Safe sleep and fever: two newborn rules worth knowing by heart

There is a lot of advice in the newborn weeks, and much of it changes from one auntie, one website or one generation to the next. But a few things are worth learning so well that you could follow them half asleep at three in the morning. This article is about two of them: how to put your baby down to sleep safely, and what to do if your young baby has a fever.

Rule one: a safe sleep, every sleep

Safe sleep advice is designed to lower the risk of sudden infant death syndrome (SIDS) and accidents during sleep. It applies to naps as well as night-time.

• On the back. Always lay your baby on their back to sleep, never on their front or side. Babies who sleep on their backs are not more likely to choke.
• Flat, firm and clear. Use a cot, crib or Moses basket with a firm, flat, waterproof mattress that fits well. Keep it clear: no pillows, cot bumpers, duvets, quilts, positioners or soft toys.
• Feet to foot. Place your baby with their feet at the foot of the cot so they cannot wriggle down under any covers. Use a baby sleeping bag that fits, or a thin blanket tucked in firmly no higher than the shoulders.
• Close by. Keep your baby's cot in the same room as you for at least the first six months, for naps and nights.
• Not too hot. Avoid hats and heavy layers indoors. Feel the back of the neck or the tummy: if it is hot or sweaty, remove a layer.
• Smoke-free. Keep your baby away from cigarette smoke during pregnancy and after birth, at home and in the car.

The places to avoid

Never fall asleep with your baby on a sofa or armchair. This is one of the most dangerous places for a baby to sleep. If you feel yourself drifting off while feeding, put your baby back in their cot.

If your baby ever ends up in your bed, keep it as safe as possible: a firm mattress, no pillows or duvets near the baby, nothing they could fall into or be covered by, and no other children or pets in the bed. Do not share a bed with your baby if you or anyone in the bed has been drinking alcohol, smokes, has taken medicine or drugs that make you drowsy, or is extremely tired, or if your baby was born prematurely or at a low birth weight.

Car seats are for travel. Once you arrive, take your baby out to sleep flat. In a sling, your baby's face should always be visible, close enough to kiss, with the chin up off their chest.

Rule two: a fever under three months is urgent

In older children a mild temperature is often manageable at home. Young babies are different. Their immune systems are still immature, and a fever can be the only early sign of a serious infection.

If your baby is under three months old and has a temperature of 38°C or higher, seek urgent medical help straight away, by going to your nearest emergency department or calling your doctor or emergency service. Do not wait to see if it settles, and do not give any medicine unless a doctor has told you to.

Have a digital thermometer at home and ask your midwife or health visitor to show you how to use it. An under-the-arm reading is usual for young babies.

Other signs that need urgent help

Call your emergency number or go to the hospital straight away if your baby:

• Is struggling to breathe, grunting, has long pauses in breathing, or the skin between the ribs sucks in
• Has blue, grey or very pale skin, lips or tongue
• Is floppy, unusually sleepy, hard to wake, or not responding to you as normal
• Is not feeding, or has repeated or green vomit
• Has a rash that does not fade when you press a glass against it
• Has a fit (seizure) or a bulging soft spot
• Feels unusually cold to the touch, or has cold, mottled hands and feet with a warm body

You know your baby. If something feels seriously wrong, act. It is always better to be checked and reassured.

Watching, and being watched over

Many new parents find it hard to sleep because they keep checking that the baby is breathing. Following safe sleep advice is a real way of loving your baby, and then you are allowed to rest too. Your vigilance has limits; God's does not:

"He will not suffer thy foot to be moved: he that keepeth thee will not slumber. Behold, he that keepeth Israel shall neither slumber nor sleep." (Psalm 121:3-4, KJV)

Lay your baby down on their back in a clear cot, and then lay down your worry too. The One who keeps you is awake.

A prayer at bedtime

Lord, You never slumber or sleep. As I lay my baby down, keep them safe through the night. Give me wisdom to act quickly when something is wrong, and peace to rest when all is well. I place my child, and myself, in Your keeping. Amen.