From bathing habits to meal planning, your parenting style might differ from what friends and family members do – and that’s OK! But when it comes to infant safety, recommendations are less flexible.
That’s especially true for infant sleep practices, which can be a matter of life or death. Each year in the U.S., around 3,400 sudden unexpected infant deaths (SUIDs) occur in infants younger than 1 year old. Two of the main causes are:
- Accidental suffocation and strangulation in bed (ASSB), which occurs when a sleeping baby’s airway is blocked by something in the sleeping environment, such as a pillow or a parent’s or sibling’s body.
- Sudden infant death syndrome (SIDS), which has no known cause but typically occurs in sleeping babies between 1 and 4 months old. SIDS is not the same as suffocation.
While the SIDS rate has decreased over the past few decades due to national efforts to promote safe sleep practices, the ASSB rate has increased. Tragically, many sleep-related infant deaths could be prevented with a safer sleeping environment, such as avoiding soft bedding or sleep wedges and sharing your room – but not your bed – with your baby.
By learning and following safer sleep practices, you and your baby can rest easier through the night.
Infant sleep safety tips
1.Provide a flat, firm sleeping surface.
Your baby needs a dedicated sleeping space, but it doesn’t have to be a crib. You can use a bassinet, a playpen, or a bedside sleeper that attaches to your bed – as long as it meets Consumer Product Safety Commission (CPSC) standards, which manufacturers are required to verify with a Children’s Product Certificate (CPC). Do not lay the baby down on a couch or a chair, as they could easily roll off or suffocate between cushions.
Babies don’t need the soft, padded surfaces adults tend to favor. Sleep products that incline more than 10 degrees are dangerous, as comfortable as they might look. These include baby rockers, loungers, and nappers, which can restrict a baby’s airway if it falls asleep with its chin on its chest.
Unfortunately, many unsafe products are readily available through several retailers, but the CPSC recently approved a new federal rule that will require every product created for infant sleep to meet its standards for providing a safe sleep environment for babies under 5 months old. The rule won’t go into effect until mid-2022, so continue to confirm safety certification for any sleeping product you purchase.
2. Don’t put anything in, on, or around your baby’s sleeping space.
- Blankets and comforters
- Crib bumpers
- Sleep wedges or positioners
- Stuffed animals and other toys
Loose items increase the risk of suffocation or strangulation. Only the mattress should have a tightly fitted sheet. Your baby will not get cold without a blanket to snuggle under. They will be warm enough if you dress them in one more layer than what you wear. Or you can put them in a correctly sized wearable blanket, also called a sleep sack.
Crib bumpers are soft pads placed between a crib’s slats. Though they were developed to keep babies from getting injured by the slats, they do more harm than good; your baby could easily roll into them and suffocate. This is why the Safe Cribs Act, a bill to ban the sale of crib bumpers, was introduced to Congress in April 2021.
3. Always place your baby on its back.
Several studies have shown that back sleeping decreases the risk of SIDS compared to side or stomach sleeping, which can obstruct the baby’s airway and cause overheating and low oxygen levels. Research has also shown that putting babies to bed with a pacifier reduces the risk of SIDS up to 90%. However, don’t force your baby to take one if they don’t like it or put a pacifier back in your baby’s mouth if it falls out during sleep. The protective effect was found to continue in babies who went to sleep with a pacifier even after it fell out.
You can safely swaddle your baby on its back but only until the baby starts rolling over, which usually occurs between two and four months. At this point, if your baby rolls onto its tummy during the night, it’s OK to leave them there; you don’t need to flip them over on their back again. This movement is part of a baby’s growth and development.
4. Take the baby out of the car seat when you’re not traveling.
New parents are usually surprised to learn that car seats are not meant for sleeping. While a nap in the car from time to time is inevitable, remove a sleeping baby from a car seat when you stop traveling. The angle of a car seat on the ground is different from the angle in the car and can put your baby in a position that blocks its airway.
5. Share your room, not your bed
The American Academy of Pediatrics (AAP) recommends sharing a room with your baby for at least the first six months of life, if not a full year, to reduce the risk of SIDS by approximately 50%. Room-sharing can be mutually beneficial for you and your baby because:
- It helps your baby maintain regular heart and breathing rates, as babies tend to mimic their mothers’ rates as they sleep.
- The noise you make as you move around and breathe during sleep helps keep your baby in the lighter stages of sleep. SIDS is more common in deeper stages of sleep.
- Nighttime feedings are more convenient when you don’t have to go very far to reach your baby. AAP also notes that breastfeeding for at least two months can reduce the risk of SIDS by almost half.
- You can notice when something is wrong and comfort your baby quicker and easier if it is nearby.
Sharing a bed with your baby cancels these benefits and increases the risk of ASSB. In Texas, rates of infant deaths where bed-sharing was a factor have risen from 140 deaths in 2019 to more than 160 in 2021.
Even if your grandmother or a co-worker tells you they experienced no problems sharing a bed with their baby, it is not recommended for infants younger than 12 months old. There are too many risk factors, such as heavy blankets or the possibility of you or your partner rolling onto your baby.
Transitioning baby out of your room takes time
When my baby was born, room-sharing decreased my anxiety. I felt more comfortable knowing that if anything were to happen, I could help her in an instant instead of running to a room across the hall or up the stairs.
Still, having a newborn is bound to disturb your sleep cycle, and poor sleep quality increases depression and anxiety in new moms. So, transition your baby to its own room at your own pace when you feel the time is right – and safe.
Related reading: 5 tips to help manage the baby blues – and when to seek help
It helps to first have naptime in your baby’s new room while continuing to have bedtime in your room before gradually putting your baby to bed in the new room a few nights a week. Keep the same bedtime routine, and spend more time playing with your baby in the new room during the day so they feel more comfortable in it.
After six months, I felt comfortable moving my baby into her own room. The risk of SIDS decreased and my quality of sleep increased.
Listen to the experts
It can be hard to ignore the parenting opinions of the people closest to you or even from your favorite bloggers or influencers. But to prevent SUID, education is key – be sure you’re getting it from the experts.