The Children's Division requires the following recognized safe sleep practices to be used with all infants (children under one year of age) in foster care. As an approved relative caregiver or licensed resource provider you are required and must agree to use the safe sleep practices listed below with every infant placed in your care by the Division.
Failure to adhere to required safe sleep requirements is a serious infraction of licensing regulations and may result in:
- Preventable death of the infant placed in your care,
- Criminal investigation and potential criminal charges,
- Child abuse and neglect investigation and potential child abuse and neglect findings, and
- Denial or revocation of a foster home application or license.
Safe Sleep Requirements
- A foster child, including infants, shall never co-sleep or bed-share with foster parents.
- Infants shall never share the same sleeping surface with any adult (beds, couches, recliners, etc.).
- Babies shall be placed on their back on a firm, safe sleep surface such as a crib, bassinet, portable crib or play yard with a tight-fitting sheet.
- Only cribs and firm mattresses that meet the Consumer Product Safety Commission (CPSC) or Consumer Product Safety Improvement Act (CPSIA) safety standards shall be used. This can be verified by reviewing the manufacturing details.
- Cribs and safe sleep surfaces shall be completely free of soft bedding and objects (including crib bumpers, blankets, pillows and soft toys).
- Only one infant shall sleep in each approved crib, bassinet, portable crib or play yard.
- Licensed resource providers are prohibited from smoking inside the foster home or in the presence of a foster child. Supervision must be ensured if caregivers go outside to smoke.
- Car seats shall not be used for routine sleep, including naps or overnight sleeping. After travel, infants shall be immediately transferred to an approved safe sleep surface. Car seats shall be properly secured and installed at the correct angle according to the manufacturer's instructions.
Safe Sleep Recommendations
- Infants should have an approved, safe sleep surface in a caregiver's room for the first six months and up to one (1) year of age, if possible.
- Infant sleep clothing, such as a wearable blanket, is recommended to keep the infant warm while reducing the chance of head covering or entrapment that could result from blankets.
- Infants should be dressed appropriately for the environment, with no greater than one (1) layer more than an adult would wear to be comfortable in that environment.
- Caregivers should evaluate the infant for signs of overheating, such as sweating or the infant’s chest feeling hot to the touch. Visually check on sleeping babies often.
- Offer a pacifier at naptime and bedtime.
- Supervised, awake tummy time is recommended daily to facilitate development.
- Safe sleep deaths are often the result of caregivers falling asleep with the infant while feeding. The following recommendations are suggested to prevent accidental suffocation or aspiration:
- Feeding in an upright position, while sitting on a hard surface.
- Not feeding in a bed or on a soft surface.
- Setting an alarm on your phone for every 10 minutes.
- Feeding in a lit room.
- Watching TV during feeding.
- Asking for help/assistance with feeding when you are overly tired, ill, medicated, or recovering from a medical procedure.
Required Documents and Training
Safe Sleep Environment Flyer (form)
Safe Sleep Discussion Guide (form)
Safe Sleep Training (training)
Additional Resources (Highly Recommended)
Advanced Safe Sleep Part 2 (training)
Safe Sleep Missouri (website)
Final.Distributed.Missouri-Safe-Sleep-Strategic-Plan-11-20-2020.pdf (article)