bolts, knobs and corner posts) that might catch onto a child s 
clothing and cause distress or strangulation. 

Old or second hand cots may not meet the current Australian standards and may be 
dangerous for the following reasons: 

  Wobbly or broken parts that make the cot weak 

  Gaps where an infant or child may get caught  

  Knobs, corner posts or exposed bolts that can hook onto an infant or child s 
clothing and tighten around the neck 

  Sides that are too low and can be climbed over by active children 

  Sharp catches or holes in the wood that can hurt curious little fingers 

  Paint that might contain poisonous lead. 

A helpful resource that has been developed for consumers by the ACCC called  Find out 
More: Keeping Baby Safe - a guide to infant and nursery products  that provides advice to 
parents/caregivers on what to look for when purchasing items for an infant s nursery.   

It is available on their website www.accc.gov.au.   
  




 
 
 
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Indicators of best practice 
 
To meet this Standard, all workers must be able to: 

1. Explain to expectant and new parents the benefits of initiating and establishing 
breastfeeding as a preferred feeding option for their infant after birth. 

2. Provide pregnant women with information about breastfeeding and support services 
post birth to assist them to make informed choices re methods of feeding. 

3. Work in partnership with individuals to increase breast feeding uptake and support 
them to initiate breastfeeding as soon after birth as possible. 

4. Describe to families the benefits of breastfeeding on the infant and mother attachment 
relationship. 

5. Explain to expectant and new mothers that several studies have demonstrated that 
infants who sleep in close proximity to their mothers have better outcomes relating to 
successful initiation and duration of breastfeeding.   

All birthing hospitals and community facilities will promote breastfeeding and display 
information and resources to support expectant mothers and new mothers decision to 
initiate and establish breastfeeding including information on access to breastfeeding 
support (e.g. antenatal and maternity outpatient clinics, postnatal wards, neonatal units, 
child care centres, etc.). 

All agencies will ensure educational messages relating to breastfeeding as a preferred 
feeding option for infants is available to secondary care providers including day care and 
child care providers, grandparents, foster parents and babysitters. 

 

 
  

Standard 6 

All staff will ensure that expectant and new parents are made aware of the benefits of 
breastfeeding as a protective factor in reducing the risk of SIDS and are later given support to 
breastfeed. 



 
 
 
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Appendices 
 
 
 

Appendix 1: 
Additional best practice indicators  

specific to SA Health staff and volunteers 
 

Appendix 2: 
Additional best practice indicators  

specific to Department for Child Protection staff and volunteers 
 

Appendix 3: 
Additional best practice indicators  

specific to Department of Education 
  Early Childhood 

Services staff and volunteers 
 

Appendix 4: 
Details of the original committee who developed the Standards  

 
 

 

 

 

 

 
  



 
 
 
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Appendices 
Appendix 1 

  
Additional best practice indicators specific to SA Health 
staff and volunteers 
 

 

 

To meet this Standard, all health workers must be able to: 

1. Provide parents and caregivers with information on how to position infants safely in 
the cot and an explanation of the risks associated with side and front (tummy) 
positioning. 

2. Provide sleep and settling strategies that support parents and caregivers in ways that 
take into account the specific needs of the infant and the family circumstances. 

3. Demonstrate the practice of placing all infants, including those with gastroesophageal 
reflux, on their back to sleep on a firm, flat mattress that is not elevated. 

4. Provide parents and caregivers with strategies to manage gastroesophageal reflux 
effectively without placing the infant at risk. 

5. Demonstrate the practice in neonatal units of placing premature and low birth weight 
infants on their backs as soon as their oxygen requirements allow and well before 
discharge. 

6. Demonstrate, where a medical directive exists that requires the infant is not placed on 
their back to sleep in a health facility, that information is provided to parents or 
caregivers prior to discharge about the importance of placing baby on their back once 
home. 

 

 

 

 

To meet this Standard, all health workers must be able to: 

1. Work in partnership with parents and caregivers to identify settling and sleep 
strategies which take into account the families  social, cultural and life circumstances. 

1. Demonstrate that the birthing and post-natal facilities where they work model the 
placing of cots by the mother s bed (away from blind cords) and promote the return of 
infants to their cot after feeding and before parents fall asleep. 

2. Demonstrate that discharge planning, in particular from postnatal or neonatal care 
units, takes into account risk factors (infant characteristics, parental capacity and 
environment) and ensures accurate information is provided and appropriate referrals 
are made in response to these. 

3. Demonstrate that discharge planning, in particular from postnatal or neonatal care 
units, includes information for parents about the risks of sharing the same sleep 
surface with infants and the benefits of room sharing. 

  

Standard 1: All staff will place well infants under 12 months on their back to sleep from birth, 
never on the front (tummy) or side, unless there are medically indicated reasons. 

Standard 2: All staff will be fully informed about the risks of sharing the same sleep surface 
with an infant and promote the placing of infants for sleep in an Australian Standards (AS/NZS 
2172)20 compliant cot in the same room as the parents for the first  
six to 12 months. 



 
 
 
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To meet this Standard, all health workers must be able to: 

1. Specifically discuss the six safe infant care practices and intended infant sleeping 
environment with families prior to discharge. 

2. Discuss safe infant care practices and proposed sleeping arrangements with families 
on their return home and work in partnership with them to address any barriers to 
implementing safe infant care practices at home through the provision of culturally 
appropriate referrals, information and services based on the specific needs of the 
infant and the family. 

 

 

 

 

There are no additional indicators of best practice specific to health workers for this 
Standard. 

 

 
 

To meet this Standard, all health workers must be able to: 

1. Provide information and appropriate referrals to parents and caregivers at each point 
on the care continuum   from the first antenatal contact until the end of infancy. 

2. Document information about discharge preparation and referrals to support safe infant 
sleeping on clinical care pathways and medical and nursing records for both parent 
and child. 

3. Work in partnership with families to identify their reasons for being unable to provide a 
safe sleeping environment for their infant. These reasons could include cots given as 
family heirloom, financial constraints, high levels of transience, inadequate housing or 
other reasons. 

4. Engage supports and referrals as appropriate. 

 

 

 

 
To meet this Standard, all health workers must be able to: 

1. Provide information and appropriate referrals to parents and caregivers at each point 
on the care continuum   from the first antenatal contact until the end of infancy. 

2. Document information about discharge preparation and referrals to support 
breastfeeding on clinical care pathways and medical and nursing records for the 
mother. 

3. Work in partnership with expectant and new mothers to identify their reasons for being 
unable to initiate breastfeeding for their infant. 

4. Engage supports and referrals as appropriate. 

Standard 3: All staff will consider the social, cultural and life circumstances of each family 
when promoting safe sleeping practices and ensure the information is provided in ways that 
are culturally accessible and can be easily understood by that family. 

Standard 4: All staff will ensure that expectant and new parents are made aware of the strong 
association between smoking and the increased risk of fatal infant sleeping incidents, and are 
supported and referred to smoking cessation or reduction programs. 

Standard 5: All staff will provide parents/caregivers and families with accurate information 
about a safe cot, with a safe mattress, safe bedding and in a safe environment. 

Standard 6: All staff will ensure that expectant and new parents are made aware of the 
benefits of breastfeeding as a protective factor in reducing the risk of SIDS, and are later given 
support to breastfeed. 
 



 
 
 
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Appendix 2 
  

Additional best practice indicators specific to 
Department for Child Protection staff and volunteers 
 
All staff have a duty of care which extends beyond the individual child and includes other 
family members. 

The role of the Department for Child Protection (DCP), as the statutory child protection 
agency is to provide assessment, education and support to parents and carers aimed at 
preventing sudden and unexpected infant death. Where the parenting environment has 
been assessed as being unsafe, DCP may take action to secure the care and protection 
of an infant under the Children and Young People (Safety) Act 2017. DCP workers, foster 
carers, relative/kinship carers and contracted out of home care service provider staff must 
adhere to the relevant policies, procedures and practices including: 

  Aboriginal Child Placement Principle Policy, 

  Care and Protection Assessment Framework Policy, 

  Care and Protection Assessment Framework Practice Guidelines for Investigation 
and Assessment, 

  Families SA safe sleeping procedure, 

  Families SA Duty of Care for Children and Young People in Care Policy and 
Practice Guide, 

  Relative Kinship and Specific Child Only Care Policy, 

  Standards of Alternative Care in South Australia (specifically standard 3.7.1). 

