Infant Sleep Survey

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* 1. For the night, where do you think a baby under the age of ONE should sleep? (Check all that apply as “safe”)

Crib or pack-n-play

Couch

Recliner

Swing

Car seat

Bouncy seat

Floor

In the same room with an adult, but not in the same bed, couch or recliner

In the same bed, couch or recliner with an adult, another child or pet

Whatever helps them go to sleep

Other (please specify)

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* 2. At nap time, where do you think a baby under the age of ONE should sleep? (Check all that apply as "safe")

Crib or pack-n-play

Couch

Recliner

Swing

Car seat

Bouncy seat

Floor

In the same room with an adult, but not the same bed, couch or recliner

In the same bed, couch or recliner with an adult, another child or pet

Whatever helps them go to sleep

Other (please specify)

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* 3. Is it "safe" for stuffed animals, toys, pillows, quilts, blankets, wedges, positioneers, bumpers, or loose bedding to be in an infant's sleep environment?

Yes

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* 4. Is it safe for babies to share a sleep surface like a bed, couch, or recliner with a sibling, adult or pet?

Yes

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* 5. When napping, babies should be placed on their:

Back

Side

Stomach

Whatever makes them go to sleep

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* 6. When sleeping for the night, babies should be placed on their:

Back

Side

Stomach

Whatever makes them go to sleep

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* 7. Now, think about your own child, grandchild, sibling, niece, nephew, daycare/babysitting customer and answer the following. How often do you place a baby under the age of ONE down for nap on their back?

100% of the time

99-75% of the time

74-50% of the time

49-25% of the time

Less than 25% of the time

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* 8. How often do you place a baby under the age of ONE down for the NIGHT on their back?

100% of the time

99-75% of the time

74-50% of the time

49-25% of the time

Less than 25% of the time

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* 9. How often do you ACTUALLY USE the following places for infant's nap-time sleep?

	ALWAYS	OFTEN	SOMETIMES	NEVER
Crib or pack-n-play	Crib or pack-n-play ALWAYS	Crib or pack-n-play OFTEN	Crib or pack-n-play SOMETIMES	Crib or pack-n-play NEVER
Couch or recliner	Couch or recliner ALWAYS	Couch or recliner OFTEN	Couch or recliner SOMETIMES	Couch or recliner NEVER
Swing, car seat or bouncy seat	Swing, car seat or bouncy seat ALWAYS	Swing, car seat or bouncy seat OFTEN	Swing, car seat or bouncy seat SOMETIMES	Swing, car seat or bouncy seat NEVER
Floor	Floor ALWAYS	Floor OFTEN	Floor SOMETIMES	Floor NEVER
In the same room with an adult, but not the same sleep surface (bed, recliner, couch)	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) ALWAYS	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) OFTEN	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) SOMETIMES	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) NEVER
In the same bed, recliner or couch with an adult, child or pet	In the same bed, recliner or couch with an adult, child or pet ALWAYS	In the same bed, recliner or couch with an adult, child or pet OFTEN	In the same bed, recliner or couch with an adult, child or pet SOMETIMES	In the same bed, recliner or couch with an adult, child or pet NEVER

Question Title

* 10. How often do you ACTUALLY USE the following places for infant's night-time sleep?

	ALWAYS	OFTEN	SOMETIMES	NEVER
Crib or pack-n-play	Crib or pack-n-play ALWAYS	Crib or pack-n-play OFTEN	Crib or pack-n-play SOMETIMES	Crib or pack-n-play NEVER
Couch or recliner	Couch or recliner ALWAYS	Couch or recliner OFTEN	Couch or recliner SOMETIMES	Couch or recliner NEVER
Swing, car seat or bouncy seat	Swing, car seat or bouncy seat ALWAYS	Swing, car seat or bouncy seat OFTEN	Swing, car seat or bouncy seat SOMETIMES	Swing, car seat or bouncy seat NEVER
Floor	Floor ALWAYS	Floor OFTEN	Floor SOMETIMES	Floor NEVER
In the same room with an adult, but not the same sleep surface (bed, recliner, couch)	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) ALWAYS	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) OFTEN	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) SOMETIMES	In the same room with an adult, but not the same sleep surface (bed, recliner, couch) NEVER
In the same bed, recliner or couch with an adult, child or pet	In the same bed, recliner or couch with an adult, child or pet ALWAYS	In the same bed, recliner or couch with an adult, child or pet OFTEN	In the same bed, recliner or couch with an adult, child or pet SOMETIMES	In the same bed, recliner or couch with an adult, child or pet NEVER

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* 11. Have you ever found yourself in a situation where you needed to put a baby to sleep in a way that may not align with recommended safe sleep practices to put babies to sleep Alone, on their Back, in a Crib?

Yes

If yes, what was the main reason for doing so?

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* 12. I am a (check all that apply)

Parent/guardian

Grandparent

Aunt/uncle

Sibling

Daycare worker

Babysitter

Other (please specify how you interact with infants)

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* 13. If you are a parent, where do you go for healthcare? (check all that apply)

CMU Health

Covenant HealthCare

Valley OB

Great Lakes Bay Health Centers

Other

I don't have a healthcare provider

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* 14. OPTIONAL: If you are interested in receiving information about services and resources for families and children in Saginaw County, please provide us with your contact information.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number