Alone, Back, Crib: Mobile County Health Department Urges Families to Follow Safe Sleep ABCs

MOBILE, Ala. — Alone, Back and Crib. Those three words are the heart of the safe sleep ABCs, and the Mobile County Health Department wants every parent, grandparent, babysitter and child care provider to follow them every single time a baby goes down for a nap or for the night.

October is National Safe Sleep and Sudden Infant Death Syndrome (SIDS) Awareness Month, and the Mobile County Health Department (MCHD) is using the occasion to remind families that a safer night’s sleep for an infant starts with a few simple, consistent habits.

The numbers behind the message

In Alabama, 414 infants died in 2024. Of those deaths, 65 were classified as sudden unexpected infant deaths, or SUID, according to the health department. SUID is a broad category that includes sudden infant death syndrome, accidental suffocation and strangulation in bed, and deaths from unknown causes.

The health department noted that those are statewide figures, not totals for Mobile County.

Sleep-related infant deaths are especially painful because many of the risks are ones caregivers can reduce. Public health agencies, pediatricians and hospitals across the country have spent decades spreading the same core advice, and health officials say it works best when every person who cares for a baby follows it the same way.

“Every baby deserves a safe place to sleep, and every caregiver has a role in making that possible,” said Dr. Kevin Michaels, Mobile County’s health officer. “The ABCs are a simple reminder: alone, on their back, in a crib. We encourage families to share these steps with everyone who cares for their baby so safe sleep becomes a consistent routine.”

Know the ABCs

The health department breaks safe sleep into three easy-to-remember steps.

A is for Alone

Give your baby a separate sleep space without other people, pillows, loose blankets, bumper pads or stuffed toys. MCHD encourages parents to share a room with their baby, but not a bed, ideally for at least the first six months.

Soft objects and extra bedding can block a baby’s airway or trap a baby who rolls into them. A bare sleep space may look less cozy to adults, but it is the safest setup for an infant.

B is for Back

Place your baby on their back for every nap and every nighttime sleep. That means every sleep, including short naps and sleep at a grandparent’s house or at day care.

Back sleeping is the single change most closely linked with the drop in SIDS deaths since the 1990s. In 1994, the federal government launched the national “Back to Sleep” campaign, now known as “Safe to Sleep,” to encourage parents to put babies on their backs. SIDS rates fell sharply in the years that followed.

C is for Crib

Use a safety-approved crib, bassinet or portable play yard with a firm, flat mattress and a fitted sheet. Couches, armchairs and adult beds are not safe sleep spaces for infants.

Falling asleep with a baby on a sofa or recliner is considered especially dangerous, because a baby can become wedged between the adult and the cushions. Parents who feel themselves getting drowsy while feeding or holding a baby are encouraged to put the baby down in their own safe sleep space.

More steps that lower the risk

Beyond the ABCs, the health department recommends a few more habits that help reduce the risk of sleep-related infant deaths:

• Avoid overheating. Dress the baby for the room temperature and skip heavy layers and blankets.
• Keep the head uncovered. Hats, hoods and loose bedding should not cover a sleeping baby’s head or face.
• Keep the air clean. Maintain a smoke-free and nicotine-free environment for your baby, both during pregnancy and after birth.

National guidance from the American Academy of Pediatrics adds several other recommendations, including breastfeeding when possible, offering a pacifier at nap time and bedtime once breastfeeding is established, keeping up with regular prenatal care and well-baby checkups, and avoiding products marketed to reduce the risk of SIDS that have not been shown to work.

Federal law has also changed the market for baby sleep products. The Safe Sleep for Babies Act, signed in 2022, banned the sale of padded crib bumpers and inclined infant sleepers in the United States. Families using hand-me-down nursery items are encouraged to check them against current safety standards and recall lists from the U.S. Consumer Product Safety Commission.

Safe sleep is a shared responsibility

Health officials stress that safe sleep only works if everyone follows the same rules. A baby who always sleeps on their back at home but is placed on their stomach at a relative’s house may be at higher risk, because the position is unfamiliar.

MCHD encourages parents to talk about their baby’s sleep routine with relatives, babysitters and child care providers, and to ask their baby’s doctor or other health care professional about any safe sleep questions or concerns.

Some practical ways families can make sure the message gets through:

• Walk grandparents and sitters through the ABCs, since recommendations have changed since many of them raised their own children.
• Ask child care providers how and where babies nap, and what their safe sleep policy is.
• Keep a portable play yard or bassinet available for overnight trips and visits.
• Remove blankets, pillows and stuffed animals from the sleep space before each sleep, not just at bedtime.

How MCHD supports families

The health department’s safe sleep reminder is part of a larger set of programs aimed at improving pregnancy outcomes and supporting infant health in Mobile County.

Healthy Start Enhanced

The Healthy Start Enhanced program is designed to help new parents build skills and confidence. MCHD is encouraging pregnant women and families with children 18 months old and younger to enroll in the free program, which provides support, education and resources to help families thrive.

Through the program, parents are connected with trained Parent Educators who offer one-on-one support, parenting guidance and access to community resources throughout pregnancy and early childhood.

Fetal and Infant Mortality Review

The Fetal and Infant Mortality Review program, known as FIMR, studies the community factors that contribute to fetal and infant deaths. Through case reviews and voluntary interviews with mothers, the program identifies gaps in care and opportunities to improve.

The Mobile County FIMR program, also known as the Alabama Baby Coalition, has worked since 1998 to strengthen systems of care for women, infants and families.

Its Community Action Team uses those findings to recommend changes such as stronger follow-up systems, better parent education and greater access to community-based services. The team works closely with MCHD’s Maternal and Child Health programs, hospitals, laboratories and local organizations so that families receive comprehensive care.

Maternal and Child Health

MCHD’s Maternal and Child Health program is funded by the Title V Maternal and Child Health Services Block Grant, in partnership with the Alabama Department of Public Health’s Bureau of Family Health Services. Title V is a long-running federal program that helps states support the health of mothers, infants and children.

The program serves mothers and expectant parents who live in Mobile County. Its services include:

• Education before, during and after pregnancy
• Safe sleep classes
• Breastfeeding education and resources
• Car seat safety
• Referrals to other programs, including WIC services, the Fatherhood Initiative, Healthy Start Enhanced and FIMR

Why it matters

For many families, the first months with a newborn are a blur of feedings, diaper changes and very little sleep. Health officials say that is exactly why simple, repeatable rules matter: when everyone is exhausted, a routine that is easy to remember is more likely to be followed.

The ABCs ask caregivers to do the same three things every time: put the baby down alone, on their back, in a crib, bassinet or play yard. Health officials say sharing those steps with everyone who watches a baby is one of the most important things a family can do.

How to get help

Parents and caregivers with questions about safe sleep should talk with their baby’s pediatrician or other health care provider. Families in Mobile County who want to learn more about safe sleep classes, Healthy Start Enhanced or other Maternal and Child Health services can contact the Mobile County Health Department.