 

 

 

Best practice indicators 
1. Foster carers, relative/kinship carers and contracted out of home care service provider 

staff who care for infants are informed about, and implement safe sleeping practices 
for infants under 12 months. 

2. Foster carers, relative/kinship carers and contracted out of home care service 
providers staff who care for infants must seek advice from medical staff about 
positioning infants safely where a medical directive exists that requires the infant not 
to be placed on their back to sleep. 

  

Standard 1: All staff will place well infants under 12 months on their back to sleep from birth, 
never on the front (tummy) or side, unless there are medically indicated reasons. 



 
 
 
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Best practice indicators 
1. When investigating a notification, DCP staff must sight the infant, view the infants 

sleeping environment and discuss the sleeping arrangements with the infant s 
parents/caregivers. 

2. This is undertaken as part of the child protection assessment process, or it can be 
incorporated into an already existing assessment process (e.g. drug and alcohol 
assessment) which should explore how parents/caregivers who use drugs and/or 
alcohol will mitigate risks to their infants safe sleeping. 

3. It is recommended that DCP staff demonstrate safe sleeping techniques to support 
parents/caregivers understanding of the importance of providing safe sleeping 
environments to their infants. 

 

 

 
 

Best practice indicators 
1. DCP recognises that families who are disadvantaged and marginalised may be harder 

to reach using traditional public health education strategies and therefore require more 
direct intervention to ensure that safe sleeping strategies are understood and 
implemented. 

2. DCP staff must promote safe sleeping depending on the family s circumstances (and 
unless it  is not required due to good practices already being in place) including 
recommending that parents/caregivers do not share the same sleep surface  with their 
infant due to risks associated with substance abuse, overlaying by another person and 
suffocation from pillows and blankets. 

3. DCP staff will consult with the Principal Aboriginal Consultant to ensure engagement 
with Aboriginal and Torres Strait Islander families/carers/kin/community is supported 
in a culturally appropriate manner. 

4. DCP staff will consult with other relevant cultural consultants to ensure engagement 
with families/carers/kin/community is supported in a culturally appropriate manner for 
those people from culturally and linguistically diverse backgrounds. 

5. Staff must document in the investigation notes on C3MS what safe sleeping promotion 
was undertaken with the parents/caregivers, or why safe sleeping promotion was not 
required (i.e. the parents/caregivers were already practicing safe sleeping strategies). 

  

Standard 2: All staff will be fully informed about the risks of adults sharing the same sleep 
surface with an infant and promote the placing of infants for sleep in an Australian Standards 
compliant cot (AS/NZS 2172)20 in the same room as the parents for the first six to 12 months. 

Standard 3: All staff will consider the social, cultural and life circumstances of each family 
when promoting safe sleeping practices and ensure the information is provided in ways that 
are culturally accessible and can be easily understood by that family. 



 
 
 
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Best practice indicators 
DCP staff will work in partnership with parents/caregivers to ensure that they are aware of 
the increased risk of SIDS associated with smoking and support them to engage with 
programs to address their smoking behaviour. 

 

 

 

 
Best practice indicators 
1. There may be many reasons why parents/caregivers and families do not have safe 

cots or goods to provide a safe sleeping environment for their infants. Staff must work 
in partnership with families to identify the reasons for this such as financial constraints, 
high levels of transience, inadequate housing or other reasons. 

2. Families who are disadvantaged may also find it harder to adapt their home 
environment to reduce the risk of SUDI, and therefore may require additional support 
to do so. 

3. Where assessed to be appropriate, DCP workers should consider integrated practice 
with the DCP Financial Counsellor to assess the family s financial difficulties/needs 
and assist the family to obtain safe cots, baby sleeping bags or appropriate bedding. 

4. Staff must document what safe sleeping promotion was undertaken with the 
parent/caregiver. 

5. Staff must document the parents/caregivers willingness and capacity to meet the 
needs of the infant as part of the overall assessment of risk to the infant. 

 

 

 

 
Best practice indicators 
1. DCP staff will work in partnership with parents/caregivers to ensure that they are 

aware of the benefits of breastfeeding. 

2. Engage supports and referrals as appropriate. 
  

Standard 4: All staff will ensure that expectant and new parents are made aware of the strong 
association between smoking and the increased risk of fatal infant sleeping incidents, and are 
supported and referred to smoking cessation or reduction programs. 

Standard 5: All staff will provide parents/caregivers and families with accurate information 
about a safe cot, with a safe mattress, safe bedding and in a safe environment. 

Standard 6: All staff will ensure that expectant and new parents are made aware of the 
benefits of breastfeeding as a protective factor in reducing the risk of SIDS, and are later given 
support to breastfeed. 

  
 



 
 
 
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Appendix 3 
 

Additional best practice indicators specific to 
Department for Education   Early Childhood Services 
staff and volunteers 
 
 

It is important to acknowledge the critical role early childhood workers play in promoting 
and modelling safe sleeping practices and environments to families with infants. 

The South Australian Safe Sleeping Standards have important implications for both 
Childcare Centres and Family Day Care workers in relation to the onus they place on staff 
and family day care providers to model and promote accurate information to parents 
about: 

  placing infants under 12 months of age in an Australian Standards compliant cot, 
away from blind cords, with appropriate supervision and lighting, 

  sleeping infants on their back, the effects of smoking and the risks of sharing the 
same sleep surface, and conveying this in a way that parents/caregivers of infants 
in their care can understand, and 

  supporting mothers to maintain breastfeeding. 

  



 
 
 
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Appendix 4 
 
Details of the original committee who developed the 
Standard 
 
 

The initial Committee who developed the first standard included representatives from: 

  The Centre for Health Promotion, CYWHS 
  Health Promotion Branch, DoH 
  SIDS and Kids SA 
  Kidsafe SA 
  Child and Family Health Services, CYWHS 
  Families SA, Department of Families and Communities (DFC) 
  SA Health Injury Surveillance and Control Unit 
  Child Death and Serious Injury Review Committee 
  SA DoH Maternal, Perinatal and Infant Mortality Committee 
  Aboriginal Health Division, DoH 
  Association of Neonatal Nurses 
  Australian College of Midwives 

In addition access to the following information supported the development of the 
Standard:  

  the research carried out by Prof (Adj) Jeanine Young and Queensland Health 
identifying the important role health professionals play in the uptake of safe 
sleeping messages by parents,  

  the Safe Infant Care to Reduce the Risk of Sudden Unexpected Deaths in Infancy 
Policy Statement and Guidelines developed by Queensland Health, and  

  the expert advice received by the Head of Gastroenterology at the Women s and 
Children s Hospital South Australia, Dr David Moore and supported by a 
Cochrane Review, regarding the placement of infants, including those with 
gastroesophageal reflux. 

  



 
 
 
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Evidence 
 
 
 

Challenges to meeting best 
practice, evidence and resources 

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
  



 
 

 
 

10. Evidence: Challenges to meeting best practice, evidence and resources 
Standard 1: All staff will place well infants under 12 months on their back to sleep from birth, never on the front (tummy) or side, unless there are 
medically indicated reasons. 

 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Parents and staff may 
hold personal views for 
not placing infants on 
their back.  

These may include: 

All infants should be placed on their back to sleep.  

&gt; Concerns about 
infants aspirating 
after feeding and 
regurgitating. 

Studies have demonstrated that even in healthy 
infants, respiratory rates, swallowing and arousal are 
each reduced in the prone (tummy) position compared 
to the supine (back) position. There is no evidence to 
support the elevation of the head of the cot for Gastro-
oesophageal Reflux Disease (GORD)37. 

 

&gt; Belief that the infant 
sleeps and settles 
better on their front 
(tummy) or side38,39. 

&gt; Difficulty settling and 
putting infant down 
to sleep. 

Front (tummy) and side sleeping positions significantly 
increase the risk of SIDS, a finding supported by a 
large body of international studies16,40  42. 

All aids and devices intended to keep infants in a 
certain sleep position are not recommended as they 
do not prevent infants from rolling on to their tummies 
and limit the movements of the baby as they get older. 

Sleep (Children 0 6 years) Parent Easy Guide 
http://www.parenting.sa.gov.au/pegs/peg34.pdf  
 
Parent Helpline can provide advice on settling   available  
24 hours a day 7 days a week. Ph. 1300 364 100 
 
Kidsafe SA and SIDS and Kids SA can provide advice on 
safe sleeping and the risks and safety aspects of aids and 
devices for infant Ph. 8161 6318 or Ph. 83321066 
 
SIDS and Kids Information Statement  Wrapping Infants  
available at www.sidsandkids.org  Ph. 83321066 
 
Helping Your Baby to Sleep - by Gethin A and McGregor B 
2007. 





