About 3,500 infants die unexpectedly each year in the United States due to SIDS (sudden infant death syndrome) and other sleep-related causes. According to researchers, face-down sleeping is the highest risk factor for SIDS.
Rules for Safe Infant Sleep
Follow these safe sleep guidelines from the American Academy of Pediatrics:
Put Your Baby on Their Back
Always place your baby on their back at night and for all naps. Studies have shown that babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides. The AAP also says:
- Newborns should be placed skin-to-skin with their mother as soon after birth as possible.
- Preemies may need to be on their stomachs temporarily in the NICU, but they should then be placed on their backs as soon as possible.
- Some babies roll on to their stomachs: If they are comfortable rolling from back to tummy and tummy to back, then it is okay not to place them on their back again. Be sure to clear any blankets, pillows, or other soft objects from the crib.
Use a Firm, Flat Sleep Surface
The AAP defines a firm surface as a sleep surface that does not indent when your baby is lying on it.
- Any surface that inclines more than 10 degrees is unsafe for your baby to sleep on.
- Place your baby in a crib, bassinet, portable crib, or play yard that meets safety standards. Be sure that your crib has not been recalled before using it.
- Be sure that your crib mattress is designed specifically for your crib and that it fits tightly. Use only a fitted sheet on the mattress, with no other objects in the crib.
- Only use an alternative sleep surface if it meets existing federal safety standards.
- If your baby falls asleep in a car seat, stroller, swing, infant carrier or sling, move them to a firm sleep surface as soon as possible. Do not use products for sleep that aren't specifically marketed for infant sleep.
- In an emergency, you can temporarily put your baby to sleep in a box, basket, dresser drawer, or something similar with the addition of thin, firm padding. Move your baby to an approved sleep surface as soon as you can.
Never Sleep With Your Baby
The AAP does not recommend bed sharing under any circumstances. Here is what they recommend:
- If you bring your baby into bed to feed or comfort, place them back on their own space when they're ready to sleep.
- If there is any chance of you falling asleep with your baby in bed, be sure there are no pillows, sheets, blankets or any other items that could cover your baby's face, head or neck or overheat them. Move them to their own bed as soon as you wake up. Avoid falling asleep with your baby in other areas too, like couches or arm chairs.
- Be extra cautious if you have been drinking, using marijuana, or taking medicines or illicit drugs.
- Share your room with your baby instead of your bed: keep your baby's crib or other approved sleep surface in your bedroom, close to your bed. Room sharing is not only safer than bed sharing, it also makes it easier for you to feed, comfort and watch your baby.
Keep Soft Objects Out of Your Baby's Sleep Area
Soft objects and loose bedding increase your baby's risk of entrapment, suffocation or strangulation. You can keep your child warm by dressing them in layers or clothing or using a wearable blanket. Do not use weighted objects or weighted blankets, weighted sleepers, or weighted swaddles on or near your baby. Swaddling is okay, but does not reduce the risk of SIDS.
Keep all of the following out of your baby's sleep space:
- Pillows and pillow-like toys
- Mattress toppers
- Non-fitted sheets
- Bumper pads or related products that attach to crib slats or sides
Check Your Baby for Signs of Overheating
Overheating puts your baby at risk for SIDS. Your baby only needs one more layer than you would wear in the same environment to be comfortable. Don't put a hat on your baby while indoors once you're home from the hospital.
Signs of Overheating:
- Hot chest
- Flushed skin
Other Ways to Reduce SIDS Risk
- Feed your baby breast milk: The AAP recommends breastfeeding or feeding expressed breast milk as the sole source of nutrition for about 6 months. Continue breastfeeding until at least 12 months or longer even after you add solid foods.
- Try giving your baby a pacifier at nap time and bedtime: This helps reduce SIDS risk even if the pacifier falls out. Don't hang a pacifier around your baby's neck or attack it to their clothing when sleeping.
- Get regular prenatal care: Evidence shows that prenatal care reduces your baby's risk of SIDS. Avoid alcohol, smoking/nicotine, marijuana, opioids and illicit drugs.
- Schedule and go to well-child visits with a pediatrician. In addition to tracking growth and development, well-child visits include vaccinations that may protect against SIDS.
- Supervise awake tummy time: Tummy time helps your baby develop motor skills and prevents flat head syndrome.
- If you swaddle, follow safe guidelines: Be sure your baby is on their back and the swaddle is not too tight for them to breathe or move their hips. When they try to roll over, stop swaddling. Do not use weighted swaddles.
- Use safe products and check safety claims: Check the Consumer Product Safety Commission (CPSC) website to ensure that all baby products meet safety standards. In particular, the AAP recommends steering clear of home cardiorespiratory monitors to reduce the risk of SIDS. These kinds of devices are not backed by evidence and are not a substitute for following safe sleep guidelines.
More Safe Sleep Resources
Always ask your pediatrician if you have any questions or concerns about your infant's safety.
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More information from the AAP: