Child Care Basics: Safe Sleep and Rest Practices

Why Safe Sleep and Rest Practices Matter

Safe sleep means setting up sleep in a way that reduces risks during rest, especially for infants who cannot reposition themselves well. Rest practices also support emotional regulation, learning, and behavior across all ages. In child care, safe sleep is not only about comfort—it is about using consistent, evidence-based routines and a sleep space that stays safe every time, even during short naps.

Safe Sleep Essentials (What to Do Every Time)

1) Sleep Space Setup: “Clear, Flat, Firm”

Use a sleep surface that is firm, flat, and designed for sleep (crib, cot, or approved mat depending on age). Keep the sleep space clear of items that can obstruct breathing or cause overheating.

• Infants: Use a safety-approved crib or bassinet with a firm mattress and tight-fitting sheet only. No pillows, quilts, comforters, stuffed animals, bumpers, or loose blankets.
• Toddlers: Use a cot or mat appropriate to the program’s policy. A small blanket may be allowed if it stays away from the face; avoid bulky bedding.
• Preschoolers: Use a mat/cot with a light blanket if permitted. Keep personal items organized so walkways remain clear.

2) Back-to-Sleep Positioning (Infants)

Place infants on their backs for every sleep—naps and overnight. This is the default safe position for healthy infants.

• If an infant rolls independently both ways, continue placing them on their back at the start of sleep; allow them to find their own position afterward.
• Do not use wedges, positioners, or rolled blankets to “keep them on their side.”
• If a family requests a different position due to a medical reason, follow your program’s requirement for written medical documentation and an individualized plan.

3) Crib/Cot Safety: Fit, Spacing, and Condition

Check the sleep equipment before use. A safe sleep space is not only about what you put in it, but also about the condition of the equipment.

• Crib basics: Mattress fits snugly; no gaps. Sheet fits tightly. Hardware is secure. No broken slats or sharp edges.
• Cots/mats: Stable, cleanable, and placed with enough spacing to reduce contact and allow staff movement for checks.
• Placement: Keep sleep spaces away from cords, hanging blinds, heaters, and heavy items that could fall.

4) Temperature and Clothing: Prevent Overheating

Overheating can increase risk for infants and disrupt sleep for all ages. Aim for a comfortably cool room and dress children in light layers.

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• Rule of thumb: Dress the child in about one more light layer than an adult would wear in the same room.
• Infants: Use a wearable blanket/sleep sack if allowed; avoid loose blankets. Check the back of the neck for sweat (a better indicator than hands/feet).
• All ages: Remove hats/hoods for sleep indoors. Avoid heavy coats or thick sweaters during rest.

5) Pacifier Considerations

Pacifiers can be soothing for sleep. If used, keep the approach simple and safe.

• Offer a pacifier at sleep time if the child already uses one and the family approves.
• Do not force a pacifier or reinsert it repeatedly once the child is asleep.
• Never attach pacifiers to clothing with cords, strings, or clips during sleep.
• Keep pacifiers clean and stored in a labeled, sanitary way per program practice.

6) Supervision During Rest: Active, Predictable Checks

Rest time still requires active supervision. Plan a consistent pattern of checks and maintain visibility.

• Infants: Frequent visual checks for breathing, color, and position; ensure the face remains uncovered and the head is not pressed into soft material.
• Toddlers/preschoolers: Regular checks for safe sleep posture, comfort, and to prevent unsafe behaviors (climbing, covering faces, sharing bedding).
• Keep lighting and room arrangement so caregivers can see each child’s face and body position as needed.

Age-Specific Rest Routines

Infants (0–12 months): Responsive, Individual Schedules

Infant sleep is driven by individual wake windows rather than a single group nap. A predictable mini-routine helps infants transition without unsafe props.

• Timing: Watch for early cues (staring off, yawning, decreased movement, fussiness). Put down before overtiredness.
• Mini-routine (3–5 minutes): diaper check if needed, dim lights, quiet voice, brief cuddle, place in crib awake or drowsy.
• Safe soothing: gentle patting, shushing, steady hand on chest (if policy allows), brief pick-up to calm then return to crib.
• Avoid: sleeping in swings, bouncers, car seats (unless in a vehicle), or on couches/armchairs.

Toddlers (1–3 years): Consistent Nap Window + Clear Boundaries

Toddlers often resist naps due to independence and fear of missing out. A consistent schedule and calm limits reduce power struggles.

