Putting your baby to bed may seem straightforward, but there are many factors involved to ensure safe sleep for your baby. The American Academy of Pediatrics (AAP) released updated guidelines in 2016 that specify sleep recommendations for babies up to 1 year of age. Unfortunately, many parents do not adhere to these recommendations, putting their baby at a higher risk for death. It is estimated that about 3,500 babies in the U.S. die suddenly and unexpectedly during sleep. In 2014, 69% of these deaths were caused by sudden infant death syndrome (SIDS) or accidental strangulation or suffocation in bed. SIDS is sudden, unexpected death that can occur in babies less than 1 year of age who otherwise appear healthy. Providing your baby with a safe sleep environment and putting your baby to bed properly is key to keeping your baby safe and healthy.
Safe sleeping surface
Your baby should be provided with a safe sleeping surface. Babies should never be placed on an armchair, sofa, or couch. An acceptable sleep surface for your baby is a firm, tight-fitting mattress placed in a crib, portable crib, bassinet, or play yard that conforms to the safety standards of the Consumer Product Safety Commission (CPSC). The mattress can be covered by a fitted sheet, but no other bedding, pillows, blankets, soft toys, or other objects should be placed in your baby’s sleep area. Soft mattresses, such as memory foam, should not be used because they can increase the risk of suffocation or breathing complications.
Bumper pads that are attached to the sides of cribs can also be dangerous to your baby and should not be used. These have been associated with causing deaths in some babies by strangulation, suffocation, and entrapment. Bumper pads were originally developed to prevent a baby’s head from becoming trapped between crib slats. However, new crib standards have required slats to be placed closer together, making bumper pads obsolete. It is recommended to use a new crib for your baby because old cribs may not meet current safety standards.
There are now products available claiming to reduce the risk of SIDS. However, the AAP warns that parents should be cautious of these products. Products that are not consistent with current sleep recommendations should be avoided. Special sleeping surfaces, mattresses, positioners, and wedges have not been shown by the AAP to decrease the risk of SIDS. Additionally, the AAP cannot recommend for or against in-bed or bedside sleepers because there have been no studies looking at their safety or their effect on SIDS.
Room-sharing vs bed-sharing
Parents should never bed-share with their baby. Bed‑sharing is when you share a sleeping surface, which can be a bed, chair, or sofa, with your baby. This practice could result in suffocation or strangulation of your baby. Babies should instead have their own sleep surface. Additionally, if you have twins or multiples, each baby should be provided his or her own sleeping surface.
In contrast to bed-sharing, room-sharing is recommended by the AAP for at least the first 6 months of your baby’s life. Ideally, room-sharing should continue until your baby reaches 1 year of age. Room-sharing is when your baby’s sleep surface, such as a crib, is placed in your room and close to your bed. This sleeping arrangement reduces the risk of SIDS by up to 50% and is safer than bed-sharing or having your baby sleep in a separate room. It also allows you to be near your baby for feeding and monitoring.
Parents frequently fall asleep when feeding or lying with their baby, which could result in SIDS or accidental injury. If you bring your baby into your bed for feeding or comforting, you should always return your baby to his or her own crib before you are ready to go back to sleep. Armchairs and couches pose a particularly high risk of death to your baby. Parents should be especially cautious when feeding or lying with their baby on one of these surfaces. It is safer to sit with your baby in your bed than on a couch or armchair in case you fall asleep. You should also ensure that there are no blankets, pillows, sheets, or other items near your baby that could cause suffocation or overheating.
When putting your baby to bed, you should always place your baby on his or her back (the supine position). It is not safe for babies to be placed on their side or on their stomach (the prone position). Some parents worry that the supine position will increase the risk of choking, but this is not the case.
Once your baby reaches 4 to 6 months, he or she may learn to roll over while sleeping. It is ok for your baby to roll over onto his or her stomach while sleeping, as long as you originally placed your baby in the supine position for bed.
In addition to providing a proper sleep environment for your baby and putting your baby to bed correctly, the AAP has some additional recommendations to keep your baby safe. It is important to avoid covering your baby’s head while he or she is sleeping. Breastfeeding your baby reduces the risk of SIDS. Exclusive breastfeeding is best, but any breastfeeding is beneficial. Offering your baby a pacifier before naps or bedtime also reduces the risk of SIDS. Furthermore, you should avoid the use of alcohol after the birth of your baby and not smoke near your baby’s sleep or play areas.
Following recommended sleep guidelines can help keep your baby healthy and safe. You can read more about sleep recommendations at the AAP’s healthychildren.org and at the National Institutes of Health Safe to Sleep.