Newborn Sleep Safety

Guidelines for Sleep Safety up to 1 Year of Age

• Place your baby on their back when sleeping at all time, for naps or for bed. It’s been confirmed that babies who sleep on their backs are much less likely to die from SIDS compared to babies who sleep on their stomach or side. Some parents may feel worried that their baby might choke while laying on their back, but this isn’t a big concern. If something were to happen, babies have a good gag reflex that can prevent them from choking. It’s been recommended that even babies with gastroesophageal reflux should still sleep on their backs.
• Newborns should have skin-to-skin contact with their mother after birth, for at least the first hour. If the mother needs to sleep or is not able to do skin-to-skin contact, the baby should always be placed on their back in a bassinet. Some premature babies have to be placed on their stomach temporarily if they’re in the NICU, but as soon as they recover from any problems they should start being placed on their back.
• Babies should always be placed on their back to sleep, but some babies become comfortable rolling back and forth easily. If this happens, you do not always have to return your baby to lie on their back, but there should be no blankets, pillows, stuffed animals, or any toys around your baby. These items could come into contact with your baby as they roll and could cause them to suffocate.
• If your baby falls asleep in a different location, such as in a stroller, car seat, or baby sling, you should move them to a firm sleeping location and lay them on their back.
• Make sure to use a firm sleeping surface for your baby. You should always use a crib or bassinet that has met the standards of the Consumer Product Safety Commission (CPSC). Their recommendation states that parents should use a tight-fitting, firm mattress with a fitted sheet made for that specific bed. There should be no other items inside the crib. The surface should be hard enough that she is no indent in the bed when the baby is placed inside of it. There are some sleeping products that use advertisements claiming their product reduces the risk of SIDS. It’s important to know that there has been no conclusive evidence that confirms these claims.
• Keep your baby’s bed in the same room as where you sleep. The crib or bassinet should be placed close to your bed. Room sharing is recommended by the AAP because it’s been proven to reduce the risk of SIDS by up to 50%.
• Never let your baby sleep on other items such as a couch or armchair. This can be extremely dangerous for your baby.
• Do not share your bed with your baby. It’s not recommended for any baby to sleep in bed with you, but there are other risks that could make the situation even more dangerous. Babies younger than 4 months old, premature babies, and mothers who smoke increase the chance of a baby dying from SIDS.
• You can swaddle your baby. Some parent’s become worried if swaddling could suffocate their baby, but this isn’t a concern as long as you learn the proper way to swaddle. The swaddle should be snug, but not tight enough to the point where it can make it hard for the baby to breathe or move their hips. When a baby starts trying to roll over on their own, you can stop swaddling.
• Try using a pacifier when your baby sleeps at night or during a nap. It’s been shown that using a pacifier helps reduce the risks of SIDS, even if the baby drops it while sleeping. It’s important to note that breastfeeding mothers should wait until breastfeeding has been well established before using a pacifier.

Additional Recommendations

• Do not smoke after your baby is born. All babies should be kept away from smokers or anywhere where there is smoke present. If you are a smoker, never share your bed with your baby as it can increase their chance of SIDS. Keep your home and care completely smoke-free. Never smoke anywhere near your baby.
• Avoid alcohol after your baby is born. Never share your bed with your baby if you have used alcohol or taken any medications that can make you drowsy.
• If you’re comfortable with it, breastfed babies are known to have a lower risk of SIDS. The AAP recommends that breastmilk should be the sole source of nutrition for your baby for around 6 months of age.
• Remember to give your baby tummy time every day.
• Don’t automatically believe a product that claims to reduce the risk of SIDS.
• Don’t rely on heart or breathing monitors to reduce the risk of SIDS.

Sources and Additional Literature

Anderson, T. M., et al. (2019). Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death. Pediatrics, 143(4), e20183325.

Marinelli, K. A., Ball, H. L., McKenna, J. J., & Blair, P. S. (2019). An integrated analysis of maternal-infant sleep, breastfeeding, and sudden infant death syndrome research supporting a balanced discourse. Journal of Human Lactation, 35(3), 510-520.

Lead, T., Lead, L. P. T., & Fishwick, C. (2019). Safer Sleeping and Reducing the Risk of Sudden Infant Death Syndrome Guidelines.

Liaw, P., Moon, R. Y., Han, A., & Colvin, J. D. (2019). Infant deaths in sitting devices. Pediatrics, e20182576.

Lambert, et al. (2019). Sleep-related infant suffocation deaths attributable to soft bedding, overlay, and wedging. Pediatrics, 143(5), e20183408.

Moon, R. Y., et al. (2012). Pacifier use and SIDS: evidence for a consistently reduced risk. Journal of Maternal Child Health (3): 609-14.