 
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Standard 1:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Parents and staff may 
hold personal views for 
not placing infants on 
their back. These may 
include: 

All infants should be placed on their back to sleep.  

&gt; Concerns about 
misshapen head 
shape 
(plagiocephaly).  

Positional plagiocephaly is a flattened spot on the 
head that can develop if an infant lies with their head 
in one position for long periods of time. 

Studies43 have shown that there is no significant 
relationship between sleeping infants on their back 
and the development of deformational plagiocephaly; 
positional preference and infant care practices used 
by parents including the frequency of tummy time, 
played a greater role. 

Some of the ways to prevent positional plagiocephaly 
are: 
&gt; Always place an infant to sleep on the back. 

Alternate an infant s head position (left or right) 
when placed to sleep. 

&gt; From birth offer baby increasing amounts of time 
playing on the tummy while awake and watched 
by an adult. 

&gt; If bottle feeding, alternate the holding position 
when feeding the infant. 

There is no evidence to suggest that sleeping an 
infant on their back affects brain development. 

SIDS and Kids Information Statement    Baby s Head 
Shape  (under Information Statements) for information and 
strategies to reduce the risk of positional plagiocephaly, 
available at www.sidsandkids.org  
 
Women and Children s Health Network (WCHN) for 
information sheet on plagiocephaly visit www.cyh.com  
 
 Tummy time  brochure available from SIDS and Kids SA  
Ph. 83321066 

  





 
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Standard 1:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Parents and staff may 
hold personal views for 
not placing infants on 
their back. These may 
include: 

All infants should be placed on their back to sleep.  

&gt; Inconsistent role 
modelling by staff 
conflicts with these 
recommendations. 

Many infants in neonatal special care units are placed 
on their front or side for medical reasons. However, 
premature and low birth weight infants are placed on 
their backs as soon as their oxygen requirements 
allow and well before discharge, to ensure that the 
infant and parents are accustomed to the infant being 
placed on its back to sleep. 

 

&gt; Observation on 
television or through 
other media which 
suggests front or 
side sleeping of 
infants is safe. 

 

It is sometimes implied during advertisements or 
television programs that it is safe to place baby on the 
tummy or side to sleep. The side sleeping position is 
unstable and therefore increases the risk of SIDS by 
two to four times, attributed mainly to the side position 
being relatively unstable, resulting in some infants 
rolling to the tummy position during sleep and 
asphyxiating. Side sleeping is not recommended as a 
safe alternative to sleeping on the back. Positioning 
devices are also not recommended. 

 

  



 
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Standard 2: All staff will be fully informed about the risks of sharing the same sleep surface with an infant and promote the placing of infants for sleep in 
an Australian Standards compliant cot (AS/NZS 2172)44 in the same room as the parents for the first six to 12 months. 
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Families may cite 
reasons for sharing the 
same sleep surface with 
infants in preference to 
room-sharing. These 
may include: 

Infants are more at risk of SUDI and fatal sleeping 
accidents when adults  share the same sleep surface 
with infants  

 

 

&gt; Being too tired or 
exhausted to return 
baby to the cot after 
breastfeeding. 

&gt; Having trouble 
settling their baby. 

&gt; Falling asleep 
unintentionally on 
the couch. 

It is not safe for anybody to fall asleep with an infant 
on the same sleep surface34. Placing an infant to 
sleep or falling asleep together with an infant on a 
bed, sofa or couch is extremely hazardous. There is a 
greatly elevated risk of infant death and sleeping 
accidents when an infant shares the same sleep 
surface (e.g. bed, sofa or couch) with an adult during 
sleep. The risks are increased when the parent or 
family member is under the influence of alcohol and/or 
other drugs or under the influence of medication that 
causes sleepiness and they share the same sleep 
surface. 

See Coroner s Findings in the matter of inquest number 
6/2008. Adelaide: Courts Administration Authority SA; 2008 
June p2645   
 
SIDS and Kids Information Statement on:  Sharing a sleep 
surface with a baby , Canberra, June 
2015. www.sidsandkids.org  

&gt; Frequent changes 
to infant routines 
and usual sleeping 
environments lead 
to difficulty settling. 

When infants become unsettled and have trouble 
sleeping, parents may be tempted to share the same 
sleep surface with their infant. Parents will benefit 
from settling advice ideas which can be found in the 
Sleep Parent Easy Guide. 

A bassinette or travel cot which has been specifically 
designed as an infant sleeping environment can be 
used for daytime sleeps and moved from room to 
room or used when visiting or moving from one house 
to another.                                                     Cont.  

Kidsafe SA can provide advice on the use of portable/travel 
cots Ph. 8161 6318 
Parenting SA have information on sleep and settling in their 
Parent Easy Guide    Sleep (Children 0-
6)  www.parenting.sa.gov.au/pegs/peg34.pdf and 
also www.cyh.com 

Parent Helpline can provide advice and support 24 hours a 
day 7 days a week Ph. 1300 364 100 

  






 
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Standard 2:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Families may cite 
reasons for sharing the 
same sleep surface with 
infants in preference to 
room-sharing. These 
may include: 

Infants are more at risk of SUDI and fatal sleeping 
incidents when adults share the same sleep surface 
with infants.  

 

 

 A portacot should only be used with the thin mattress 
which it comes with. No other mattress or padding 
should be added to the portacot. The mattress which 
the portacot comes with is designed to provide 
adequate comfort for the infant. 

Car seats, bouncinettes, hammocks, bean bags, 
pillows and sofas (armchairs, lounges, couches) are 
not designed as sleeping environments for infants and 
are not be used for that purpose. 

 

&gt; Historically and 
culturally   adults 
sharing the same 
sleep surface with 
infants is considered 
normal. 

&gt; Parents, particularly 
those for whom 
English is a second 
language, may not 
be aware of the 
risks of sharing the 
same sleep surface 
with infants. 

Despite the practice of adults sharing a sleep surface 
with baby being common in culturally diverse 
communities, Coronial inquests have determined that 
sharing the same sleep surface with infants is a risk to 
all infants including those from culturally diverse 
backgrounds. 

Although it may seem difficult, it is essential that staff 
provide all families with information about the risks of 
sharing the same sleep surface with infants and the 
benefits of room-sharing regardless of the family s 
cultural background. 

                                                                

                                                                 Cont.  

Aboriginal Maternal Infant Care (AMIC) Workers provide 
Aboriginal Women with continuity of care for antenatal, 
birthing and postnatal services. They can be contacted 
through: 

&gt; Women s and Children s Hospital  
Ph. 8161 7000 

&gt; Lyell McEwin Hospital   Birthing and Assessment Unit  
Ph. 8182 9326 

&gt; Northern Area Midwifery Group Practice  
Ph. 8252 3711, and 

&gt; Nunkuwarrin Yunti  
Ph. 8406 1600 



 
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Standard 2:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Families may cite 
reasons for sharing the 
same sleep surface with 
infants in preference to 
room-sharing. These 
may include: 

Infants are more at risk of SUDI and fatal sleeping 
incidents when adults share the same sleep surface 
with an infant. 

 

 

&gt; Lack of funds to 
purchase a cot 

&gt; No room for a cot in 
the parents  
bedroom. 

&gt; Lack of stable 
housing. 

&gt; Overcrowding, with 
many children 
sharing the same 
bed. 

All families, particularly those from diverse 
backgrounds, need to be aware that the risks of 
sharing the same sleep surface with infants under 12 
months are increased when protective factors such as 
a firm mattress or mat on the floor are substituted with 
softer sleeping surfaces. 

All parents also need to be particularly aware of the 
risks of sharing the same sleep surface with infants 
and smoking. Where possible: 

&gt; Ask the parents or caregivers about the infant s 
sleep environment at home.  

&gt; If the caregiver consents and if home visiting takes 
place, take a look at the infant s sleeping place. 

&gt; Whether it is obvious that sharing the same sleep 
surface with an infant is occurring or not - discuss 
the risks of sharing the same sleep surface and 
the benefits of room sharing (including 
breastfeeding). 

Cont.  

