Safe and secure sleep

By Health Visitor Kathrine Klem Vernersen

Babies have a different sleep pattern than adults. When I visit new parents in my role as a health visitor, I’m often asked questions relating to their child’s sleep. So I've written this guide with tips for safe and secure sleep.

Sleep is vital to a baby’s growth and development. While a baby sleeps, growth hormone is produced in the brain, the baby’s immune system is strengthened and the brain has a resting period to integrate the day’s sensory activity and stimuli. It is therefore important to give your child the best conditions for safe and secure sleep.

The 1-4 week old baby needs to sleep approximately 15-18 hours a day. However, there are big differences between children, and while some can’t sleep for 15 hours in a 24-hour period, others can sleep for more than 18 hours. The number of consecutive sleep hours can also vary from child to child. The need for sleep and the length of sleep regulate as the child grows older.

Safe sleep

The Danish Health Authority recommends that it is safest for a young child to sleep in their own bed in the same room as their parents. For example, their bed can be placed at the foot of or next to the parents’ bed.

If your child is restless, place them at the bottom of the bed so they can feel the edge of the bed with their feet. Being able to sense barriers and boundaries reminds the baby of their time sleeping in the safety of the womb. It helps your baby to calm down when they are surrounded by safe hands, a baby duvet or when they can feel the edge of a bed.

If you choose to co-sleep with your child, the child should be positioned between you and the child's own bed. Make sure that there are no gaps for your child to fall into while you sleep.

The bed should have a firm mattress and be wide enough to accommodate both you and your child. The child should sleep with their own duvet and there should be no other siblings (or pets) in the bed that could lie on the child.

Whether your child sleeps in their own bed or in your bed, they should always sleep on their back with their head alternating between right and left sides. This prevents the back or side of the child’s heads becoming flat.
It is important that the temperature in the room where your child sleeps is not too high, as heat is associated with a risk of sudden infant death syndrome (SIDS). It is recommended that the temperature in the room the child sleeps in is between 18-20 degrees with no draught. It is also important that the child lies on a firm mattress to prevent sinking into the mattress and blocking their airways. If the child sleeps in their own bed, the mattress should go all the way to the edge of the bed to avoid any gaps that the child could fall into.

Create security with a baby bumper

For the first few months of your baby’s life, you can equip their bed with a baby bumper. A baby bumper helps to keep your child safe and protect them from the sides of the bed. It’s important to select a baby bumper that is breathable so that your child can still breathe if they end up lying with their face against the bumper.

It is recommended that you remove the baby bumper when your child can stand up on their own, as it can provide a foothold that could allow the child to climb out of bed. A good and safe bed with firm sides can also have a reassuring effect on the child when the baby bumper has been removed.

Differentiate between day and night

Sleep plays an important role in a child's growth and development. From newborn onwards, it is recommended that parents differentiate between night and day when putting their baby to bed.

When putting your child to bed during the day, it's a good idea to let them sleep in daylight. In the evening, you can put your child to sleep in a dark room, and at night it is recommended that they sleep in the dark. The darkness helps the body produce the sleep hormone melatonin, which makes the child feel tired.

You can help your baby get into a good circadian rhythm by using dimmed lighting at night when changing nappies. This sends a signal to your child that it's night time and still time to sleep.

Routines and sleep

After the first few months of life, your baby starts to sense and recognise different routines and begins to have a circadian rhythm.

Around 3-4 months of age, your child can be helped to sleep in a more structured way. Set nap times during the day, along with regular bedtime routines, can help your child understand that it's time to sleep.

If your child becomes restless after being tucked in, it can help to let them know you’re there, to comfort them and let them know it's time to sleep. Talking to your child in a low, calm tone of voice and holding them gently while in bed can have a soothing effect.

If that doesn't help, pick your baby up and rock them gently. Experience suggests that your baby calms down faster when you keep their head elevated. Once they have calmed down/fallen asleep, try putting them back in bed by letting their feet touch the mattress first. Next, place them on the mattress, and then lay them down. The method can help the child remain in a state of tiredness/sleep and continue sleeping after being placed in their own bed.

The transition to safe sleep in an open bed

When your child grows older, it's time for them to sleep in a bed without sides. Every child is different when it comes to making this transition.

A bed that allows you to remove one or both sides and keep the same bed can make the transition from closed to open bed easier. This makes the bed recognisable to the child and can help make the transition smoother.

For questions related to safe and secure sleep, you can always contact your healthcare professional.

Kathrine Klem Vernersen

Health visitor Kathrine Vernersen (38) is a mother of three and a trained nurse. She worked for a number of years in neonatal and paediatric intensive care units both in Denmark and abroad.

When she and her family moved back to Denmark in 2017, Kathrine completed her specialised training as a health visitor and began working as a municipal health visitor.

In 2023, she started her own company and became a private carer, offering families counselling and guidance on babies and children, both in person and online. She also shares her expertise as a health visitor on Instagram, where you can follow her @sundhedsplejerske_kathrine

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