Safe Sleep for Infants

There are an estimated 3,500 sleep-related infant deaths every year in the United States. As a first-time parent, it can be hard to know what’s safe and what’s not for your baby.

What does a safe sleep area look like?

A safe sleep area has the ABCs

A- Alone: Your baby should sleep alone with no pillows, blankets, duvets or stuffed animals.

B- Back: Your baby should sleep on their back.

C- Crib: Your baby should sleep in their crib.

A safe sleep area for your baby will feature a flat, stable surface—this can come in the form of a crib, portable crib, bassinet, or play yard. The surface your baby is gently placed on should be firm; visible indentations in a mattress indicate that it’s not firm enough.

The clean, fitted sheet you’re using on your baby’s mattress or alternative flat surface should fit snugly. Do not put anything else (blankets, stuffed animals, bumper pads, or toys of any type or size) in your baby’s sleep space. Babies tend to move around a lot when they sleep, and a clutter-free sleep space will eliminate the risk of any potential hazards.

Avoid putting your baby on what would be considered an “alternative sleep surface”: inclined sleep products, hammocks, baby boxes, in-bed sleepers, baby nests and pods, compact bassinets, travel bassinets, and baby tents. Per American Academy of Pediatrics: “If a product doesn't meet federal safety standards, avoid it.”

Also, be sure to follow the “back is best” rule. Place your baby on their back when you place them on their sleep surface, whether that’s a crib in their own room, a bassinet in your bedroom, or another place where you can regularly check on your baby. Sleep Foundation writes, “Experts recommend infants should sleep only on their backs until they reach 1 year of age. Back sleeping is the safest position for infants because it reduces the risk for SIDS. When a child reaches 1 year old, they can begin sleeping on their stomach or in another position.”

Is it safe for my baby to sleep in a car seat or stroller?

Despite how peaceful and comfortable your baby may look while sleeping in their car seat or stroller, neither a car seat nor a stroller is conducive to a safe, extended sleep environment for your child.

If your baby falls asleep in their car seat during a long drive and you can adjust their neck and supervise their sleep, this would be the only circumstance in which extended sleep in a car seat could be considered acceptable, but for all regular sleep—including naps—the most ideal place for your infant to sleep is in a bassinet, crib, or on another safe sleep surface.

If your baby falls asleep while on a walk, or during a car ride around town, your best bet is to gently lift your child out of the car seat or stroller and place them in their crib, bassinet, portable crib, or play yard that has met the safety standards established by Consumer Product Safety Commission (CPSC).

Can my baby sleep with me?

Sleeping with your baby sounds lovely, but it’s not a good idea. Sharing your bed with your baby exposes your child to bedding such as sheets, blankets, duvets, and pillows that might inadvertently cover their face, head, or neck. This can block their airflow.

Avoid falling asleep with your baby in other spots, too, suggests the American Academy of Pediatrics. Their website on safe sleep for babies notes two other important reasons why you should not share your bed with your baby: alcohol, marijuana, illicit drugs, and certain medications can pose safety risks, as can sleeping with a baby who is very young or was born prematurely.

American Academy of Pediatrics shares these alarming statistics: “The risk of sleep-related infant death is more than 10 times higher for babies who bed share with someone who is fatigued or has taken medications that make it harder for them to wake up or has used substances such as alcohol or drugs. The risk of sleep-related infant death while bed-sharing is 5 to 10 times higher when your baby is younger than 4 months old. And the risk of sleep-related infant death is 2 to 5 times higher when your baby was born preterm or with low birth weight.”

A parent who is in a deep sleep due to drugs, alcohol, medications, and other factors could unintentionally roll onto their child. Also, parents who smoke shouldn't sleep with their babies because it increases the child’s risk of potentially developing respiratory problems, and The Lullaby Trust warns: “It has been shown that the chance of SIDS if bed sharing when you or your partner is a smoker is much greater than if you were both non-smokers.”

What if I fall asleep while holding my baby?

American Academy of Pediatrics also notes that “the risk of sleep-related infant death is up to 67 times higher when infants sleep with someone on a couch, soft armchair or cushion.” Suffocation can occur on these types of furniture because the baby could become trapped between a sleeping parent and the cushions.

Falling asleep while holding your baby is not uncommon, especially because they’re such a joy to snuggle, but keep in mind that you must always prioritize your baby’s safety. If you fall asleep while feeding or comforting your baby, place your baby in their own sleep space as soon as you wake up. And don’t forget to tell others—grandparents, aunts, uncles, and others—about the importance of avoiding falling asleep while holding the baby.

Remember your ABCs

Alone

Back

Crib

Remember, it’s your responsibility to cultivate a safe sleep space for your baby. As your baby grows and develops, the sleep environment you create will continue to provide your baby with a sense of comfort and security. Giving your baby a peaceful and safe place to sleep will contribute to their growth and development.

A clean, safe, and relaxing sleep space also brings you and your partner peace of mind. Should you have any concerns about how to create a safe sleep space for your infant, please contact your child’s pediatrician for personalized recommendations and thorough answers to your specific sleep space questions.