Welcome to Safe Sleep 101
This post is a beginner-friendly introduction to safe sleep. Links to evidence and more in-depth discussions are provided underneath each section.
Why this matters
Sudden Infant Death Syndrome (SIDS) is the #1 cause of death in healthy, full-term babies.
The good news is that the vast majority of SIDS cases are preventable. This post covers how to do just that.
Table of Contents
Guiding principles
Two things to understand up front.
Safe sleep basics
The ABC’s of safe sleep and common risky behaviors.
Swaddling
When to stop swaddling and why.
Nursery decor
The safety risks of wall hangings, mobiles, bumpers, and window treatments.
Baby wearing
Is it safe if your baby falls asleep while you’re wearing him in a carrier?
Travel systems
Should your baby sleep in his car seat or stroller?
Dressing for sleep
How to prevent overheating while still keeping your baby warm.
Pacifiers
Offer a pacifier to reduce the risk of SIDS.
Breastfeeding
Breastfeed to reduce the risk of SIDS.
Roomsharing
Share a room (not a bed) to reduce the risk of SIDS.
Products that are unsafe for sleep
A list of popular products that shouldn’t be used for sleep.
Products that are safe for sleep
What qualifies a product as safe and recommendations for safe sleep spaces.
Guiding principles
Let’s quickly cover two principles to wrap your head around:
1 – Your perception of the risk of SIDS is inherently biased.
Do not dismiss the risk of SIDS just because you don’t personally know people have lost babies.
2 – Many of the strategies to make babies sleep “better” are dangerous for that very reason.
Parents and caregivers commonly complain that their babies sleep like crap. (We’ve all been there!)
It’s important to realize that this is a life-saving mechanism. An infant’s ability to wake easily is what protects them against SIDS.
Now let’s dive in…
Safe Sleep Basics
Follow the ABC’s of safe sleep:
Infants should sleep…
A – alone
B – on their back
C – in a regulated crib, bassinet or play yard, with nothing but a fitted sheet and a pacifier
Remember that “sleep” doesn’t just mean at night… it refers to supervised naps too.
If a baby falls asleep in his swing, seat, lounger, etc., it is not enough to just watch him — you must move him to a safe sleep space.
Why can’t you just supervise — why do you have to move him? Because asphyxia can look just like sleeping. There isn’t necessarily a fight for life or choking sound to alert you that something is wrong.
Safe sleep spaces are federally regulated. There are only 3 types of products that have undergone mandatory safety testing for infant sleep:
- CRIB
- BASSINET
- PLAY YARD (often called Pack N Play)
Surprisingly common and surprisingly risky…
Never share a bed with an infant. Bedsharing increases the risk of SIDS.
Never place a sleeping baby on a couch, chair, or adult bed due to the high risk of entrapment and suffocation.
Never add additional mattresses, blankets, or anything to make a baby’s sleep space more “comfortable.”
Never leave a baby alone with pets. Make sure animals are in a different room if you are unable to supervise.
READ MORE
- The ABC’s of Safe Sleep: How To Protect Your Baby From SIDS
- 3 Things I Can’t Believe I Didn’t Know About Safe Sleep
- Bassinet vs Pack ‘n Play: The Ultimate Guide to Help you Decide
- How Long Can a Baby Sleep in a Bassinet? [Guide]
Evidence:
- SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment (AAP)
- Ways to Reduce The Risk Of SIDS And Other Sleep-Related Causes Of Infant Death (NIH/NICHD)
- Safe Sleep – Cribs and Infant Products Information Center (CPSC)
- More resources and definitions
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
REQUEST A GRAPHIC! If you’d like to see any piece of safe sleep info in an easily shareable graphic, shoot me a quick email!
Swaddling
It’s no longer safe to swaddle when your baby starts showing signs of rolling. The risk of death is high if a swaddled infant rolls onto his stomach.
Many safe sleep experts instruct caregivers to stop swaddling at 8 weeks or first signs of rolling, whichever comes first.
Make sure the swaddle is tight enough so that it doesn’t ride up near the baby’s face. (Swaddling should not restrict the lower body for healthy hip development).
