Every year, thousands of babies die from sleep-related causes. Some of these deaths happen when a baby accidentally suffocates, becomes trapped, or is strangled in an unsafe sleep environment. Others are linked to sudden infant death syndrome (SIDS), which can happen unexpectedly and without a clear explanation.
The good news is that parents and caregivers can take simple, evidence-based steps to create a safer sleep environment and help reduce the risk of sleep-related infant deaths.
Here are 9 simple ways to help create a safer sleep environment for your baby. Be sure to share these recommendations with anyone who cares for your baby, including grandparents, relatives, friends, babysitters, and childcare providers. Consistency is important, no matter where your baby sleeps.
These recommendations are intended for healthy babies up to 1 year old. In rare cases, babies with certain medical conditions may need to sleep in a different position. Your baby’s pediatrician can help you understand what is safest for your baby.
1. Always place your baby on their back to sleep
For every nap and nighttime sleep, place babies under 1 year old on their backs. If your baby can roll from their back to their tummy and from their tummy to their back on their own, you do not need to reposition them if they roll onto their side or stomach during sleep.
If your baby falls asleep in a car seat, stroller, swing, infant carrier, or sling, move them to a firm, flat, non-inclined sleep surface as soon as possible.
Swaddling can sometimes help soothe a fussy baby. If you choose to swaddle your baby, always place them on their back to sleep and stop swaddling as soon as they begin showing signs of trying to roll. Weighted swaddles should not be used.
When your baby is awake, give them plenty of supervised tummy time. This helps strengthen their neck and upper-body muscles and may help prevent flat spots from developing on the back of the head. Always stay with your baby during tummy time and make sure they are awake.
2. Use a firm, flat sleep surface
Your baby’s crib, bassinet, portable crib, or play yard should have a firm, flat mattress with a tightly fitted sheet. Make sure the product meets current Consumer Product Safety Commission (CPSC) safety standards and has not been recalled. Never use a crib that is broken, missing parts, or has drop-side rails.
Keep the sleep space completely free of loose or soft items, including:
- Blankets
- Pillows
- Quilts and comforters
- Bumper pads
- Stuffed animals
- Sheepskins
- Other objects that could increase the risk of suffocation, entrapment, or strangulation
Never place your baby to sleep on a sofa, armchair, waterbed, cushion, or sheepskin. These surfaces are not safe for infant sleep. Caregivers should also be careful not to fall asleep while holding a baby on a sofa or armchair.
3. Share a room, but not a bed
The safest arrangement is for your baby to sleep in the same room as you—but on a separate sleep surface. Ideally, keep your baby’s crib or bassinet within arm’s reach of your bed for at least the first 6 months, and preferably through the first year of life.
Room-sharing makes it easier to keep an eye on your baby and can help reduce the risk of SIDS. Bed-sharing, however, can increase the risk of suffocation, strangulation, and SIDS. A sleeping adult can accidentally roll onto a baby, or a baby can become trapped in bedding.
The American Academy of Pediatrics does not currently recommend for or against bedside or in-bed sleepers because more research is needed to determine their safety.
4. Breastfeed if you can
Breastfeeding, when possible, can help reduce the risk of SIDS. The American Academy of Pediatrics recommends exclusive breastfeeding for about the first 6 months, followed by continued breastfeeding as long as you and your baby choose—even after solid foods are introduced.
Skin-to-skin contact is also beneficial for newborns. If you plan to breastfeed, try to begin as soon as possible after birth. Skin-to-skin contact can also benefit babies who are bottle-fed.
5. Keep up with well-child visits and immunizations
Regular well-child visits help make sure your baby receives important preventive care and recommended immunizations. Recent research suggests that immunizations may also help protect against SIDS.
6. Keep your baby away from smoke
Exposure to cigarette smoke increases the risk of SIDS. Keep your home and car smoke-free, and do not smoke near your baby—even when you are outside.
If you smoke, quitting is the best way to protect your baby’s health. Until you are able to quit, never smoke inside your home or car.
7. Avoid overheating
Keeping your baby from getting too hot can help reduce the risk of SIDS. Keep the room where your baby sleeps at a comfortable temperature.
As a general rule, dress your baby in no more than one additional layer of clothing compared with what you are wearing. Your baby may be too warm if they are sweating or their chest feels hot.
Instead of loose blankets, consider warm sleeper clothing or a properly sized wearable blanket, such as a sleep sack. Make sure the wearable blanket fits your baby correctly and cannot cover their head or face.
Never use weighted blankets or weighted clothing for infants. Babies generally should not wear hats indoors, except during the first hours after birth or when directed by medical staff in a neonatal intensive care unit.
8. Consider offering a pacifier at naps and bedtime
Offering a pacifier at nap time and bedtime may help reduce the risk of SIDS.
If you are breastfeeding, you may want to wait until breastfeeding is well established and your baby is gaining weight before introducing a pacifier. If you are not breastfeeding, you can offer a pacifier whenever you choose. Some babies simply do not want to use one—and that’s okay.
If the pacifier falls out after your baby falls asleep, you do not need to put it back in. Avoid pacifiers attached to clothing, blankets, stuffed animals, or other objects that could create a choking or suffocation hazard.
More Information
- How to Keep Your Sleeping Baby Safe: AAP Policy Explained
- Ask the Pediatrician: Are some babies at higher risk for SIDS?
- Safe Sleep: Charlie’s Story
- Inclined Sleepers, Soft Nursing Pillows & Other Baby Products to Avoid
- Swaddling: Is it Safe for Your Baby?
- Back to Sleep, Tummy to Play
- A Child Care Provider’s Guide to Safe Sleep (downloadable pledge sheet)