Sleep Space Data Record (2021)

Welcome to the Pepi-Pod® Programme's online database for monitoring infant portable sleep space services. 

From June 2021Change for our Children requires all agencies supplying Pepi-Pod® sleep spaces in New Zealand, to enter distribution and impact data here.  We have reintroduced this quality process to support effective implementation at local level. The hope is that we see a return to reducing infant death rates, from careful monitoring and regular feedback of data.

This is a 'one stop shop' for the reporting options below. It can be used for any type of sleep space offered (Wahakura, Pepi-Pod® ...)

  1. Service details 
  2. Distribution reporting Are we offering sleep spaces to appropriate infants and implementing the programme with fidelity (i.e. as intended)?
  3. Impact reporting Does infant care at 6-8 weeks reflect appropriate use of sleep spaces and safe sleep principles?

INSTRUCTIONS: For online entry, please enter distribution and impact data at the same time. Use the tab key to move to the next response.                                                                                                                                                   (Revised 14 April 2021

1. Service details (essential for linking data to your DHB or region)

DHB Region:

Distributing Agency 



 (please specify)

 Type of safe sleep device provided: 

Pod ID Number (copy from your paper form)

                Not applicable
Date safe sleep device was provided: to whanau/family   
 day   month   year 
to 2. Distribution Reporting      
2. Distribution Reporting (data collected when sleep space is issued)
To answer: Are sleep spaces going to more vulnerable babies? 
 Current age of mother:  
 Age of baby at distribution (completed weeks):  
 Any smoking before most recent pregnancy:  

yes   no 

 Any smoking during most recent pregnancy:  
yes   no
 Baby born <37wks or weighing<2500gm):  
yes   no

 Any other concerns:

 (more than one option may be selected)  


regular smoking in baby's household

regular alcohol or drug use in baby's household


mental health concerns  

low maternal support  

infant welfare

 Baby's ethnicity includes: 

(more than one option may be selected)  





Baby has a baby bed  

yes (family has a cot, bassinet ...) 

no (family has no other baby bed

To answer: Are core components of the programme implemented?
 Was a standard safety briefing completed with you?  
 Was infant breathing demonstrated to you, using the tube provided (or a drinking straw or similar)?  
yes   no
 Were you (whanau) encouraged to use your demo tube to share your knowledge  about protecting babies' breathing, with others?
yes   no
to Impact Reporting      OR      if finished, to SUBMIT at the end.  

3. Impact Reporting  (data collected at follow-up when baby is 6-8 weeks)
 To answer: Are sleep spaces used appropriately? Are safe sleep principles applied?

1. How many people have you spoken with so far about protecting babies' breathing?  
2. Since getting the sleep space, has your baby ever shared a bed, mattress or couch with someone who was also asleep?
yes   no
3. If yes, was your baby also in their sleep space at the time?  
4. Do you place your baby on the back for sleeping?  
5. Do you do safe sleep checks and remove hazards from where your baby sleeps, such as: pillows, soft or loose items and toys?  
6. Does your baby sleep in the same room as a main carer at night?  
7. Is your baby currently breastfed?
(use standard definitions for 'feeding in past 48 hours'?
8. Is a main carer receiving support to be smokefree?  
9. How often did your baby sleep in their sleep space this past week?  
10. What age is your baby now? (in completed weeks  

11. Please rate how well your sleep space has supported you.

(on a scale of 1(low) to 9 (high))

  a) with better sleep for mother 

b) with breastfeeding  

c) with safety  

d) in other ways   (please specify)

12. Where will your baby usually sleep next, when too big for their sleep space or bassinet?  
 COMMENT: Would you like to comment on your experience using a portable sleep space?  
      You will know that your form has been submitted successfully when you get an immediate acknowledgement.