Running an infant room requires constant attention to many important details—feeding, comforting, maintaining schedules, and adhering to state licensing rules. Among these critical responsibilities, ensuring a safe sleep environment stands out as particularly essential.

Safe sleep practices are designed to significantly reduce the risk of Sudden Infant Death Syndrome (SIDS), the leading cause of infant death in the U.S., tragically taking the lives of 100 babies in North Carolina each year.

Following these practices isn't just best practice; these practices are part of North Carolina’s child care licensing requirements, created to protect infants. Here are 10 essential safe sleep practices explained clearly, along with related North Carolina state regulations.

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1. Back to Sleep, Every Time

Placing infants on their backs to sleep is essential because it helps keep their airways clear, allowing for easier breathing and fluid drainage. This practice significantly reduces the risk of airway obstruction associated with stomach sleeping. 

North Carolina licensing specifically requires infants to be initially placed on their backs unless you have a documented waiver from a healthcare provider (for infants under 6 months) or a healthcare professional or parent (for infants over 6 months). If an infant rolls onto their stomach independently, there is no need to reposition them; however, always begin sleep by placing them on their back.

2. Loose Bedding? Skip It.

While cozy blankets and sheets may seem comforting, safety requires that cribs, bassinets, mats, or cots remain free of loose bedding. Loose bedding significantly increases suffocation risks. North Carolina licensing regulations explicitly prohibit loose bedding, so fitted sheets that securely fit the mattress are the safest option.

3. Make Sure Everyone Is Trained on Safe Sleep

Regular and thorough training isn't just important—it's mandatory. SIDS remains the leading cause of death for infants aged one month to one year, making safe sleep practices absolutely critical. Every team member must be trained in safe sleep guidelines.

4. Clear Crib, Safe Baby

While decorative nursery items can be tempting, an empty crib is essential for safe sleep. According to NC regulations, the crib must be completely free of all items—no blankets, toys, pillows, or bumper pads. Clear cribs mean safer sleep for every infant.

5. One Infant, One Sleep Space

Each infant must have their own dedicated crib, bassinet, playpen, mat, or cot. Sharing sleep spaces increases the risks of suffocation, injury, and illness. North Carolina child care regulations mandate one sleep space per infant, with no exceptions.

6. Keep It Cool and Comfortable

Keeping the room temperature at or below 75°F ensures infants remain comfortable without overheating. Overheating is a known risk factor for SIDS. Instead of loose blankets, use wearable sleep sacks to safely keep infants warm.

7. Pacifiers Are Safe for Sleep

Offering pacifiers during naps can provide comfort and, according to research, may even help lower the risk of SIDS. North Carolina licensing regulations allow pacifiers during sleep as long as they are not attached to clothing, stuffed animals, or cords that could pose safety risks. Always offer pacifiers clean and dry, and never force an infant to use one if they're uninterested.

8. Conduct Regular Sleep Checks

NC regulations require caregivers to visually check each sleeping infant at least every 15 minutes. These checks involve observing the infant’s breathing, position, and overall comfort. Clear documentation of these checks is required to demonstrate compliance and ensure infants' safety.

9. Avoid Sleeping in Sitting Devices

Infants sleeping in sitting devices such as car seats, strollers, swings, or infant carriers is unsafe and strictly prohibited by North Carolina regulations. Sleeping upright in these devices can cause an infant’s heavy head to tilt forward, restricting the airway and making breathing difficult. If an infant falls asleep in any sitting device, immediately move them to their approved sleep space.

10. Post and Share Your Safe Sleep Policy

North Carolina requires child care centers caring for infants aged 12 months or younger to have a written safe sleep policy. This policy must be posted prominently in the infant room and provided to parents and explained clearly before the infant’s first day at the center. Parents are required to sign a statement acknowledging receipt and understanding of this policy.

Following these safe sleep practices protects infants, reassures families, and supports your team in providing the highest level of care. Together, you're keeping North Carolina’s youngest residents safe and secure every single day.

Staying Compliant While Providing Peace of Mind

Following these 10 practices not only helps you stay compliant with North Carolina child care licensing requirements but also provides the highest standard of care for the infants entrusted to you.

Remember that North Carolina requires annual training on infant safety topics, including SIDS prevention. Investing in comprehensive, up-to-date training ensures your team remains confident and competent in implementing these critical practices. The right training transforms these practices from "rules we have to follow" into "the way we naturally care for infants every day.

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ProSolutions Training offers subscriptions with state-aligned courses tailored just for North Carolina. These comprehensive training options make sure staff members are classroom-ready and compliant with state requirements.

Here are a few key courses included in our subscription:

✅ Required Health and Safety Training

✅ New and Improved! Nutrition and Food Service Package

✅ Many more North Carolina-approved courses!

Our subscription is designed to make staff training easier, help you meet compliance, and allow your team to manage their classrooms confidently.

For Child Care Center Directors:

Managing training for your entire staff? Our Group Subscription includes unlimited access to all required North Carolina health and safety courses, including SIDS prevention training. Track completion, manage assignments, and ensure compliance all in one place. Director features include staff tracking, assignment management, and comprehensive reporting—all designed to save you time and reduce your administrative burden. 📊

For Individual Teachers:

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This blog post is for informational purposes and does not replace comprehensive SIDS prevention training. For official North Carolina child care licensing requirements, please refer to the North Carolina Division of Child Development and Early Education website.