Facts, Checklists, and Tips to Keep a Sleeping Baby Safe

Practicing Safe Sleep Is Essential

3,400 sudden unexpected infant deaths (SUID) occur each year in the United States.

Many of these deaths are related to sleep. Most are categorized as sudden infant death syndrome (SIDS), which is when there isn’t an obvious cause. Another common reason is accidental suffocation or strangulation.

The good news? Since 1994, a campaign now known as Safe to Sleep has helped educate parents and caregivers about safe sleep practices, which has helped decrease the risk of sleep-related death in the United States by almost 50%.

How You Can Protect Your Baby

Know These Dos and Don’ts for Safe Sleep

• Do place your baby on their back for all naps and nighttime sleep.
• Don’t fall asleep with the baby in your arms. Risk of sleep-related death is 67 times higher if the baby sleeps with a caregiver on a couch or armchair.
• Do transfer a sleeping baby into their crib or bassinet for safe sleep.
• Don’t let your baby sleep in a car seat, carrier, stroller, or swing.
• Do use a safe crib, bassinet, or play yard. Look for products approved by the CPSC (Consumer Product Safety Commission). Your baby should sleep on a flat, firm mattress covered with a fitted sheet.
• Don’t use soft bedding, blankets, crib bumpers, sleep positioners, stuffed animals, or pillows.
• Do share a bedroom with your sleeping baby for at least the first 6 months. This can greatly reduce risk of SUID.
• Don’t let your baby sleep in your bed. They should have their own separate sleeping surface.

Why Your Baby Shouldn’t Sleep in Your Bed

Although bed sharing is a common practice in some cultures, the American Academy of Pediatrics (AAP) strongly advises against it.

When a caregiver and baby sleep together in the same bed, it increases the baby’s risk of sleep-related death:

• 5x–10x if the baby is younger than 4 months old
• 2x–5x if the baby was born prematurely or had low birth weight
• More than 10x if the caregiver is fatigued or has been drinking or using drugs

Sleeping on a separate surface in the same room as a caregiver can reduce a baby’s SIDS risk as much as 50%.

Use This Checklist to Set Up Your Baby’s Sleep Space

• Crib, bassinet, or play yard that follows safety requirements set by the CPSC
• Firm mattress made for the crib, bassinet, or play yard, and fits snugly inside
• Fitted sheet only (no loose blankets, bumpers, pillows, or stuffed animals)
• Far away from strangulation hazards like window cords or electrical wires
• No exposure to secondhand smoke
• Cool, comfortable temperature, usually between 68 and 72 degrees Fahrenheit

On a Budget?

Be very careful of using hand-me-downs or secondhand sleep products. If you’re considering one:

• Make sure it comes with the original hardware and instructions.
• Check CPSC.gov/recalls to make sure the item hasn't been recalled.
• Avoid any product that is older than 10 years.
• Don’t use it if it has loose parts, is damaged or broken, or has been modified in any way.

Contact your state’s social services agency to see whether there are any local programs to help you afford a safe sleep surface for your baby. Your doctor or hospital may be able to recommend some, as well.

If you find yourself in a pinch, you can use a box, basket, or dresser drawer with thin, firm padding for your baby to sleep in temporarily. Do what you can to get your baby a safe crib, bassinet, or play yard as soon as possible.

Be Blanket Savvy

It’s important not to let your baby overheat, and loose bedding can be a suffocation hazard.

If you want, you can dress your baby in a light sleep sack or swaddle them with a receiving blanket.

• Don’t swaddle too tightly. Make sure you can get 2 to 3 fingers between the baby’s chest and the swaddle blanket.
• Keep them on their back. The baby should always lie face up while swaddled.
• Check for signs of overheating. These include sweating, damp hair, flushed cheeks, heat rash, or rapid breathing.
• Don’t swaddle forever. Stop swaddling once the baby can roll over, usually when they’re around 3 to 4 months old, to prevent hip problems.

What Else You Can Do

There are some other things you can do to decrease your baby’s risk of SUID:

• Don’t smoke, drink, or use drugs during pregnancy or after childbirth.
• Chest/breastfeed or feed your baby expressed breast milk, if you can.
• Give your baby a pacifier if you want to and they like one, but don’t use a cord or attach it. (Also, if you’re chest/breastfeeding, wait until after nursing has been well established.)
• See your doctor or midwife for prenatal visits throughout your pregnancy.
• Take your baby for regular checkups, called well visits, once they’re born.
• Give your baby tummy time when they’re awake.

When to Stress Less

Your baby’s risk of SUID decreases the older they get. Keep putting them down to sleep on their back until they’re at least 1 year old.

Eventually, your baby will learn to roll over on their own. If they roll onto their tummy or side in their sleep, you don’t have to worry about it once they’re able to roll from back to front and front to back by themselves.

Sources

American Academy of Pediatrics

Centers for Disease Control and Prevention

Consumer Product Safety Commission. Safe Sleep — Cribs and Infant Products. Accessed December 10, 2022.

March of Dimes. (Last reviewed February 2019) Safe Sleep for Your Baby.

Mayo Clinic. (2022) Baby naps: Daytime sleep tips.

Moon, Rachel Y. (Last updated July 2022) How to Keep Your Sleeping Baby Safe: AAP Policy Explained. American Academy of Pediatrics.

Moon, Rachel Y. et al. (2022) Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics.

National Institute of Child Health and Human Development. Safe to Sleep. Accessed December 10, 2022.

Nemours KidsHealth

Summer, J. (Last updated April 2022) What Is the Best Room Temperature for a Sleeping Baby? Sleep Foundation.