Where is the safest place to position a cot?

Once you have found the perfect cot that meets the necessary safety standards for your nursery, identifying the safest place to position it is the next challenge. Although you may base its position on the shape of the room or around other furniture, it is important to think carefully where you place it as it is the item your baby will spend the most amount of time in. Therefore ensuring it is safely placed away from any potential hazards is essential.  

The safest position for your baby’s cot to be placed, is in your room. It should be right up against the wall or at least 30cm away from the wall. It should not be placed near a window with curtains or blinds, near a heater or near plug points.

It is often difficult to anticipate all the possible hazards around your baby’s cot as there are often things you may not have thought of. Keeping up to date with the most current safety guidelines assists with that and also gives you peace of mind knowing you are protecting your baby as best as you can.

Should your baby’s cot be in their own room or in your room?

Evidence shows that sharing a room with your baby reduces the risk of SIDS by almost 50%, especially for the first 6 months when the risk of SIDS is highest. 

The benefit of sharing a room with your baby is that they are within your view which makes it easier for you to monitor them, respond to them quicker if you identify any dangers as well as comfort and feed them.    

The American Association of Paediatrics (AAP), The Lullaby Trust, and UNICEF all recommend room-sharing but not bed-sharing. While both fall under the term co-sleeping, there are significant differences which impact the safety of your baby.  

• Room-sharing is when a baby sleeps in a separate and safe space but is in close proximity to their parents. This is often done by using a bassinet, camp cot, or bedside sleeper alongside your bed.  
• Bed-sharing is when you and your baby sleep together in an adult size bed and has been flagged as a risk for SIDS.     

Room-sharing ensures that your baby is able to sleep on their back on a flat and firm surface in a safe space with no loose items such as pillows or blankets which is in line with the current safety guidelines. 

The risk of suffocation, strangulation and entrapment which could occur if your baby slept with you in bed is reduced. Room-sharing can extend up to and is often encouraged for the first 12 months. 

Where should a baby's cot be placed in a room?

Ideally, your baby’s cot should be placed either right up against a wall with no gaps, or at least 30cm away from the wall. 

This is to ensure that your baby cannot get trapped between the wall and the side of the cot when they learn to climb out of the cot. Placing the cot in a corner is also acceptable as long as the above is adhered to.

Recommendations about placing the cot near the doorway of your baby’s room have also been suggested. This allows you to be able to reach them quickly and safely without falling over any items in your way.  By placing the cot close to the entrance, you are also less likely to wake up or disturb them as you will not need to move far to find them. 

What are considered dangerous spots for a cot in a room ?

There are various hazards which can arise by placing your baby’s cot in a dangerous spot. Possible hazards which should be avoided include placing the cot:

1. Under or close to an open window that has curtains or blinds.  

• If the curtains or blinds are within your baby’s reach, or hang above your baby’s cot, they can pose a strangulation and suffocation risk.  
• Blind cords which accidentally get wrapped around a baby’s neck can be fatal as it only takes 20 seconds for a baby to die from strangulation if they get tangled in a blind cord.  
• A research study spanning from 1990 to 2015 which looked at window and blind related injuries among children under 6 years of age showed there were various main categories of injuries. Within the entanglement-related injuries category, 98.9% of reported cases involved blind cords of which 13% resulted in death by strangulation. 
• Being close to a window also adds the risk of your child falling out or becoming trapped in burglar bars when they become more mobile. 

• A baby is not yet able to regulate their own body temperature and so allowing them to be near or in close proximity to an window could expose them to direct sunlight and cause overheating. The same can potentially happen if they are too close to an aircon or heater. Overheating is one of the risk factors for SIDS. 

What other potential hazards can be found near a baby’s cot?

It is important to be aware of other objects near your baby’s cot which could potentially cause injury. When positioning their cot, be sure to avoid the following: 

1.  Placing the cot close to or against a plug point. 

• Although most power outlets nowadays have a built in safety mechanism, children can still be electrocuted if they manage to stick their fingers in them.  
• Power outlets are also where most electrical fires start. 

2. Placing hanging mirrors, shelves or artwork above the          cot.

• Not only can items placed on the shelf fall off and injure your baby, but the shelf or ledge itself can also come loose. 
• Your baby could try and grab artwork or decorations on the wall which may then fall on top of them. 

3. Placing decorations near or around the cot which have          ribbons or loose strands. 

• These are potential strangulation hazards and should be removed. 
• Cot mobiles are included in this and need to be carefully placed out of your baby’s reach.  

5.  Placing cameras on the side of the cot or the wall the           cot is up against. 

• The power cables attached to the camera pose a safety concern as your baby could grab hold of them causing the camera to fall on top of them or become entangled in the cable which is a strangulation risk.  
• This also goes for any other power cables which may be in reach of your baby. 

6. Placing the cot too close to other furniture such as a              compactum, changing table or nursing chair.           

• As your baby becomes more mobile and adventurous, these items can be used to assist them climbing out of their cot and may result in injuring themselves. 

Is it safe for my baby to sleep near a fan or in an air conditioned room?

