CONCORD — During stay-at-home orders and disrupted routines, the State Office of the Child Advocate is urging parents to ensure safe sleep practices with infants.

Director Moira O’Neill warned that confinement conditions may increase risk for sleep-related infant deaths.

An average of 3,500 infants die in the United States annually from sudden unexplained infant death.

In recent months, these deaths are on the rise in New Hampshire and across the region.

The OCA has received reports of two deaths since February that may be associated with unsafe sleep practices.

O’Neill expressed concern that early observations of behavior under Stay-at-Home orders are suggesting people are sleeping more and ingesting more alcohol.

Together, those two factors increase the risk of unsafe care and sleeping practices with infants.

The likelihood of napping on the sofa or co-sleeping with an infant may be on the increase while families wait out the COVID-19 crisis.

Department of Health and Human Services data demonstrate the two leading causes of sleep-related infant deaths are soft bedding and bed sharing.

O’Neill lamented the tragedy a parent must face in the death of a child from an unsafe sleep situation that can be avoided.

“The American Academy of Pediatrics is quite clear on the importance of safe sleep environments, especially in the first six months of life,” O’Neill said.

She urged parents and other caregivers to follow their simple guidance:

• Back to sleep for every sleep. Infants should always sleep on their backs.

• Use a firm sleep surface to avoid indenting or creating pockets.

• Breastfeed whenever possible and return the infant to a separate sleep area when done.

• Share the room but not the sleep surface with infants.

• Keep soft objects and loose bedding away from an infant’s sleep area.

• Offer a pacifier at nap and bedtime.

• Avoid smoke exposure.

• Avoid alcohol or other substances when caring for an infant.

• Avoid overheating.

O’Neill noted that the upside of stay at home orders is the opportunity for families to spend more time with each other and bond in ways that work schedules often do not allow.

Following simple guidance and ensuring everyone is well-rested and attentive to a new infant is a recipe for healthy development and avoidance of preventable tragedies.

For information and guidance in safe sleep, resources are available at New Hampshire’s COVID-19 Parent Resource Page at and the American Academy of Pediatrics recommended website for helping your baby sleep safely at

The Office of the Child Advocate provides independent oversight of DCYF to assure that the best interests of children are being protected.

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