Australian Refugee Association provide assistance with 
community and cultural orientation and emergency financial 
and material assistance Ph. 8354 2951 

Migrant Resource Centre provides help with settlement, 
family relationships, counselling, financial support and 
emergency relief, CALD families and children s support 
services. Ph. 8217 9510 

Translating and Interpreting Service provides professional 
translating services 24/7. Ph. 131 450 

 Information about Safe Sleeping resources are available in 
other languages to download from the SIDS and Kids 
website www.sidsandkids.org  

  




 
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Standard 2:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Families may cite 
reasons for sharing the 
same sleep surface with 
infants in preference to 
room-sharing. These 
may include: 

Infants are more at risk of SUDI and fatal sleeping 
incidents when adults share the same sleep surface 
with infants.  

 

 

 &gt; Note the discussion in the case notes and ensure 
relevant supports and services have been 
engaged. 

Maternal awareness of the risk factors associated with 
SIDS and fatal sleeping incidents is likely to be lower 
where English is a second language or health literacy 
is low. 

If parents use sharing the same sleep surface with 
infants as a means for settling their child before sleep, 
work in partnership with them to identify other settling 
strategies which enable them to return the infant to 
his/her own sleep surface or contact the Parent 
Helpline to get assistance with this. 

 

&gt; Parents being 
concerned about not 
being able to 
respond to baby 
quickly enough 
during the night. 

Research in New Zealand and the UK has shown that 
sleeping an infant in the same room, but not in the 
same bed, with the parents for the first 12 months is 
protective. This is thought to be because parents can 
see the baby and easily check to see that baby is 
safe. Recent evidence from the UK indicates that 
sharing the same room during infant s daytime sleeps 
is also protective16. 

Cont.  

See Coroner s Findings in the matter of inquest number 
6/2008. Adelaide: Courts Administration Authority SA; 2008 
June p2630   

SIDS and Kids (2008) Information statement: Room-sharing. 
May, 2008. Canberra www.sidsandkids.org  

  




 
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Standard 2:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Families may cite 
reasons for sharing the 
same sleep surface with 
infants in preference to 
room-sharing. These 
may include: 

Infants are more at risk of SUDI and fatal sleeping 
incidents when adults  share the same sleep surface 
with infants  

 

 

 Several studies have shown that when a caregiver 
sleeps in the same room, but does not the share the 
same sleep surface with their infant, the chance of the 
baby dying suddenly and unexpectedly is reduced by 
up to 50% when compared to infants sleeping in a 
separate bedroom. 

If an infant is sleeping in a separate room, parents are 
not expected to observe their infant constantly but 
they should check the infant regularly to ensure that 
the infant remains on their back and the head and 
face remain uncovered (as an infant grows beyond  
5 6 months they will move around the cot and may 
roll over). 

Room-sharing facilitates a rapid response to a baby s 
needs, more convenient settling and comforting of 
infants, and closer mother-infant contact and 
communication. 

Room sharing is recommended for all infants although 
the room where an infant sleeps must be kept smoke 
free. 

 

  



 
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Standard 3: All staff will consider the social, cultural and life circumstances of each family when promoting safe sleeping practices and ensure the 
information is provided in ways that are culturally accessible and can be easily understood by that family. 
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Staff may miss 
opportunities for not 
providing information in 
culturally accessible 
and appropriate ways 
including: 

Families need information to be provided in ways that 
assist them to make decisions and exercise greater 
control over their health 

 

&gt; Assumptions of 
family literacy 
levels. 

&gt; Over reliance on 
written health 
information and 
resources. 

Much of the information provided to families 
assumes more than a basic level of health literacy. 
Prior to the birth and after the birth of an infant, 
families are exposed to an enormous amount of 
information from a variety of sources including 
media, marketing,  bounty bags , nurses, doctors and 
family members. 

Unpublished market research conducted in Adelaide, 
South Australia in 2009, found parents and 
caregivers more likely to act on and understand 
information about safe sleeping when this 
information is provided verbally from a health 
professional. 

Parents stressed the importance of the relationship 
with nurses and health professionals as once at 
home with the infant they are often time poor, tired 
and stressed. Some parents also reported they 
relied very little on books, pamphlets and other 
written information preferring to act on experience. 

Cont.  

SIDS and Kids provide resources in a number of 
languages  www.sidsandkids.org  

  




 
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Standard 3:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Staff may miss 
opportunities for not 
providing information in 
culturally accessible 
and appropriate ways 
including: 

Families need information to be provided in ways that 
assist them to make decisions and exercise greater 
control over their health 

 

 It is essential that staff work in partnership with 
families and provide information in ways that assist 
families and caregivers to understand and implement 
safe infant care practices and that they encourage 
families to ask questions and critically consider the 
information available to them. The provision of this 
essential information to parents should be 
documented in client records for both mother and 
infant. 

 

&gt; Time taken to 
communicate 
effectively. 

&gt; Lack of knowledge 
about where to 
access culturally 
appropriate 
information and 
support. 

&gt; Difficulties engaging 
with client relatives 
and kin. 

The time taken to communicate safe sleeping 
messages to families can significantly improve 
parents  capacity to provide a safe sleeping 
environment for their infant and reduce unnecessary 
risks. Failure to communicate or the provision of 
inconsistent, wrong or misleading information, 
significantly impairs parental capacity to problem solve 
and make critical decisions around achieving 
recommended safe sleeping practices. 

Wherever possible information should be provided in 
the most appropriate language and format. 
Approximately 2.7 million Australians (18%) have 
difficulty understanding and using information relating 
to health issues46.  

Cont.  

Aboriginal Maternal Infant Care (AMIC) Workers provide 
Aboriginal Women with continuity of care for antenatal, 
birthing and postnatal services. They can be contacted 
through: 

&gt; Women s and Children s Hospital 
Ph. 8161 7000 

&gt; Lyell McEwin Hospital   Birthing &amp; Assessment Unit 
Ph. 8182 9326 

&gt; Northern Area Midwifery Group Practice  
Ph. 8252 3711  

&gt; Nunkuwarrin Yunti  
Ph. 8406 1600  

Cont.  



 
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Standard 3:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Staff may miss 
opportunities for not 
providing information in 
culturally accessible 
and appropriate ways 
including: 

Families need information to be provided in ways that 
assist them to make decisions and exercise greater 
control over their health 

 

 Merely translating written health information may 
exclude those who are illiterate or have exceptionally 
low literacy levels, regardless of the language used47. 

Despite the difficulties that communication exchanges 
might present, it is very important that staff call on 
people who have credibility with the family or are able 
to effectively convey the messages and their 
importance. This may involve seeking people out who 
are able to help translate the information into the 
language or in a manner that is suitable and has 
meaning for the family. By doing this staff can ensure: 

&gt; knowledge and understanding of safe sleeping 
messages by families is improved, 

&gt; families have greater commitment and confidence 
to problem solve and overcome the barriers to 
implementing the safe infant care practices at 
home, and 

&gt; they have a greater awareness of families  needs 
and preferences. 

Many agencies now have Culturally and Linguistically 
Diverse (CALD) workers and Aboriginal Health or 
Liaison workers. Staff should familiarise themselves 
with these supports and call on them as needed. 

Australian Refugee Association provides assistance with 
community and cultural orientation and emergency financial 
and material assistance  
Ph. 8354 2951                        

Migrant Resource Centre provide help with settlement, 
family relationship counselling, financial support and 
emergency relief, CALD family and children s support service 
Ph. 8217 9510 

Translating  and  Interpreting Service provide professional 
translating services 24/7 
Ph. 131 450 



 
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Standard 4: All staff will ensure that expectant and new parents are made aware of the strong association between smoking and the increased risk of 
fatal infant sleeping incidents, and are supported and referred to smoking cessation or reduction programs. 

 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Expectant and new 
parents may not 
disclose their smoking 
status for a number of 
reasons 

Infants of mothers who smoke or who are exposed to 
second hand smoke are more likely to be stillborn, 
born prematurely and of low birth weight and suffer 
perinatal death. 

 

&gt; Families and 
caregivers may 
underestimate the 
effects of smoking 
on infants and 
children. 

&gt; Families and 
caregivers are 
under- informed 
about the risks 
between smoking, 
infants and fatal 
sleeping incidents. 

Infants and children are at a higher risk of harm from 
passive smoking than adults because of their smaller, 
developing bodies, higher breathing rates and less 
developed respiratory and immune systems. 

Infants of mothers who smoke or who are exposed to 
second hand smoke are more likely to be stillborn, 
born prematurely and of low birth weight and suffer 
perinatal death. Specific effects of passive smoking on 
infants and children include SIDS; respiratory 
infections and conditions including croup, bronchitis, 
and pneumonia; ear infections; learning difficulties; 
behavioural problems; and increased likelihood of 
childhood asthma48 51. 

