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Safe Sleep for Your Baby Around the Clock:
Birth to 12 Months
- Introduction
- U.S. Consumer Product Safety Commission Cautions
- Tips to Make Sleeping Safe for Your Baby
- Where Should My Baby Sleep?
- Where Not to Sleep
- What Position Should My Baby Be In?
- How Do I Make My Baby's Sleep Area Safe?
- Breastfeeding
- AAP Recommendations
Introduction
As a parent or caregiver, you have an important job in choosing where and how your baby will sleep at night and naptime. Your baby's sleep safety is essential to help keep the baby healthy and alive. A number of things may put your baby at risk while sleeping.
What are some risks for SIDS? In general, a risk is something that can increase the chance of a harmful event happening to your baby. For example, sleeping on their tummies puts babies at risk for Sudden Infant Death Syndrome (SIDS). The number of babies dying of SIDS has become much lower since more parents and caregivers began placing babies on their backs to sleep.
Another risk for babies is suffocation in soft bedding. Soft bedding includes pillows, quilts, comforters, sheepskins, pillow-like stuffed toys, and other soft products that may keep the baby from breathing easily. These items should be removed from the area in which a baby is sleeping. Keep your baby's head uncovered during sleep.
Letting a baby sleep in an adult bed can also put your baby at risk for suffocation and SIDS. This risk includes the baby sleeping in an adult bed with any adult or child. It is also important to know that SIDS or “"crib death"” is not caused by sleeping in a crib.
Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under 1 year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.
(Willinger,
James, and Catz.
“Defining the Sudden Infant Death Syndrome (SIDS).”
Pediatric Pathology 1991; 11(5): 677-84)
The U.S. Consumer Product Safety Commission (CPSC) cautions about using adult beds for sleeping babies:
The U.S. Consumer Product Safety Commission (CPSC) cautions about using adult beds for sleeping babies:
Many parents and caregivers are unaware of the SIDS risk and hidden hazards when placing babies on adult beds.
Babies placed on adult beds risk suffocation from several hidden hazards:
- Suffocating in soft bedding, such as, pillows, thick quilts, or comforters;
- Falling and becoming trapped between the bed and wall, or between the bed and another object;
- Falling and becoming trapped between the bed frame and headboard or footboard; and
- Falling from an adult bed onto piles of clothing, plastic bags, or other soft materials resulting in suffocation.
Tips To Make Sleeping Safe for Your Baby
The American Academy of Pediatrics (AAP) recommends that parents talk to their baby's doctor or nurse about the baby's sleep area and possible risks. Talk to the doctor or nurse to learn more ways to reduce the risk of SIDS.
Do not forget to talk with your baby's child care providers, grandparents, other family members, babysitters, and all caregivers about the importance of the back sleep position and ways to keep the baby's sleep area safe.
Where Should My Baby Sleep?
Consider placing the baby's crib in your room near your bed. AAP suggests that parents consider placing the baby's crib near their bed, rather than having their baby sleep with them in the bed.
Use a crib and mattress that meet CPSC safety standards. The mattress should fit tightly in the crib. This is to make sure the baby's face is not trapped between the mattress and the side of the crib.
According to the CPSC, a safe crib has:
- A firm, tight-fitting mattress. The mattress is too loose if you can fit more that two finger widths between the edge of the mattress and the crib side.
- A tight-fitting bottom sheet, never use an adult sheet on a crib mattress.
- No loose, missing, or broken hardware or slats.
- No more than 2 3/8" between the slats (about the width of a soda can).
- No corner posts over 1/16" high.
Where Not to Sleep
Some of the dangerous places for a baby to sleep are
- Couch/sofa
- Recliner
- Waterbed
- Soft mattress
- Any soft surface including pillows, sheepskins, quilts, or cushions
- Any bed with another adult or child
The Dangers of Bed Sharing
AAP recommends putting your baby to sleep in a safe crib or bassinet in your room for the first few months of life. AAP does not recommend sleeping in bed with your baby. Bed sharing can increase the chances that your baby might die from SIDS or might suffocate. Many babies have died while sleeping in bed with their parents or other family members. Some of these babies died from overlaying. Overlaying is when someone rolls on top of the baby or against the baby. Other babies got trapped in soft bedding or pillows and could not breathe. And some babies died when they got stuck between the mattress and the wall or bed frame.
If you bring your baby into bed for nursing or comforting, place your baby back in the crib before you go to sleep. Sharing your bed for a few minutes with your baby can be safe only when you are wide awake. Never bring your baby into bed when you are sleepy. Never bring your baby into bed if you have been drinking alcohol or taking drugs or medicines that may make you sleepy. The only safe place for babies to sleep is in their own crib.
What Position Should My Baby Be In?