You can switch to a sleep sack (a wearable blanket) when it is no longer safe to swaddle.
READ MORE
My lay-person friendly posts:
- My Baby Can Roll Over… Now What? (The Evidence-Based Guide)
- What is the Difference Between a Swaddle and a Sleep Sack? (When to stop swaddling and why, the safety of specific swaddle products, and more!)
- How to Keep a Baby Warm at Night (Evidence-Based Guide)
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Nursery Decor
Hard items like frames, mirrors, and name signs should not be hung over a crib.
Mobiles attached to the crib are safe until 5 months or when baby begins to push up, whichever happens first.
Bumpers and rail covers are unsafe.
Window treatments and window cords should not be within 3 feet of a crib.
This is NOT an exhaustive list of nursery safety.
READ MORE
My lay-person friendly post:
- 8 Things to DELETE from Your Baby Registry — and What to Register for Instead (Check out the sections about wall hangings and bedding sets)
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Baby Wearing
It’s fine if your baby falls asleep while you’re baby wearing, but it’s best to transfer him to a safe sleep space when one is available.
Follow the “TICKS” guidelines: Tight, In view at all times, Close enough to kiss, Keep chin off the chest, Supported back.
READ MORE
My lay-person friendly post:
- The ABC’s of Safe Sleep: How To Protect Your Baby From SIDS (The FAQs address baby wearing and related questions)
Evidence:
SHAREABLE GRAPHICS
Travel Systems
It’s fine if your baby falls asleep in his car seat or stroller while you’re out and about, as long as he is properly buckled. Transfer him to a safe sleep space when one is available.
Car seats and strollers should not be used for routine sleep. They should only be used to transport your baby from one location to another.
Never leave the straps unbuckled or partially buckled due to strangulation risk.
READ MORE
A few car seat safety tips:
- If on a long drive, make sure to remove baby from the carseat at least every 2 hours.
- Don’t put anything in the carseat that didn’t come with it (strap covers, head support pillow, etc.) as these have not been crash tested with the carseat.
- There should be no blankets or bulky clothing under the car seat straps or on the baby’s body.
My lay-person friendly post:
- The ABC’s of Safe Sleep: How To Protect Your Baby From SIDS (The FAQs address car seats and strollers)
Evidence:
SHAREABLE GRAPHICS
REQUEST A GRAPHIC! I don’t currently have any graphics for car seats but if you have any ideas, shoot me a quick email!
Dressing for Sleep
Dress your baby based on the temperature of the room, not the temperature outside.
Baby should be wearing no greater than 1 layer more than you. (Use the graphic below as a guide).
Hats and mittens are unsafe for sleep.
READ MORE
My lay-person friendly post:
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Pacifiers
Offering a pacifier at the start of every sleep period reduces the risk of SIDS by up to 90%.
The protective effect persists even if the baby drops the pacifier (so there is no need to replace it).
Pacifiers are safe to leave in the sleep space, but pacifier CLIPS are not.
READ MORE
Notes:
- Scientists are not sure exactly how pacifiers reduce the risk of SIDS. While we have hard data on the effectiveness of pacifiers as a protective factor, the hypothesized mechanisms remain unconfirmed.
- There is no replacement for following the ABC’s of safe sleep. The ABC’s are the foundation of preventing SIDS.
- Protective factors do not stack.
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Breastfeeding
Breastfeeding reduces the risk of SIDS by up to 50%.
Moms should be careful not to fall asleep while breastfeeding.
READ MORE
Notes:
- Studies show that breastfed infants are more easily aroused from sleep than their formula-fed counterparts.
- Studies do not distinguish between direct breastfeeding and providing expressed milk.
- There is no replacement for following the ABC’s of safe sleep. The ABC’s are the foundation of preventing SIDS.
- Protective factors do not stack.
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Roomsharing
Roomsharing decreases the risk of SIDS by up to 50%.
The AAP recommends that infants sleep in the same room as a parent ideally for the first year after birth, but at least for the first 6 months.
Note: Room-sharing and bed-sharing are not the same thing.
