Safe Sleep & Other Tips

Reducing the Risk of SIDS and Other Sleep-Related Causes of Infant Death

• Always place baby on his/her back to sleep for all sleep times for the first 12 months.

  • When baby knows how to roll both ways, by around 6 months, it is ok if he/she then changes position during sleep.

  • There has been no increased risk of choking with back to sleep.

• Babies sleep safest on a firm and flat mattress in a crib, bassinet, portable crib or play yard that meets current safety standards. (see Consumer Product Safety Commission link in Education Tool Kit Section)

  • Cover the mattress only with a tightly fitted sheet

  • A firm mattress means one that doesn't indent or sag when baby lies on it

  • No additional mattresses or pads should be added.  They reduce safety.

  • Use only the type of mattress intended for your baby's sleep product.

  • No adults, children or pets should be sleeping with baby in his crib, bassinet, portable crib or play yard.

• Share your room with your baby when you sleep, but not your bed.

  • Keep baby in your room close to your bed but in his/her own sleep space (crib bassinet, portable crib or play yard)

  • Room-sharing can decrease the risk of SIDS by as much as 50% and is much safer than bed-sharing.

  • Share your room with baby for the first year, if possible, but at least for the first 6 months.

  • Only bring baby into your adult bed to feed or comfort, and place baby back in his/her own close-by space when you feel ready to sleep.

  • In case you fall asleep before returning baby to his/her separate space, all pillows, blankets, other bed-sharers, or other items that can cover baby's head or face or overheat baby should be removed from the adult bed.  As soon as you wake up, baby should be returned to his sleep space.

  • Bed-sharing can be especially dangerous if:

    • your baby is younger than 4 months old

    • your baby was premature or of low birth-weight

    • you or anyone else in the bed is a smoker, even if you don't smoke in bed

    • the baby's mother smoked during pregnancy

    • you have taken medication or drugs that may make your drowsy

    • you drank any alcohol

    • you are not the baby's parent

    • the adult sleep surface is soft, such as a waterbed, old mattress, couch or armchair

    • there is soft bedding such as pillows or blankets in the bed

• Do not put pillows of any kind, including nursing pillows, bumpers, blankets, quilts, stuffed animals or other loose bedding in the baby's sleep space.

  • If warmth is needed, use sleep clothing, sometimes called a wearable blanket, instead of a regular blanket. It should be the correct size for the baby.

• Baby should not sleep on a couch, sofa, or armchair, alone or with an adult.

• Do not let your baby get too hot during sleep.

  • Avoid over-bundling your baby

  • Watch for signs of overheating, such as sweating or baby's chest feeling hot to the touch.

• Avoid smoking or smoke exposure during pregnancy. Keep baby's environment smoke-free.

• Breastfed babies have a lower risk of SIDS. Breastfeed or feed your baby expressed breast milk.

  • If you bring baby into bed to nurse, remove your pillows and blankets and return baby to nearby crib when done. Room sharing supports both safe sleep and breastfeeding.

• If your baby happens to fall asleep while in a car seat, stroller, swing, or other device, move him or her to a firm flat sleep surface on his or her back as soon as possible.

• The Consumer Product Safety Commission has raised concerns about inclined sleepers

• Give baby plenty of tummy time while awake and watched by mom dad or another caregiver.  This is good for baby's development and helps prevent flat spots on the back of the head.

• Consider offering a pacifier for naps and nighttime sleep. Wait until breastfeeding is well established, about 4 weeks, before offering. It should be clean, in good condition. Do not attach it to baby or baby's clothing with a string or clip or to a stuffed animal.

• Avoid products that go against safe sleep recommendations, especially those that claim to prevent SIDS. Evidence does not support the safety or effectiveness of wedges, positioners or other such products, and many have been associated with injury or death when used in baby's sleep space.

• Keep up with baby's well baby health care appointments and follow your health care provider's guidance on vaccinations.

• Tell everyone who takes care of your baby about back to sleep and the other safe sleep recommendations. Grandparents may recall doing things differently.  We know better now, and, even though SIDS remains a leading cause of infant mortality, the rate has been cut by more than half since the safe sleep recommendations of the American Academy of Pediatrics were introduced.

• Discuss these American Academy of Pediatrics Recommendations with your baby's physician.