Babies should always be placed on their backs for every sleep,
at bedtime and naptime. When babies sleep on their backs,
it helps to keep their mouths and noses unblocked so they
breathe in clean, fresh air and do not overheat. This lowers
the chance of dying from SIDS or suffocation.
Do not place babies on their sides to sleep. Side sleeping
is not as safe as back sleeping, and babies may roll over onto
their tummies. After babies start to roll over from back-to-tummy
or back-to-side, they should still be put to sleep on their
backs. But there is no need to keep turning them over onto
their backs or to check on them all the time while they are
sleeping.
Babies need some tummy time every day when they are awake.
Placing babies on their tummies to play when they are awake
and being watched by an adult is good for two reasons: 1) it
helps babies develop strong muscles, and 2) it may help to
reduce the chances of baby developing a flat spot on the back
of the head.
How Do I Make My Baby's Sleep Area Safe?
Remove pillows, quilts, comforters, sheepskins, pillow-like stuffed toys, bumper pads, and other soft products from the crib.
Consider using a sleeper or other sleep clothing instead of blankets. If using a blanket, place baby with feet at the foot of the crib. Tuck a thin blanket around the crib mattress, reaching only as far up as the baby's chest. Make sure your baby's head remains uncovered during sleep.
Avoid overheating. Babies can be clothed for sleep with a bedroom temperature that is comfortable for a lightly clothed adult. The baby should not be sweating or feel hot to the touch (especially the hands).
DO NOT use any device to prop the baby on the side, or one that claims to "prevent SIDS" and suffocation. According to the AAP, these devices have not been tested to show if they are safe or even reduce SIDS risk. There is no way to prevent SIDS, but there are ways to reduce the risk. The back sleep position is best for your baby.
Create a smoke-free zone around the baby. Do not smoke during pregnancy and avoid being around other smokers. Make sure that no one smokes around your baby.
Never put your baby to sleep with other children who can accidentally roll over and suffocate the baby.
When traveling or visiting check the safety of any crib for your baby, especially motel and hotel cribs (see CPSC guidelines in this publication).
Breastfeeding
Breast milk is the best nutrition for your baby. Sleeping close to your baby can make breastfeeding more convenient. Having the baby's crib near your bed is recommended. Place your baby in a crib next to your bed after breastfeeding.AAP Also Recommends:
Consider offering a pacifier at nap time and bedtime:
It has been shown that the risk of SIDS is lower when a pacifier is used during sleep. Using a pacifier does not affect breastfeeding, and does not cause later dental problems. The task force recommends use of a pacifier until one year of age according to the following procedures:
Use the pacifier when placing the baby down for sleep, and do not reinsert once he/she falls asleep. If the baby refuses the pacifier, he/she should not be forced to take it.
- Pacifiers should not be coated in any sweet solution.
- Pacifiers should be cleaned often and replaced regularly.
- For breastfed infants, do not start using the pacifier until 1 month of age to ensure that breastfeeding is firmly established.
Avoid development of positional plagiocephaly (flat head):
- Do not have the baby spend excessive time in car-seat carriers and “bouncers,“ in which pressure is applied to the back of the head. It is best to “cuddle” with baby sitting up rather than lying down.
- Adjust the head position while baby sleeps on the back. Ways to do this include placing baby to sleep with the head to one side for a week and then changing to the other side.
Do not use home monitors to reduce the risk of SIDS:
There is no evidence that use of monitors decreases the incidence of SIDS. Also, there is no evidence that in-hospital monitoring of the baby's breathing or heart will show which babies are at increased risk of SIDS.
For the complete version of the AAP recommendations, visit http://aappolicy.aappublications.org/cgi/content/full/pediatrics;116/5/1245
The information in this publication is based on recommendations from the American Academy of Pediatrics (AAP), the National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH), and the Consumer Product Safety Commission (CPSC). The Association of SIDS and Infant Mortality Programs (ASIP) and First Candle/SIDS Alliance also provided recommendations on safe sleep environment for babies.
National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center
The original version of this document was produced in May 2007 by the National Sudden Infant Death Syndrome (SIDS)/Infant Death Resource Center under Contract No. NIH IDIQ-263-01-D-0208 with the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau. The Center was operated by Circle Solutions, Inc.
The updated online version of this document was produced by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center, Georgetown University, under its cooperative agreement (U48MC08717) with HRSA’s Maternal and Child Health Bureau. Additional copies of this document may be downloaded. Other online and print materials may be found under Publications on the Resource Center Web site.
Available from:
National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource
Center
Georgetown University
Box 571272
Washington, DC 20057-1272
(866) 866-7437 (Toll-free)
(202) 687-7466 (local)
(202) 784-9777 (Fax)
info@sidscenter.org (E-mail)