• Timing: Typically after lunch; keep the start time consistent.
• Routine: bathroom/diaper, drink of water if permitted, choose a book, settle on cot/mat.
• Expectations: “Rest your body” can be the goal even if sleep doesn’t happen every day.
• Comfort items: If allowed, a small blanket or soft toy that stays on the cot and does not cover the face.

Preschoolers (3–5 years): Quiet Rest with Options

Many preschoolers still benefit from a rest period even if they do not nap. Offer quiet choices that keep the room calm.

• Timing: After lunch or early afternoon.
• Routine: bathroom, choose a quiet activity option (book basket, soft manipulatives) if not sleeping.
• Expectation: Stay on your mat/cot; use a quiet voice; bodies stay calm.
• Transition: Plan a gentle wake-up and a calm re-entry activity (puzzles, drawing) to prevent post-rest dysregulation.

Step-by-Step Rest-Time Flow (Wind-Down → Placement → Checks → Wake-Up)

Step 1: Wind-Down (10–20 minutes)

• Lower stimulation: dim lights, reduce noise, slow movement.
• Predictable sequence: toileting/diapering, hand-off of comfort item (if allowed), short story or quiet song.
• Body cues: invite deep breaths, “hands on belly,” or gentle stretches for toddlers/preschoolers.
• Set expectations: state the plan in one sentence: “It’s rest time. We lie on our mats and let our bodies get calm.”

Step 2: Placement (Infants: Back in Crib; Older: On Cot/Mat)

• Infants: place on back on a firm mattress with a tight sheet; keep the crib empty.
• Toddlers/preschoolers: guide to assigned cot/mat; ensure blankets (if used) stay low and light.
• Positioning: keep faces uncovered; avoid children sleeping with heads under blankets.

Step 3: Checks and Ongoing Monitoring

• Infants: frequent visual checks; confirm airway is clear, color is normal, and breathing appears regular.
• All ages: scan for unsafe behaviors (covering faces, piling items, moving mats too close, climbing).
• Document as required: record sleep start/end times and any notable observations per program policy.

Step 4: Wake-Up and Transition

• Gentle wake-up: soft voice, gradual light increase, calm touch if appropriate.
• Re-orient: “Rest time is finished. We’re going to sit up and stretch.”
• Post-rest needs: offer toileting/diapering, water, and a quiet activity before high-energy play.

Soothing Without Unsafe Sleep Aids

Some soothing strategies feel helpful but create risk, especially for infants. Use calming methods that do not add soft items or unsafe positions.

Safe Soothing Tools

• Voice: quiet, repetitive phrase (“You’re safe. It’s time to rest.”).
• Touch: gentle patting or steady hand (if permitted), then reduce contact gradually.
• Rhythm: consistent shushing or humming; slow rocking while awake, then place in crib before sleep.
• Environment: dim lights, consistent white noise if program-approved and kept at a safe volume and distance.

Avoid These Common Unsafe Aids (Especially for Infants)

• Loose blankets, pillows, stuffed animals, crib bumpers, or sleep positioners.
• Letting an infant sleep in a swing, bouncer, or car seat outside of travel.
• Propping bottles for sleep or feeding to sleep unattended.
• Covering a child’s head with a blanket or hood to “block light.”

Sample Caregiver Language

For Nap Resistance (Toddlers/Preschoolers)

• Clear and calm: “Your job is to rest your body on your mat. You don’t have to sleep, but you do have to be quiet.”
• Choice within limits: “Do you want the blue blanket or no blanket?”
• Reassurance: “I’ll check on you. You’re safe. It’s time for your body to rest.”
• Consistency statement: “Rest time happens after lunch every day. When rest is done, we’ll read a book together.”
• For repeated getting up: “I’m going to help you back to your mat. Feet stay on the floor, body stays on the mat.”

For Family Coordination (Aligning Schedules and Comfort Items)

• Aligning routines: “We notice your child sleeps best with a short wind-down. At home, you might try the same two steps we use: bathroom/diaper, then one short story.”
• Sleep timing: “Our group rest starts at 12:30. If bedtime is getting late, we can talk about adjusting the nap length or the wake-up routine within our program’s approach.”
• Comfort items within policy: “If you’d like to send a comfort item, please choose something small and washable. We’ll keep it on the cot during rest and store it afterward.”
• Safe sleep boundary (infants): “For safety, the crib must stay empty—no blankets or toys. We can use a wearable sleep sack instead if you’d like.”
• Pacifier plan: “If you want us to offer a pacifier at sleep time, please send labeled pacifiers. We won’t clip it to clothing during sleep.”

Rest Environment Checklist