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About 3,600 babies die each year in the United States during sleep because of unsafe sleep environments.
Some of these deaths are caused by entrapment, suffocation, or strangulation. Some infants die of Sudden Infant Death Syndrome (SIDS). However, there are ways for parents to keep their sleeping baby safe.
Read on for more information from the American Academy of Pediatrics (AAP) on how parents can create a safe sleep environment for their babies. This information should also be shared with anyone who cares for babies, including grandparents, family, friends, babysitters, and childcare center staff.
NOTE: These recommendations are for healthy babies up to 1 year of age. A small number of babies with certain medical conditions may need to be placed to sleep on their stomach. Your baby’s primary healthcare provider can tell you what is best for your baby.
What You Can Do:
Place your baby to sleep on their back.
Babies up to 1 year of age should always be placed on their back to sleep during naps and at night. However, if your baby has rolled from their back to their side or stomach on their own, they can be left in that position if they have already been able to roll from tummy to back and back to tummy.
If your baby falls asleep in a car safety seat, stroller, swing, infant carrier, or infant sling, they should be moved to a firm sleep surface as soon as possible.
Swaddling (wrapping a light blanket snuggly around a baby) may help calm a crying baby. However, if you swaddle your baby before placing them on their back to sleep, stop swaddling them as soon as they start trying to roll.
Place your baby to sleep on a firm, flat sleep surface.
The crib, bassinet, portable crib, or play yard should meet current safety standards.
Check to make sure the product has not been recalled.
Do not use a crib that is broken or missing parts or that has drop-side rails.
For more information about crib safety standards, visit the Consumer Product Safety Commission Web site at www.cpsc.gov.
Cover the mattress with a fitted sheet.
Do not put blankets or pillows between the mattress and fitted sheet.
Do not place your baby to sleep on an inclined sleep surface.
Never put your baby to sleep on an armchair, a sofa, a waterbed, a cushion, or a sheepskin. (Parents should also make sure not to fall asleep on an armchair or a sofa while holding a baby.)
Keep soft objects, loose bedding, or any other items that could increase the risk of entrapment, suffocation, or strangulation out of the crib.
Pillows, quilts, comforters, sheepskins, bumper pads, and stuffed toys can cause your baby to suffocate.
NOTE: Research has not shown us when it is 100% safe to have these objects in the crib; however, most experts agree that these objects pose little risk to healthy babies after 12 months of age.
Place your baby to sleep in the same room where you sleep but not the same bed.
Keep the crib or bassinet within an arm’s reach of your bed. You can easily watch or breastfeed your baby by having your baby nearby.
The AAP cannot make a recommendation for or against the use of bedside sleepers or in-bed sleepers until more studies are done.
Babies who sleep in the same bed as their parents are at risk of SIDS, suffocation, or strangulation. Parents can roll onto babies during sleep, or babies can get tangled in sheets or blankets.
Breastfeed as much and for as long as you can. This helps reduce the risk of SIDS.
The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.
Schedule and go to all well-child visits. Your baby will receive important immunizations.
Recent evidence suggests that immunizations may have a protective effect against SUID.
Keep your baby away from smokers and places where people smoke. This helps reduce the risk of SIDS.
If you smoke, try to quit. However, until you can quit, keep your car and home smoke-free. Do not smoke inside your home or car, and do not smoke anywhere near your baby, even if you are outside.
Do not let your baby get too hot. This helps reduce the risk of SIDS.
Keep the room where your baby sleeps at a comfortable temperature.
In general, dress your baby in no more than one extra layer than you would wear. Your baby may be too hot if she is sweating or if her chest feels hot.
If you are worried that your baby is cold, use a wearable blanket, such as a sleeping sack, or warm sleeper that is the right size for your baby. These are made to cover the body and not the head. You can use layers of clothing, if necessary, when it is very cold.
Offer a pacifier at nap time and bedtime. This helps reduce the risk of SIDS.
If you are breastfeeding, wait until breastfeeding is going well before offering a pacifier. This usually takes 3 to 4 weeks. If you are not breastfeeding, you can start a pacifier as soon as you like.
It is OK if your baby does not want to use a pacifier. You can try offering a pacifier again, but some babies do not like to use pacifiers.
If the pacifier falls out after your baby falls asleep, you do not have to put it back in.
Do not use pacifiers that attach to infant clothing.
Do not use pacifiers attached to objects, such as stuffed toys and other items that may be a suffocation or choking risk.
Do not use home cardiorespiratory monitors to help reduce the risk of SIDS.
Home cardiorespiratory monitors can be helpful for babies with breathing or heart problems, but they have not been found to reduce the risk of SIDS.
Use caution when using products that claim to reduce the risk of SIDS.
Products such as wedges, positioners, special mattresses, and specialized sleep surfaces have not been shown to reduce the risk of SIDS.
What Expectant Moms Can Do:
Schedule and go to all prenatal primary healthcare provider visits.
Do not smoke, drink alcohol, or use drugs while pregnant or after the birth of your newborn. Stay away from smokers and places where people smoke.
Remember to hold your newborn skin to skin while breastfeeding. If you can, do this as soon as you can after birth. Skin-to-skin contact is also beneficial for bottle-fed newborns.
Remember Tummy Time:
Give your baby plenty of “tummy time” when awake.
This will help strengthen neck muscles and help prevent flat spots on the head.
Always stay with your baby during tummy time, and make sure they are awake.
This publication was adapted from information from American Academy of Pediatrics Patient Education materials.
Reviewed by: MC MD, CPCMG Newborn Committee, TT DO | 05/2024