There is no safe level of passive smoke exposure, and 
even brief exposures can be harmful. The elimination 
of smoking in indoor spaces is the only way to fully 
protect children from exposure to second hand smoke. 
Primary sources of infants  and children s passive 
smoke exposure are the home and vehicle.  

Cont... 

Smoking and Pregnancy booklet available from Quit SA  
 www.quitsa.org.au/aspx/order_ online.aspx  
 
Pregnant and Smoking (Aboriginal) booklet available from 
Quit SA    www.quitsa.org.au/aspx/order_ online.aspx  
 
Quit SA can provide information and advice on how to quit 
smoking. Ph. 137848  or visit  www.quitsa.org.au  
 
SIDS and Kids also have an information statement on 
Smoking   www.sidsandkids.org  

  







 
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Standard 4:  cont.   
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Expectant and new 
parents may not 
disclose their smoking 
status for a number of 
reasons: 

Infants of mothers who smoke or who are exposed to 
second hand smoke are more likely to be stillborn, 
born prematurely and of low birth weight and suffer 
perinatal death. 

 

 A single cigarette smoked in a room with poor 
ventilation generates much higher concentrations of 
toxic substances in the air than normal, everyday 
activities in a city, while nicotine from second hand 
smoke is deposited on household surfaces and in 
dust. Environmental tobacco smoke permeates the 
entire house and lingers long after the cigarette has 
been extinguished, so smoking in certain rooms, at 
certain times, or by a window, fan or door is not safe37. 

 

&gt; They are unaware of 
the opportunities 
pregnancy presents 
to quit smoking. 

Pregnancy provides a unique window of opportunity to 
minimise smoking rates and increase the health of 
women and children. More women cease smoking in 
pregnancy than at any other time in life. One quarter 
of Australian women who are smokers when they 
become pregnant stop smoking. Most of the women 
who quit smoking spontaneously upon becoming 
pregnant have a non-smoking partner, are supported 
to quit, or have stronger beliefs about the dangers of 
smoking than do those who do not quit35,36.  

Quit SA can provide information and advice on how to quit 
smoking. Ph. 137848  or visit  www.quitsa.org.au 

  




 
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Standard 5:  All staff will provide parents/caregivers and families with accurate information about a safe cot, with a safe mattress, safe bedding and in a 
safe environment. 
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Parents and staff may 
express reasons for not 
implementing safe 
sleeping environments 
including: 

A safe sleeping environment is one where all potential 
dangers have been removed and the infant is sleeping 
in a safe place. 

 

&gt; Belief that infant 
sleeps better with 
teddy bears and soft 
toys, a pillow or 
doona. 

&gt; Belief that cot 
bumpers protect 
infant s head. 

One of the key barriers to parents and caregivers 
implementing safe infant care practices is perceptions 
of infant comfort believing their infant sleeps better 
with a teddy or a pillow. It is critical that parents are 
provided with evidence based health advice about not 
placing toys and pillows in the cot9. 

Research has found that parents who have the 
opportunity to work in partnership with health 
professionals to problem solve the issues around 
comfort and protection for their infant are more likely 
to adopt safe infant care practices52. 

Providing information in ways that allow parents to 
gain an understanding of the evidence which supports 
safe infant care practices, particularly those relating to 
the risks of asphyxiation (suffocation) and overheating 
due to soft toys, bumpers, pillows and doonas is 
essential. 

SIDS and Kids SA can provide advice on creating and 
setting up a safe sleeping environment Ph. 83321066  
www.sidsandkids.org  

SIDS and Kids also have an easy-to- read brochure with 
graphics of a safe cot and bedding on their 
website www.sidsandkids.org  

Kidsafe SA provide advice on the cot standards and safe 
sleeping environments Ph. 8161 6318  
www.kidsafesa.com.au  

  






 
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Standard 5:  cont.  
 

Challenges in meeting  
best-practice 

Evidence supporting best practice Support and resources 

Parents and staff may 
express reasons for not 
implementing safe 
sleeping environments 
including: 

A safe sleeping environment is one where all potential 
dangers have been removed and the infant is sleeping 
in a safe place. 

 

&gt; Parental concerns 
about infant not 
being warm enough 
lead to over 
dressing and 
overheating. 

Infants regulate their temperature through the head, 
particularly the face. In a heavily wrapped infant, 85% 
total heat loss is through the face. If this normal 
method of heat loss is restricted by bedding covering 
the face, wearing a bonnet or tummy sleeping (partial 
face covering by mattress and/or bedding), there is 
the propensity for thermal stress to occur 
(overheating)37. 

SIDS and Kids provide an Information statement on Room 
Temperature www.sidsandkids.org and an information 
statement bedding amount recommended for safe sleep 

The www.cyh.com  website provides a comprehensive 
explanation with pictures of the ins and outs of wrapping 
babies  

The www.cyh.com  website provides a comprehensive 
explanation with pictures of the ins and outs of wrapping 
babies 

&gt; Lack of knowledge 
about Australian 
Standards for cots. 

&gt; Relatives and 
friends give 
bumpers and pillows 
as gifts or 
heirlooms. 

A safe cot is one that meets the Australian Standard 
for cots. All new and second- hand cots sold in 
Australia must meet the Australian Standard for 
Household Cots (AS/NZ 2172)53 and will carry a label 
verifying this. Portable cots sold in Australia must now 
also meet the Australian Standard AS/NZS 2195 for 
portable cots39,54. 

Unsafe cots and bedding; whether given as a well-
meaning gift at a baby shower or passed down 
through the family as an heirloom, pose risks to 
infants. These are best kept for display only and not 
used where the infant sleeps. 

If you or a parent seeks information about the safety 
of a product, contact the Australian Competition and 
Consumer Commission. 

Kidsafe SA website www.kidsafesa.com.au  

For Information on mandatory product 
safety www.productsafety.gov.au  

The Australian Competition and Consumer Commission 
(ACCC) provides an booklet with information for consumers 
called  Find out More: Keeping Baby Safe - a guide to infant 
and nursery products  www.accc.gov.au 









 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Services and 
information 

 

 
 

Quick guide for help 

Quick guide for information 

References 

 
 
 
 
 
 
 
 
 
 
 
 

 



 
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11. Quick guide for help 
This list is intended as a guide only and does not in any way intend to be an exhaustive 
list of all available services in South Australia. 

 

Challenges to Safe 
Practice  

Services
  Details Contact 

Sleep positioning 

Placing infant on back to 
sleep may raise: 

&gt; concerns about infants 
aspirating after feeding 
and regurgitating, 

&gt; belief that infant 
sleeps and settles 
better on the front or 
side, 

&gt; difficulty settling and 
putting infants down to 
sleep, 

&gt; concerns about  
misshapen head 
(plagiocephaly). 

Child and 
Family Health 
Nurses 

Child and Family 
Health Nurses can 
provide support and 
advice to parents. 

CaFHS appointment line 
Ph. 1300 733 606 

Kidsafe SA Kidsafe SA provide 
advice on the risks 
and safety aspects 
of aids and devices 
for infants. 

Kidsafe SA 
Ph. 8161 6318 
www.kidsafesa.com.au  

SIDS and 
Kids SA 

Provide 
bereavement 
counselling and safe 
sleeping advice. 

SIDS and Kids SA  
Ph. 83321066 
www.sidsandkids.org  

SA Parent 
Helpline 

Advice on settling 
infants is available 
from the Parent 
Helpline 24/7. 

SA Parent Helpline 
Ph.1300 364 100 
www.parenting.sa.gov.au
/helpline.htm   

Health Direct 
Helpline 

24 hour call centre 
for non -urgent 
health advice. 

Health Direct Helpline  
Ph. 1800 022 222 

Cot bedding 

Removing many forms of 
bedding and toys from the 
cot may raise: 

&gt; concerns baby will get 
cold without a doona, 
hat, duvet etc., 

&gt; belief that baby sleeps 
better with toys, pillow 
or sheep skin in the 
cot, 

&gt; no funds to purchase 
baby sleeping bag. 

Child and 
Family Health 
Nurses 

CaFHS nurses can 
demonstrate 
wrapping techniques 
and advise on 
appropriate infant 
bedding and settling 
techniques. 

CaFHS appointment line 
Ph. 1300 733 606 

SA Parent 
Helpline  

Kidsafe SA 

Can provide advice 
on setting up a safe 
sleep environment 
for infants 24/7. 

