Safe Sleep Calculator

The Safe Sleep Calculator is no longer supported.

An updated version of the Safe Sleep Calculator is now built in to the Best Start Pepi form and should be used instead.

If you don't have the Best Start Pepi form, please contact Kellie Rogers from the National Hauora Coalition on 022 375 0371.

NHI:
Child's date of birth:
Gender:	Male Female
Birth weight:	gms lbs oz
Is a twin:	No Yes
Baby's ethnicity:	NZ/European NZ Maori Pacific Asian Other Unknown
Mother's age:
Relationship status:	Living with partner Single
Number of previous live births:

Modifiable risk factors:

Feeding method:	Breast Formula Mixed
Where baby sleeps:	Parents bedroom Own bedroom
	In own baby bed (including in a Pepi-pod or wahakura placed on a bed) Sometimes sharing a bed Usually sharing a bed
Sleeping position:	On back On side On front
Mother smokes:	No Yes
Father smokes:	No Yes
Number of days per week mother drinks 2+ units of alcohol:
Mother uses recreational drugs:	No Yes

Research request:

The researchers would like to contact parents or caregivers to complete a short questionnaire.

Happy to be contacted for research?

Information contained in this form is submitted in a de-identified form to a secure research dataset maintained by Procon on behalf of The University of Auckland. Health and Disability Ethics approval (16/NTB/53) has been granted for this research titled; Implementing a Safe Sleep Calculator into Primary Care to identify and address risk in infants more vulnerable to Sudden Unexpected Death in Infancy.

No Yes

This is real data and can be submitted to the research database

Key messages:

Place baby in their own baby bed in the same room as their parent or caregiver.
Eliminate smoking in pregnancy, and protect baby with a smokefree whanau(family), whare (home) and waka (car).
Position baby flat on their back to sleep - face clear of bedding.
Encourage and support exclusive breast feeding and gentle handling of baby.

Sleep safety scale for Sudden Unexpected Death in Infancy risk:

1 in 40,000	Very Low Risk
1 in 20,000
1 in 10,000
1 in 5,000
1 in 2,500
1 in 1,000
1 in 500
1 in 100
1 in 50 babies	Very High Risk

(Must be real data and implies parent has given informed consent. No identifiable information will be made available to researchers.)