Bringing a new baby home is exciting, but it can also feel overwhelming, especially when it comes to sleep. Families hear many opinions about where and how babies should sleep, and not all of them are safe. This guide shares simple, practical steps to create a safe sleep environment and reduce the risk of sleep related infant deaths, based on recommendations from the American Academy of Pediatrics (AAP).

Back to Sleep for Every Sleep

The safest position for babies to sleep is on their backs for naps and at night, and for every sleep, until their first birthday. Placing babies on their backs helps keep their airway open and reduces the risk of sudden infant death syndrome (SIDS) and other sleep related deaths.

Some families worry that babies might choke while sleeping on their backs, but healthy infants have natural reflexes that protect their airway. Side sleeping is not as safe as back sleeping and is not recommended.

Create a Safe Sleep Space

Babies should sleep in their own dedicated sleep space, such as a safety approved crib, bassinet, or portable play yard, with a firm, flat mattress and a fitted sheet. Avoid sleeping in car seats, swings, or other seated devices except while traveling, because these positions can make it harder for babies to breathe if used for routine sleep.

Keep the crib free of soft objects and loose bedding. This means no pillows, stuffed animals, crib bumpers, quilts, comforters, or loose blankets in the baby’s sleep area, which can increase the risk of suffocation, entrapment, or strangulation.

Room Share, But Do Not Bed Share

The American Academy of Pediatrics recommends that babies sleep in the same room as their parents, close to the bed but on a separate sleep surface designed for infants, ideally for at least the first six months. Room sharing without bed sharing makes it easier to feed, comfort, and watch the baby while still protecting them from the risks associated with sharing an adult bed.

Adult beds, couches, and armchairs are not safe for sleep spaces for infants. Even for a short nap, it is safe to place babies in their own sleep space.

Keep the Baby’s Environment Smoke Free and Not Too Warm

Smoke and nicotine exposure during pregnancy and after birth increase the risk of sudden infant death syndrome and other sleep related deaths. Caregivers should avoid smoking during pregnancy and keep babies away from secondhand smoke after birth.

Babies should also be dressed in light sleep clothing, without hats or heavy layers, to avoid overheating. A good rule of thumb is one more layer than an adult would wear in the same environment.

Additional Steps That Support Safe Sleep

Several other practices can further reduce the risk of sleep related infant deaths. Breastfeeding or providing human milk is associated with a lower risk of sudden infant death syndrome, and families are encouraged to follow their pediatrician’s guidance on feeding. Offering a pacifier at nap time and bedtime can also help lower risk once breastfeeding is well established, if the family chooses to use one.

During awake time, supervised tummy time helps babies develop strong neck and shoulder muscles and can prevent flat spots on the back of the head. Start with short, supervised periods on the tummy and gradually increase as the baby grows.

Partnering With Your Pediatric Team

Every family situation is unique, and safe sleep practices may bring up questions or challenges, especially tired parents and caregivers. Your pediatrician and care team can help you create a safe sleep plan that fits your home, culture, and routines while still following evidence based recommendations.

To learn more about safe sleep recommendations and see additional resources for families, visit the American Academy of Pediatrics Safe Sleep page.

Safe Sleep Resources

American Academy of Pediatrics: Safe Sleep https://www.aap.org/en/patient-care/safe-sleep/

HealthyChildren.org: Safe Sleep Articles for Parents and Caregivers https://www.aap.org/en/patient-care/safe-sleep/healthy-children-safe-sleep-articles/

AAP Policy Statement: Sleep Related Infant Deaths, Updated 2022 Recommendations https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022