Parent Helpline  
Ph.1300 364 100 
www.parenting.sa.gov.au
/helpline.htm 

Kidsafe SA 
Ph. 8161 6318 

SIDS and 
Kids SA 

Provide 
bereavement 
counselling and 
advice about 
creating a safe 
sleeping 
environment for 
infants. 

SIDS and Kids SA  
Ph. 83321066 
www.sidsandkids.org 










 
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Health Direct 
Helpline 

24 hour call centre 
for non-urgent 
health advice. 

Health Direct Helpline  
Ph. 1800 022 222 

Smoking at home 

Families &amp; caregivers: 

&gt; underestimate the 
effects of smoking on 
infants, 

&gt; are unaware of the 
association between 
smoking and fatal 
sleeping incidents, 

&gt; are unaware of the 
opportunities 
pregnancy presents to 
quit smoking. 

Quit SA Provides state-wide 
programs to help 
smokers quit 
smoking. 

Quit SA  
Ph.137 848 

Room sharing 

Sleeping an infant in their 
own cot located next to 
the parent s bed or in the 
same room as the parents 
could present difficulties if 
there is: 

&gt; no access to a cot, 

&gt; no funds for a cot, 

&gt; no room for a cot in 
the parent s bedroom, 

&gt; cultural practices 
which support other 
than safe practice, 

&gt; no stable housing, 

&gt; many children sharing 
the same bed. 

Aboriginal 
Maternal 
Infant Care 
Workers 

Aboriginal Maternal 
Infant Care Workers 
provide Aboriginal 
Women and their 
families with 
continuity of care for 
antenatal, birthing 
and postnatal 
services. 

AMIC workers can be 
contacted through: 

&gt; Women s and 
Children s Hospital  
Ph. 8161 7000 

&gt; Lyell McEwin Hospital 
  Birthing &amp; 
Assessment Unit 
Ph. 8182 9326 

&gt; Northern Area 
Midwifery Group 
Practice 
Ph. 8252 3711 

&gt; Nunkuwarrin Yunti  
Ph. 8406 1600 

Department 
for Education 
and Child 
Development 
(DECD)  

  Families SA 

Can provide 
information and 
access to financial 
services, housing 
services and family 
support for those in 
the child protection 
system. 

The DECD website has 
location and contact 
details of services 
provided  

www.decd.sa.gov.au  




 
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Centacare 

Lutheran 
Community 
Care 

Anglicare 

Uniting Care 
Wesley 

These 4 agencies 
can provide 
emergency financial 
assistance and 
housing support in 
certain 
circumstances, and 
some provide 
services in country 
areas. 

Their websites have 
location and contact 
details of services 
available: 

Centacare 
www.centacare.org.au  

Lutheran Care  
www.lccare.org.au  

Anglicare 
http://anglicaresa.com.a
u/  

Uniting Care Wesley  
www.ucwpa.org.au  

 Nunkuwarrin 
Yunti of SA 

Provide access to 
paediatrician 
services for 
Aboriginal families. 

Nunkuwarrin Yunti Ph. 
8406 1600 

Translating 
and 
Interpreting 
Service (TIS) 

Provide professional 
translating services 
24/7. 

Translating and 
Interpreting Service 
(TIS)   Ph. 131 450  
and quote your service s 
client no.  

Migrant 
Health 
Service 

The MHS provides 
culturally 
appropriate medical 
care for migrants, 
refugees and 
asylum seekers. 
Training, advice and 
information is also 
provided to 
individuals and 
groups. 

Migrant Health Service  
Ph. 8237 3900 

Migrant 
Resource 
Centre (MRC) 

Can provide help 
with settlement, 
financial support and 
emergency relief, 
CALD family and 
children s support 
service. 

Migrant Resource 
Centre (MRC) 

Ph. 8217 9510 

  








 
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Difficult social, cultural 
and life circumstances 

Difficulty implementing 
safe infant care practices 
due to: 

&gt; poor emotional health 
and wellbeing, anxiety, 
depression, 

&gt; recent migration, 

&gt; cultural and linguistic 
diversity, 

&gt; limited mental 
capacity, 

&gt; drug/alcohol use, 

&gt; violence, 

&gt; young parents. 

Nunkuwarrin 
Yunti of SA 

Have access to 
psychologist and 
psychiatric services 
for Aboriginal 
families. 

Nunkuwarrin Yunti Ph. 
8406 1600 

Alcohol and 
Drug 
Information 
Service 
helpline 

Provide confidential 
alcohol and drug 
counselling 24/7.  

If an interpreter is 
needed, ring the 
Translating and 
Interpreting Service 
on 13 1450 and ask 
to be connected to 
the SA Alcohol and 
Drug Information 
Service. 

Alcohol and Drug 
Information Service 
helpline 

Ph. 1300 13 1340 

South Australian callers 

  local call fee 

Or phone Translating 
and Interpreting Service 
on 131450 for an 
interpreter 

Beyond Blue 
Info Line 

Provides access to 
information and 
referral to relevant 
services for 
depression and 
anxiety. 

Beyond Blue Info Line 
Ph. 1300 22 4636 

Families SA Can provide access 
to financial services, 
housing services 
and family support 
for those in the child 
protection system. 

Families SA has a 
specific role to 
protect children.  
Any concerns about 
the safety and well-
being of infants and 
children can be 
made to the Child 
Abuse Report Line 
which operates 24/7. 

The Department for 
Education and Child 
Development DECD 
website has location and 
contact details of 
services provided  

www.decd.sa.gov.au  

The Child Abuse Report 
Line 
 Ph. 131 478 is a part of 
Families SA. 

 Louise Place 
(Centacare) 

Louise Place is a 
24hour supported 
accommodation 
service for young 
women who are 
pregnant or 
parenting and who 
are homeless or at 
risk of 
homelessness, 
during their 
pregnancy and in 
the early months of 
parenting.  They 
also provide an 
outreach service. 

Louise Place can be 
contacted directly on Ph. 
8272 6811 




 
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Migrant 
Health 
Service 
(MHS) 

The MHS provides 
culturally 
appropriate medical 
care for migrants, 
refugees and 
asylum seekers. 
Training, advice and 
information is also 
provided to 
individuals and 
groups. 

Migrant Health Service 
Ph. 8237 3900 

Migrant 
Resource 
Centre (MRC) 

The MRC provides 
help with settlement, 
family relationship 
counselling, financial 
support and 
emergency relief, 
CALD family and 
children s support 
service. 

Migrant Resource 
Centre  
Ph. 8217 9510 

Difficult social, cultural 
and life circumstances 

 

Difficulty implementing 
safe infant care practices 
due to: 

&gt; poor emotional health 
and wellbeing, anxiety, 
depression, 

&gt; recent migration, 

&gt; cultural and linguistic 
diversity, 

&gt; limited mental 
capacity, 

&gt; drug/alcohol use, 

&gt; violence, 

&gt; young parents. 

Translating &amp;  
Interpreting 
Service (TIS) 

Provide professional 
translating services 
24/7. 

Translating and 
Interpreting Service  
Ph. 131 450 and quote 
your service s client 
number 

Men s Line Provides a 
dedicated service for 
men with 
relationship and 
family concerns 
24/7. 

Men s Line 
Ph. 1300 789978 
www.mensline.org.au  

Domestic 
Violence 
Crisis Service  
1300 782 200 

Mon Fri 
(9am 4pm) 

Police  
131 444 

Central 
Eastern 
Domestic 
Violence 
Service - 
CALD workers 
may be 
available  
08/ 8365 5033 

These are just a 
starting place to 
contact Aboriginal 
workers located in 
the Northern and 
Southern regions of 
SA providing advice 
and assistance 
responding to 
domestic violence. 

Northern:  

Muna Paiendi  
Ph. 8182 9206 

Southern:  

ATSI Primary Health 
Care Team 
Ph. 8384 9266 

Aboriginal Family Clinic 
Ph. 8179 5943 

Flinders Medical Centre 
- Karpa Ngarrattendi  
Ph. 8204 5012 

  




 
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12. Quick guide for information 

The Child and Family Health Service website www.cyh.com provides a comprehensive 
range of up-to-date evidence-based information about safe sleeping for infants. Another 
useful source of information is the SIDS and Kids website www.sidsandkids.org.   

Listed below are further information sources available to families seeking evidence-
based information about safe infant sleeping environments and care practices. 

