Safe Sleep and Your Baby: How Parents Can Reduce the Risk of SIDS and Suffocation

About 3,600 babies die each year in the United States during sleep because of unsafe sleep environments. Some of these deaths are caused by entrapment, suffocation, or strangulation. Some infants die of sudden infant death syndrome (SIDS). However, there are ways to keep sleeping babies safe.

Here is information from the American Academy of Pediatrics (AAP) on how parents can create a safe sleep environment for their babies. This information should also be shared with anyone who cares for babies, including grandparents, family, friends, babysitters, and child care center staff.

Note: These recommendations are for healthy babies up to 1 year of age. A very small number of babies with certain medical conditions may need to be placed to sleep on their stomach. Your baby’s doctor can tell you what is best for your baby.

What You Can Do

• Place your baby to sleep on their back for every sleep.
  • Babies up to 1 year of age should always be placed on their back to sleep during naps and at night. However, if your baby has rolled from their back to their side or stomach on their own, they can be left in that position if they are already able to roll from tummy to back and back to tummy.
  • If your baby falls asleep in a car safety seat, a stroller, a swing, an infant carrier, or an infant sling, they should be moved to a firm, non-inclined, flat sleep surface as soon as possible.
  • Swaddling (wrapping a light blanket snugly around a baby) may help calm a crying baby. However, if you swaddle your baby before placing them on their back to sleep, stop swaddling them as soon as they start trying to roll. Do not use weighted swaddles.
• Place your baby to sleep on a firm, non-inclined, flat sleep surface.
  • Any sleep product, like a crib, bassinet, portable crib, or play yard should meet current Consumer Product Safety Commission (CPSC) safety standards (www.cpsc.gov). Check to make sure the product has not been recalled. Do not use a crib that is broken or missing parts or that has drop-side rails.
  • Cover the mattress with a fitted sheet. Do not put blankets or pillows between the mattress and fitted sheet.
  • Never put your baby to sleep on an armchair, a sofa, a waterbed, a cushion, or a sheepskin. (Parents should also make sure not to fall asleep on an armchair or a sofa while holding their baby.)
• Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation out of the crib.
  • Pillows, quilts, comforters, sheepskins, bumper pads, and stuffed toys can cause your baby to suffocate.
  • Research has not shown us when it’s 100% safe to have these objects in the crib; however, most experts agree that these objects pose little risk to healthy babies after 12 months of age.
• Place your baby to sleep in the same room where you sleep but not the same bed, ideally for at least the first 6 months.
  • Keep the crib or bassinet within reach of your bed. You can easily watch or breastfeed your baby by having your baby nearby.
  • The AAP cannot make a recommendation for or against the use of bedside sleepers or in-bed sleepers until more studies are done.
  • Babies who sleep in the same bed as their parents are at risk of SIDS, suffocation, or strangulation. Parents can roll onto babies during sleep, or babies can get tangled in the sheets or blankets.
• Breastfeed as much and for as long as you can. This helps reduce the risk of SIDS.
  • The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.
• Schedule and go to all well-child (health supervision) visits. Your baby will receive important immunizations.
  • Recent evidence suggests that immunizations may protect against SIDS.
• Keep your baby away from people who smoke and places where people smoke. This helps reduce the risk of SIDS.
  • If you smoke, try to quit. However, until you can quit, keep your car and home smoke-free. Don’t smoke inside your home or car, and don’t smoke anywhere near your baby, even if you are outside.
• Do not let your baby get too hot. This helps reduce the risk of SIDS.
  • Keep the room where your baby sleeps at a comfortable temperature.
  • In general, dress your baby in no more than one extra layer than you would wear. Your baby may be too hot if they are sweating or if their chest feels hot.
  • Dressing your baby with layers of clothing is safer than using blankets. Wearable blankets, like a sleeping sack, or warm sleeper clothing can also be used. If you use a wearable blanket, make sure it is the right size for your baby and it doesn’t cover the head.
  • Do not use weighted blankets or weighted clothing.
  • Do not place hats on babies when indoors except in the first hours after birth or in the neonatal intensive care unit.
• Offer a pacifier at nap time and bedtime. This helps reduce the risk of SIDS.
  • If you are breastfeeding, wait until breastfeeding is going well and your baby is gaining weight before offering a pacifier. If you are not breastfeeding, you can start a pacifier as soon as you like. Keep in mind that some babies don’t like to use pacifiers.
  • If the pacifier falls out after your baby falls asleep, you don’t have to put it back in.
  • Do not use pacifiers that attach to infant clothing, blankets, or stuffed toys that can be a suffocation or choking risk.
• Do not use home cardiorespiratory monitors to help reduce the risk of SIDS.
  • Home cardiorespiratory monitors have not been found to reduce the risk of SIDS. If parents choose to use these devices, it’s important that they continue to follow other safe sleep guidelines.
• Use caution when using products that claim to reduce the risk of SIDS.
  • Products like wedges, positioners, special mattresses, and specialized sleep surfaces have not been shown to reduce the risk of SIDS.

What Expectant Moms Can Do

• Schedule and go to all prenatal doctor visits.
• Do not smoke, drink alcohol, or use drugs while pregnant or after the birth of your newborn. Stay away from people who smoke and places where people smoke.
• Remember to hold your newborn skin to skin while breastfeeding. If you can, do this as soon as possible after birth. Skin-to-skin contact also benefits bottle-fed newborns.

Remember Tummy Time

Give your baby plenty of “tummy time” when they are awake. This will help strengthen neck muscles and help prevent flat spots on the head. Start after you come home, and work up to 15 to 30 minutes each day by 7 weeks. Always stay with your baby during tummy time, and make sure they are awake.

Disclaimer

The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2022 American Academy of Pediatrics. All rights reserved.