Promote safe sleep for your baby and reduce the risk of SIDS
As a new parent, you may wonder about safe sleep for babies. You will notice that your newborn will spend a lot of time sleeping. They will gradually sleep less as they get older, but with every stage, it is important to know how to keep your baby safe when they sleep and reduce their risk of Sudden Infant Death Syndrome (SIDS).
What is SIDS?
SIDS stands for Sudden Infant Death Syndrome – when a baby dies in their sleep without any explanation. It occurs in about 3,500 cases each year. Most babies who die of SIDS are between 2 and 4 months old, and 90% are younger than 6 months old. SIDS can be alarming, but it is a rare occurrence. Even then, it is important to know safe sleep practices – as you will reduce your infant’s risk of it by following them.
The cause of SIDS is unknown, but there are things that can put infants at a higher risk.
Some risk factors for SIDS include exposure to smoking (before or after pregnancy), lack of prenatal care, unsafe sleeping environment or positions, preterm birth or low birth weight, teen pregnancy, overheating, exposure to alcohol during pregnancy, being a sibling of a SIDS victim, being a twin, history of apnea, and the baby being male.
In order to give parents tools to lower an infant’s risk of SIDS, the American Academy of Pediatrics has guidelines for safe sleep for babies. Those guidelines include:
- Place your baby on their back to sleep
- Have your baby sleep on a firm, flat sleeping surface
- Room share with your baby, but don’t sleep with them
- Keep loose bedding and soft objects out of the baby’s bed
- Avoid letting your baby get overheated
- Breastfeed your baby, if possible
- Don’t smoke
Additionally, other measures you can take to keep your baby safe at night include letting your baby use a pacifier when they sleep, getting prenatal care before your baby is born – and taking them to their well-child doctor checks after, and having your baby do tummy time every day.
Recommendations for safe sleep
Lie your baby on their back
The most important measure to take in keeping your baby safe in their sleep is to lie them on their back. This is the safest position for your baby to be in while they sleep. This recommendation was introduced in the 1990’s, and afterward, baby deaths during sleep were greatly reduced. Declines have slowed since then, so it’s important to continue to follow this recommendation.
When your baby is able to roll around, continue to lie them down on their back and let them position themselves. Once they’re able to roll from their tummy to their back, they don’t have to stay on their back all night – it’s okay to let them sleep on their tummy.
Safe sleep bed
Sleep your baby in a crib or bassinet approved by the Consumer Product Safety Commission. Use a mattress sized for that bed. Their mattress should be firm and flat. An elevated surface can increase the risk of the baby not being able to breathe due to their head slumping.
Don’t use any props to lie your baby on or sleep them on products that aren’t approved for sleep. Don’t lie your baby on soft surfaces for sleep.
Use a fitted sheet on their mattress and don’t use any extra bedding – including pillows, toys, crib bumpers, or loose blankets.
Blankets for safe sleep
Wrap your baby in one swaddle blanket, or put them in a velcro swaddle or wearable blanket. Newborns like to be swaddled – it keeps them cozy and prevents their startle reflex from waking them up. Sleep sacks are safe, although the AAP advises against weighted sleep sacks.
Once your baby is able to start rolling over, you’ll want to stop swaddling them. You can start with keeping one arm out of the swaddle, then once they’re used to that, keep both arms out. Some sleep sacks or wearable blankets are designed to help with this transition.
The best place for a baby to sleep
The safest place for a baby to sleep is in their own crib or bassinet in their parents’ room. The AAP recommends that a baby room shares with their parent for at least 6 months, and ideally 12 months. Room sharing can decrease the risk of SIDS by up to 60%.
It is not recommended to co-sleep, or share a bed with your baby.
Avoid napping your baby in their swing, stroller, or car seat (unless you’re actually driving in the car).
Avoid letting your baby overheat
Overheating is one thing that increases the risk of SIDS, so take measures to prevent your baby from overheating. Dress them lightly to sleep, with one swaddle or wearable blanket. Generally speaking, you’ll want to dress them in one layer more than you’re dressed in. Keep your home and their sleeping environment at a comfortable temperature.
Avoid smoking and substance use
Smoking either during pregnancy or around your baby after pregnancy puts them at a greater risk for SIDS. Don’t smoke while pregnant, smoke around your baby, or allow anyone else to smoke around your baby.