Safe infant care Information 
service 

Details Contact 

Sleep and settling Parenting SA Parent Easy Guides 

 Sleep (Children 0 6 
years)  

www.parenting.sa.gov.au/p
egs/peg34.pdf  

Head shape 
(plagiocephaly) 

Child and Family 
Health 

 Plagiocephaly  

 Baby s Head Shape  

www.cyh.com  

www.sidsandkids.org  

Wrapping Infants SIDS and Kids SA  Wrapping Infants  Info 
Sheet 

www.sidsandkids.org 

Tummy time SIDS and Kids SA  Tummy time  
brochures 

SIDS and Kids 
Ph. 83321066 
www.sidsandkids.org 

Post-natal 
depression/anxiety 

Beyond Blue Provide information 
about mental health, 
anxiety and 
depression on their 
website 

Ph. 1300 22 4636 
www.beyondblue.org.au  

www.cyh.com  

Culturally and 
linguistically 
diverse written 
information 

SIDS and Kids SIDS and Kids 
provide information 
sheets in other 
languages 

www.sidsandkids.org 

Product Safety, 
cots and the 
dangers of 
positioning cots 
near blind cords 
and other hazards 

Kidsafe SA Australian Standard 
for Household Cots 
(AS/NZS 2172)55 

 

Tips to keep your baby safe 
 - Kidsafe SA  

Ph. 81616318 
www.kidsafesa.com.au  

 
Australian  
Competition and 
Consumer 
Commission 

For information about 
competition, fair trade 
and consumer 
protection laws and 
benefits for 
consumers, business  
and the community 

www.productsafety.gov.au  

www.accc.gov.au  

 

  

















 
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13. References 
 

1.   SA Health. South Australian Safe Infant Sleeping Standards. South Australia Department for 
Health and Ageing: South Australian Government; 2011 March. 

2.   Linacre S. Australian social trends 2007: Australia s babies. Catalogue no. 4102.0. Canberra: 
Australian Bureau of Statistics; 2007. 

3.   Tursan d Espaignet E, Bulsara M, Wolfenden L, Byard RW, Stanley FJ. Trends in sudden 
infant death syndrome in Australia from 1980 to 2002. Forensic Science Medicine and 
Pathology. 2008;4(2):83 90. 

4.   Maternal, Perinatal and Infant Mortality Committee. Maternal, perinatal and post-neonatal 
deaths in South Australia 2013. Adelaide: SA Health, Government of South Australia; in press. 

5.   Child Death and Serious Injury Review Committee, Annual Report, 2014  

6.   Horne RS, Hauck FR, Moon RY. Sudden infant death syndrome and advice for safe sleeping. 
BMJ 2015;350:h1989 doi: 10.1136/bmj.h1989 (Published 28 April 2015). 

7.   Hunt CE, Hauck FR. Sudden infant death syndrome. Canadian Medical Association Journal. 
2006;174(13):1861 1869. 

8.   Vennemann MMT, Butterfa -Bahloul T, Jorch G, Brinkmann B, Findeisen M, Sauerland C,  
Bajanowski T, Mitchell EA, The GeSID group. Sudden Infant Death Syndrome: No increased 
risk after immunisation. Vaccine. 2007;25(2):336 340. 

9.   Mitchell EA, Blair, PS, L Hoir MP. Should pacifiers be recommended to prevent sudden infant 
death syndrome?  Pediatrics.  2006;117(5):1755 1758. 

10. Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. The Lancet. 
2007;370(9598):1578 1587. 

11. Blair PS, Sidebotham P, Berry PJ, Evans M, Fleming PJ. Major epidemiological changes in 
sudden infant death syndrome: a 20 year population-based study in the UK. The Lancet. 
2006;367(9507):314 319. 

12. Kennare R, Scheil W, Tucker G. A public health approach to review of sudden unexpected 
infant deaths   challenges and interventions. Australian Journal of Child and Family Health 
Nursing Volume 12, Issue 1, June 2015. 

13. National Institute for Health and Care Excellence. Clinical Guideline 37, Postnatal Care. 
Routine postnatal care of women and their babies: Clinical Guideline Addendum 37.1; 
Methods, evidence and recommendations. 2014. 

14. Ibid.  

15. Monash University. Literature Review and Recommendations for Safe Infant Sleeping. The 
Ritchie Centre, Monash University. 2013. 

16. Monash University, loc. cit. 

17. Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EMA, Fleming P. 
Hazardous co-sleeping environments and risk factors amenable to change: case-control study 
of SIDS in south west England. BMJ. 2009;339(b3666):1 11 

18. Monash University, loc. cit. 

19. Ibid. 
 



 
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20. Tappin D, Ecob R, Brooke H. Bedsharing, roomsharing and sudden infant death syndrome in 
Scotland: a case-control study. The Journal of Pediatrics. 2005 July: 147(1):32 37. 

21. Carpenter RG, Irgens LM, Blair PS, England PD, Fleming P, Huber J, Jorch G, Schreuder P. 
Sudden unexplained infant death in 20 regions in Europe: case control study. The Lancet. 2004 
Jan 17;363:185 191. 

22. Monash University, loc. cit. 
 
23. Vennemann, Mechtild M., et al. "Bed sharing and the risk of sudden infant death syndrome: 

can we resolve the debate?" The Journal of pediatrics160.1 (2012): 44-48. 

24. National Institute for Health and Care Excellence, loc. cit.  

25. Carpenter, Irgens, Blair, et al., loc. cit.  
 
26. Ibid. 

27. Ibid. 
 
28. Monash University, loc. cit. 

29. Joint Technical Committee CS-003. Australia/New Zealand Standard 2172: Cots for household 
use   Safety requirements. Sydney/Wellington: Standards Australia/Standards New Zealand; 
2013 Apr 

30. Ibid. 

 

 
8.    Document Ownership &amp; History 
Document developed by:  Child Health Strategy, Women s and Children s Health Network 
File / Objective No.: eA891217    DHA2015-06350/1 
Next review due:   16/10/23  
Policy history: Is this a new policy (V2.1)?  N 
 Does this policy amend or update an existing policy version?   Y  
 If so, which version?  V2.0 
 Does this policy replace another policy with a different title?  N 
 If so, which policy (title)? 
 
ISBN No.:                             978-1-76083-079-3 
 
 
 
 

 

Approval 
Date Version 

Who approved New /  
Revised Version Reason for Change 

16/10/18  V2.1 
Interim Director Health Informatics, 
Performance, Planning &amp; 
Outcomes WCHN 

Minor changes in line with Legislation 

 



 
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03/10/16  V2.0 Approved at Portfolio Executive 

Formally reviewed in line with 1-5 year 
scheduled timeline for review.  
 
Section 5.4 and references updated to 
reflect current research and populated into 
policy template.  
 

14/02/11  V1.0 Approved at Portfolio Executive Original Portfolio Executive approved version. 
 
 

 
 
References 
 
32.   SA Health. South Australian Safe Infant Sleeping Standards. South Australia Department for 

Health and  Ageing: South Australian Government; 2011 March. 

32.   Linacre S. Australian social trends 2007: Australia s babies. Catalogue no. 4102.0. Canberra: 
Australian Bureau of Statistics; 2007. 

32.   Tursan d Espaignet E, Bulsara M, Wolfenden L, Byard RW, Stanley FJ. Trends in sudden 
infant death syndrome in Australia from 1980 to 2002. Forensic Science Medicine and 
Pathology. 2008;4(2):83 90. 

32.   Maternal, Perinatal and Infant Mortality Committee. Maternal, perinatal and post-neonatal 
deaths in South Australia 2013. Adelaide: SA Health, Government of South Australia; in press. 

32.   Child Death and Serious Injury Review Committee, Annual Report, 2014  

32.   Horne RS, Hauck FR, Moon RY. Sudden infant death syndrome and advice for safe sleeping. 
BMJ 2015;350:h1989 doi: 10.1136/bmj.h1989 (Published 28 April 2015). 

32.   Hunt CE, Hauck FR. Sudden infant death syndrome. Canadian Medical Association Journal. 
2006;174(13):1861 1869. 

32.   Vennemann MMT, Butterfa -Bahloul T, Jorch G, Brinkmann B, Findeisen M, Sauerland C,  
Bajanowski T, Mitchell EA, The GeSID group. Sudden Infant Death Syndrome: No increased 
risk after immunisation. Vaccine. 2007;25(2):336 340. 

32.   Mitchell EA, Blair, PS, L Hoir MP. Should pacifiers be recommended to prevent sudden infant 
death syndrome?  Pediatrics.  2006;117(5):1755 1758. 

32. Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. The Lancet. 
2007;370(9598):1578 1587. 

32. Blair PS, Sidebotham P, Berry PJ, Evans M, Fleming PJ. Major epidemiological changes in 
sudden infant death syndrome: a 20 year population-based study in the UK. The Lancet. 
2006;367(9507):314 319. 

32. National Institute for Health and Care Excellence. Clinical Guideline 37, Postnatal Care. 
Routine postnatal care of women and their babies: Clinical Guideline Addendum 37.1; 
Methods, evidence and recommendations. 2014. 

32. Ibid.  

32. Monash University. Literature Review and Recommendations for Safe Infant Sleeping. The 
Ritchie Centre, Monash University. 2013. 

 



 
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32. Monash University, loc. cit. 

32. Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EMA, Fleming P. 
Hazardous co-sleeping environments and risk factors amenable to change: case-control study 
of SIDS in south west England. BMJ. 2009;339(b3666):1 11 

32. Monash University, loc. cit. 

32. Ibid. 

32. Tappin D, Ecob R, Brooke H. Bedsharing, roomsharing and sudden infant death syndrome in 
Scotland: a case-control study. The Journal of Pediatrics. 2005 July: 147(1):32 37. 

32. Carpenter RG, Irgens LM, Blair PS, England PD, Fleming P, Huber J, Jorch G, Schreuder P. 
Sudden unexplained infant death in 20 regions in Europe: case control study. The Lancet. 2004 
Jan 17;363:185 191. 

32. Monash University, loc. cit. 
 
32. Vennemann, Mechtild M., et al. "Bed sharing and the risk of sudden infant death syndrome: 

can we resolve the debate?" The Journal of pediatrics160.1 (2012): 44-48. 

32. National Institute for Health and Care Excellence, loc. cit.  

32. Carpenter, Irgens, Blair, et al., loc. cit.  
 
32. Ibid. 

32. Ibid. 
 
32. Monash University, loc. cit. 

32. Joint Technical Committee CS-003. Australia/New Zealand Standard 2172: Cots for household 
use   Safety requirements. Sydney/Wellington: Standards Australia/Standards New Zealand; 
2013 Apr 

32. Ibid. 

32. Bacon C, Fleming, PJ. Design of the SUDI study. Chapter 2, p.8. In: Fleming PJ, Blair PS, 
Bacon C, Berry J, editors. Sudden unexpected deaths in infancy: the CESDI SUDI studies 
1993 1996. London: The Stationery Office; 2000. 

32. Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowsky T, Corey T, Gutz E, Hanzlik R, 
Keens TG, Mitchell EA. Sudden infant death syndrome and unclassified infant deaths: A 
definitional and diagnostic approach. Paediatrics, 2004;114(1): 234 238 

 

 

33. Mit chell EA, Hut ch ison  BL, Thom p son , J MD, Would es TA. Exp lo rat o ry st ud y o f  
b ed -sh ar ing and  m at ernal-in f an t  b ond ing . Journal o f  Paed iat r ics and  Ch ild  Healt h  
2015:51:820 825; DOI:10.1111/jp c.12833. 

34. Joint Technical Committee, loc. cit. 
 



 
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35. UNICEF UK Baby Friendly Initiative. Babies sharing their mother s bed while in hospital: a sample 
policy. London: UNICEF UK Baby Friendly Initiative; 2004 May.  

36. Joint Technical Committee, loc. cit. 

37. Craig WR, Hanlon-Dearman A, Sinclair C, Taback S, Moffatt M. Metoclopramide, thickened 
feedings, and positioning for gastro-oesophageal reflux in children under two years. Cochrane 
database of systematic reviews. The Cochrane Collaboration: John Wiley and Sons, Ltd. 2010; 
Issue 5. Art. No.: CD003502. 

38. Boschert S. Mother s race a factor in infant sleep positioning: expand education efforts. Family 
Practice News. 2004;34(2):57. 

39. Colson ER, McCabe LK, Fox K, Levenson S, Colton T, Lister G, Corwin MJ. Barriers to 
following the back-to-sleep recommendations: Insights from focus groups with inner-city 
caregivers. Ambulatory Pediatrics. 2005;5(6):349 54. 

40. Craig, Hanlon-Dearman, Sinclair, Taback, Moffatt, loc. cit.   

41. American Academy of Pediatrics Policy Statement. The Changing Concept of Sudden Infant 
Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping 
Environment, and New Variables to Consider in Reducing Risk. Pediatrics 2005;116;1245; 
originally published online October 10, 2005;DOI: 10.1542/peds.2005-1499. 

42. Galland BC, Taylor BJ, Bolton DPG. Prone versus supine sleep position: A review of the 
physiological studies in SIDS research. Journal of Paediatrics and Child Health. 
2002;38(4):332 338. 

43. Mawji A, Vollman AR, Fung T, Hatfield J, McNeil DA, Sauv  R. Risk factors for positional 
plagiocephaly and appropriate time frames for prevention messaging. Paediatrics &amp; Child 
Health. 2014;19(8):423-427. 

44. Joint Technical Committee, loc. cit. 

45. Coroner s Court South Australia. Findings in the matter of Inquest Number 6/2008 (1908/2005, 
2061/2005, 2152/2005, 2299/2005, 0953/2006). Adelaide: Courts Administration Authority 
South Australia; 2008 June. p. 26. 

46. Linacre S. Adult literacy and life skills survey, summary results. Catalogue no. 4228.0. 
Canberra, Australian Bureau of Statistics; 2006:5. 

47. Nutbeam, D. Health Literacy as a public health goal: a challenge for contemporary health 
education and communication strategies in the 21st Century. Health Promotion International. 
2000;15(3):259 267. 

48. National Health and Medical Research Council. The health effects of passive smoking: A 
scientific information paper. Canberra: Australian Government Publishing Service; 1997 Nov. 
p.57. 

49. US Department of Health and Human Services. Children and Secondhand Smoke Exposure. 
Excerpts from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report 
of the Surgeon General. Atlanta: US Department of Health and Human Services, Centres for 
Disease Control and Prevention, Coordinating Centre for Health Promotion, National Centre for 
Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2007. 

50. Lumley J, Oliver S, Chamberlin C, Oakley L. Interventions for promoting smoking cessation 
during pregnancy. The Cochrane Database of Systematic Reviews. The Cochrane 
Collaboration; John Wiley and Sons, Ltd. 2009; Issue 3. Art No.: CD001055. 

 



 
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51. Centre for Community Child Health. Preventing Smoking During Pregnancy: Practice Resource 
[Internet]. 2006 [cited 2011 Jan 12]. Available from: 
http://www.rch.org.au/ccch/profdev.cfm?doc_id=11187  

52. Australian Competition and Consumer Commission. Keeping baby safe: a guide to nursery 
furniture. Canberra: Commonwealth of Australia; 2005. 

53. Joint Technical Committee, loc. cit. 

54. Ibid. 

55. Ibid. 



	1. Policy Statement
	2. Roles and Responsibilities
	3. Policy Requirements
	4. Implementation and Monitoring
	5. National Safety and Quality Health Service Standards
	6. Definitions
	7. Associated Policy Directives / Policy Guidelines and resources
	8. Document Ownership &amp; History
	Additional best practice indicators specific to SA Health staff and volunteers
	Additional best practice indicators specific to Department for Child Protection staff and volunteers

	Appendix 3
	Additional best practice indicators specific to Department for Education   Early Childhood Services staff and volunteers

	Appendix 4
	Details of the original committee who developed the Standard

	Standard 1: All staff will place well infants under 12 months on their back to sleep from birth, never on the front (tummy) or side, unless there are medically indicated reasons.
	Standard 2: All staff will be fully informed about the risks of sharing the same sleep surface with an infant and promote the placing of infants for sleep in an Australian Standards compliant cot (AS/NZS 2172)P43F P in the same room as the parents for...
	Standard 3: All staff will consider the social, cultural and life circumstances of each family when promoting safe sleeping practices and ensure the information is provided in ways that are culturally accessible and can be easily understood by that fa...
	Standard 4: All staff will ensure that expectant and new parents are made aware of the strong association between smoking and the increased risk of fatal infant sleeping incidents, and are supported and referred to smoking cessation or reduction progr...
	Standard 5:  All staff will provide parents/caregivers and families with accurate information about a safe cot, with a safe mattress, safe bedding and in a safe environment.

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