READ MORE
Notes:
- There is no replacement for following the ABC’s of safe sleep. The ABC’s are the foundation of preventing SIDS.
- Protective factors do not stack.
Evidence:
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Products that are unsafe for sleep
MOST products are unsafe for sleep, even if they are marketed for sleep.
Keep in mind that there is no proactive agency that checks all of these products before they go on the market. Do NOT assume that something is safe just because it’s carried by a major retailer.
Related posts that explain more:
- 8 Things to DELETE from Your Baby Registry — and What to Register for Instead
- CoSleepers Attached to a Bed: Safe or Unsafe?
There is a long list of examples below.
LIST OF PRODUCTS UNSAFE FOR SLEEP
Very important: This list is NOT exhaustive. A few popular products are included as examples.
Not safe for sleep…
Crib accessories:
- BUMPERS
- RAIL COVERS
- PILLOWS
- “FLAT HEAD” PILLOWS
- HAMMOCKS
- POSITIONERS
- INCLINED WEDGES
- TENTS
- MATTRESS TOPPERS
Bassinet accessories:
- HALO NEWBORN INSERT
- SNOO POSITIONER
Inclined seats and bouncy chairs
- ROCK ‘N PLAY (recalled)
- BABY BJORN BOUNCER
Anything marketed as a “SLEEPER” or a “NAPPER”
- SWADDLEME BY YOUR BED SLEEPER (recalled)
- SWADDLEME BY YOUR SIDE SLEEPER
- PLAY YARD ATTACHMENTS
- BABY DELIGHT SNUGGLE NEST PORTABLE INFANT SLEEPER
Nests and loungers
- DOCKATOT
- SNUGGLE ME ORGANIC (read this)
- BOPPY
Swings
- MAMAROO
- GRACO DUET
Play mats + activity gyms
Weighted sleep products
- ZEN SWADDLE NESTED BEAN
Pacifier accessories
- WUBBANUB
- PACIFIER CLIPS
All this stuff
- MEMORY FOAM MATTRESSES
- SUPPLEMENTAL PLAY YARD MATTRESSES
- BABOCUSH
***One more time, just in case: this list is not exhaustive.***
SHAREABLE GRAPHICS
You may share these graphics anywhere you want on social media as long as you do not alter them.
Safe Products for Sleep
Only safe if used as intended by the manufacturer and if you’re following all of the other safety guidelines we’ve discussed here.
First, a quick recap of the very beginning of this post:
CRIBS & BASSINETS
The product should be called a “crib” or “bassinet” in the user manual.
Use a crib or bassinet manufactured after June 2011. There is a good chance that an older crib no longer meets all the current safety standards, especially if it has a drop side. DO NOT USE a vintage or heirloom crib.
Homemade or “DIY” cribs are unsafe as they have not been safety tested.
Purchasing a used crib is a risk, particularly if it’s not from someone you know and trust. You do not know whether the crib was previously broken and has been repaired or altered. (There have been many infant deaths associated with cribs that are broken and missing parts — including those that have been fixed.)
Make sure the mattress fits snugly against the inside of the crib.
Some crib mattresses have infant and toddler sides. Make sure the infant side is facing up for the first 12 months.
PLAYARDS
The product should be called a “playard” in the user manual.
Use a play yard manufactured after February 2013 (when new federal safety standards were implemented).
Read more about Pack ‘n Play safety here.
PRODUCTS THAT ARE SAFE FOR SLEEP
There are so many wonderful products that are safe for sleep. Now that you’ve read this post, you have the tools to determine for yourself whether a product is safe for infant sleep.
UPDATE TO THIS SECTION COMING SOON
READ MORE
More information: CRIBS
- Make Baby’s Room Safe: Parent Checklist (AAP)
- Federal safety standards for full-size cribs (CPSC)
- Federal safety standards for non-full-size cribs (CPSC)
- Safety alert: Drop-side cribs deemed dangerous by federal agency (AAP)
More information: BASSINETS
More information: PLAY YARDS
Wrapping up your introduction to safe sleep…
Congratulations, if you read this entire post, you are now a graduate of Safe Sleep 101!
All of my safe sleep posts here...
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