Don’t smoke inside your home or your car. If you’re a smoker, smoked while pregnant with your baby, or your baby has been exposed to secondhand smoke, then don’t co-sleep with your baby. This includes cigarettes, electronic cigarettes, and vaping.
Drinking alcohol during pregnancy is also a risk factor for SIDS. Avoid drinking any alcohol while pregnant.
Breastfeeding your baby is another thing you can do to reduce the risk of SIDS. It’s recommended to exclusively breastfeed your baby for the first six months of their life. Any breastfeeding for any amount of time is beneficial to your baby.
If you breastfeed your baby in your bed at night, move blankets and loose bedding away from your baby in case you fall asleep. If you fall asleep, place your baby back in their bed when you wake up.
Other tips for safe sleep
Getting adequate prenatal care can help you have a healthy pregnancy and be aware of any medical concerns. See your provider when you’re pregnant and keep up with your regular appointments.
Once your baby is born, make regular visits for well-baby checks, following the doctor’s recommended schedule. Get them vaccinated per the doctor’s recommendation to avoid preventable diseases.
Is a binky safe for a baby to sleep with?
It’s safe for your baby to sleep with a binky. In fact, pacifiers during sleep are actually believed to reduce the risk of SIDS. Just don’t use a binky strap while they’re sleeping to avoid the risk of it getting wrapped around their neck.
Having your baby do tummy time every day will help them strengthen the muscles they need to roll, lift their heads up, and maneuver to comfortable positions while they sleep. Tummy time can help them be safe while they sleep since it will allow them to move their head as they get older. Keep track of how often and how long your baby has tummy time on the Baby Daybook app.
Your baby’s sleep environment
In addition to having your baby’s environment at a comfortable temperature and not having any extra bedding or soft objects near them, it’s also important that there are no cords or wires near them while they’re sleeping. Also – don’t have them sleep near any heavy objects on the wall or nearby furniture that could fall on top of them.
A baby monitor can help you listen for when your baby is awake and a video monitor can allow you to check on them when you aren’t in the room. At-home cardiorespiratory monitors have been shown not to reduce the risk of sleep-related infant death.
A note on co-sleeping
It really is safest to have your baby sleep in their own bed and not co-sleep. Even though co-sleeping is not recommended at all, It might be useful to know that not all co-sleeping is equal in regards to safety and there are safer ways to do it than others.
The safest way to co-sleep can be summed up in the “safe co-sleep 7”. These are 7 things that make co-sleeping as safe as it can be.
- Being a nonsmoking parent and baby not having been exposed to smoking
- Being sober and unimpaired – co-sleeping is riskier if the parent drinks, takes illegal drugs, or any drugs that make it difficult to arouse – including sleep medicine. Even being fatigued can be risky since it can make it difficult for you to wake up.
- Baby being breastfed and co-sleeping with their breastfeeding mother.
- Baby being a healthy and full-term baby.
- Baby sleeping on their back.
- Baby being lightly dressed.
- Sleeping on a safe surface – in bed, on a firm mattress with no extra bedding (sheets, pillows, blankets) anywhere near them. Co-sleeping with your baby on a couch, chair, or cushion drastically increases the risk of sleep-related infant death.
While it’s good to be aware of the safest possible way to bedshare – again, it’s safest to avoid co-sleeping altogether. Even if you don’t plan on bed sharing, but feed your baby in bed at night, move all bedding away from your infant in any risk that you might fall asleep feeding them.
Baby Daybook app
The Baby Daybook app is designed to track baby sleep. This is an excellent way to keep track of when your baby sleeps, how long they sleep, see emerging patterns in their sleep as they get older, and take any other helpful notes about their sleep.
AAP. 2023. Safe Sleep. www.aap.org [Accessed August 2023]
CDC. 2022. Parents and Caregivers. Sudden Unexpected Infant Death and Infant Death Syndrome. www.cdc.gov [Accessed August 2023]
Cleveland Clinic. 2023. SIDS (Sudden Infant Death Syndrome). my.clevelandclinic.org [Accessed August 2023]
March of Dimes. 2019. Safe sleep for your baby. www.marchofdimes.org [Accessed August 2023]
Moon, R. 2023. AAP. How to Keep Your Sleeping Baby Safe: AAP Policy Explained. www.healthychildren.org [Accessed August 2023]
Wiessinger, D. et. al. 2018. The Safe Sleep Seven. La Leche League llli.org [Accessed August 2023]