South-African summers and heatwaves can sometimes be unbearable. Keeping your baby cool and comfortable while they sleep can be challenging and you may be tempted to use a fan or air-conditioner. These points should be used to help you choose the most appropriate method of cooling down your baby’s room:

• Fans and air-conditioners are safe to use as long as they are out of your baby’s reach. 
• They should not be placed where they would blow directly onto your baby.
• It is important that they are set on the appropriate temperature setting.  
• Free-standing fans are usually not advised due to cords being exposed on the floor which can be a tripping or strangulation hazard. 
• These fans are also top-heavy and can be pulled down with minimal effort resulting in potential injuries.  
• Using a desk or table fan placed on a higher surface such as a compactum which is out of reach of your baby is safer. It is also easier to make sure that the power cables are hidden and out of reach. 
• A bracket can also be used to attach the fan onto the wall close to the ceiling which ensures the fan and cords are out of your baby's reach.
• There is limited research about the safety of using ceiling fans in a baby’s room. However, It is important that these are correctly installed to minimise risk and should also be wiped down frequently to prevent dust accumulation.  

Is it safe for my baby to sleep with a heater on in their room?

The following points should be considered when thinking about placing a heater in your baby’s room: 

• The use of a heater in your baby’s room should be closely monitored because a room that is too hot can lead to your baby overheating which is a known risk factor of SIDS.
• A heater which has a thermostat allows the temperature of the room to be controlled and is therefore safer  to use.   
• Air heaters and gas heaters are not recommended as they can cause overheating and  pose a fire risk.  
• Gas heaters are also known to release carbon monoxide which can build up in the nursery overnight. It is a colourless and odourless gas which makes it difficult to detect. It has the potential of devastating consequences especially as your baby is unable to tell you if they are feeling unwell.
  
• If you use a wall heater, make sure that the cot does not rest against it and other safety instructions provided with the device are adhered to.  
• Oil heaters are advantageous as they maintain the temperature of the room fairly well and keep the room warmer for longer which prevents extreme drops in temperature once they are turned off.  
• Using a heater to warm up your baby’s room and then removing it once they go to sleep is a safer option. However, you then need to ensure that your baby is appropriately dressed as the temperature drops.   
• The use of electric blankets in your baby’s cot or toddlers bed is strongly discouraged. These are extremely dangerous as they are potential fire, burn, strangulation, suffocation, electrocution, and overheating hazards.   
• If you would like to warm up your child’s sleep surface before they go to sleep; rather use a microwavable bean bag or hot water bottle and place it on the sleep surface.   
• It is also important to remember to remove the bean bag or hot water bottle and make sure the surface is not too hot before placing your baby into their cot or bed.  
  

When using any of these devices, it is useful to be able to monitor the temperature of the room with an appropriate thermometer. It is also advised that you frequently enter your infant’s room to check the temperature and minimise any risk of overheating. 

To eliminate the potential hazard of heaters all together; rather make use of a sleep sack or sleep swaddle to keep your baby warm while sleeping. 

What should be considered for air-conditioners, fans and heaters:

When using an air-conditioner, fan or heater for your baby’s room, the following guidelines have been suggested by PediatricEducation.org: 

• Ideally, the item must be safety-certified. 
• Power cord: 
• The plug must be placed directly into the power socket without the use of an extension cord.  
• The cord should not be placed under objects such as carpets or bent in any way.  
• Placement: 
• Have at least a metre or more of clear space around it. This not only pertains to your baby's cot, but also curtains, artwork, carpets and bedding.  
• Placed on a level surface. 
• Out of the walking path so that it cannot be bumped over.  
• When in use: 
• These items should only be used when an adult is able to monitor the device.  
• Ensuring you have a room thermometer near your baby will help guide you in keeping the temperature around the recommended 21℃. 
• Frequently going into your baby’s room while these devices are being used is encouraged to ensure your baby is safe and comfortable.  
• Maintenance: 
• The device must be checked regularly for any damage to the unit as well as the power cord and plug. 
• The space around the unit must be checked  
• Heaters should also have an on-off switch that automatically turns the unit off at a certain temperature and if bumped over.
  

Dressing your baby appropriately for the current climate is safer than using appliances such as heaters, fans, or air-conditioners.    

If you follow the guidelines above, you will have eliminated most possible hazards to ensure a safe room for your baby. 

resources

https://pediatrics.aappublications.org/content/138/5/e20162938

https://www.webmd.com/baby/setting-up-nursery#1 

https://www.nhsinform.scot/ready-steady-baby/early-parenthood/going-home/sleeping-safely 

https://www.which.co.uk/reviews/cot-beds/article/using-cot-beds-safely-adlri8j5kOBw 

https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Make-Babys-Room-Safe.aspx 

https://www.nct.org.uk/baby-toddler/sleep/cot-safety-features-sleeping-safely-cot 

https://kidshealth.org/en/parents/cosleeping.html 

https://www.webmd.com/parenting/baby/news/20161024/infants-should-share-parents-room-to-help-prevent-sids#1 

https://pediatriceducation.org/2014/12/01/can-i-use-a-space-heater/ 

https://www.babycenter.in/x1050970/what-kind-of-heater--is-best-to-keep-my-babys-room-warm-and-safe