Sleep Safety (Updated 2021)
Sudden Unexplained Infant Death Syndrome (“SUIDS”) is the sudden and unexplained death of an infant who is younger than one year old. It is a terrifying prospect because it can strike without warning, usually in seemingly healthy babies. The cause of SUIDS is uncertain, and for many, the deaths come out of nowhere.
In addition to deaths caused by SUIDS, babies during sleep time are also at risk for accidental deaths from suffocation and strangulation. Approximately 3,500 babies in the United States die each year from SUIDS and accidental suffocation and strangulation.
The above information about infant death is so incredibly scary (an understatement), but there is good news, too. Statistically, the chance of it happening is very low. To put it in perspective, approximately 3.8 million babies are born every year in the United States. Further, in the last thirty years, the risk of SUIDS and accidental death from suffocation and strangulation has decreased dramatically. We now know that, by taking the right precautions, you can help keep your baby safe.
What are those precautions? The American Academy of Pediatrics sets them forth in its report and recommendations. To read their full report and all recommendations, which has much more information than our summary below, click here. Please note that individual medical conditions may warrant your doctor to make other, or different, recommendations after weighing the relative risks and benefits. However, the American Academy of Pediatric's report and recommendations reflect what they feel is best for most babies.
SUMMARY OF RECOMMENDATIONS1. For the first year of their lives, always place infants to sleep on their backs. Babies who sleep on their backs are much less likely to die of SUIDS or suffocation than babies who sleep on their stomachs or sides. (On their sides, baby can roll more easily onto the stomach.) Some parents worry that babies will choke when on their backs, but the baby's airway anatomy and the gag reflex will keep that from happening. While babies born prematurely may need to be on their stomachs temporarily while in the NICU due to breathing problems, they should be placed on their backs after the problems resolve, so that they can get used to being on their backs and before going home.
NOTE: Around 2-3 months, babies may start rolling onto their stomachs. While you should continue to place baby on his or her back to sleep, if your baby is comfortable rolling both ways (back to tummy, tummy to back), then you do not have to return your baby to the back should he or she roll over. However, be sure that there are no blankets, pillows, stuffed toys, or bumper pads in the sleep space, as those can cause baby to suffocate.
Also, if your baby falls asleep in a car seat, stroller, swing, infant carrier, or sling, you should move him or her to a firm sleep surface on his or her back as soon as possible.
2. Keep soft objects and loose bedding and blankets out of sleep area. This includes stuffed animals and crib bumpers. To keep your baby comfortable while sleeping, use sleep sacks, also called "wearable blankets". (Fun fact: at Bumbershoots by Nana, we call our sleep sacks “Bumbers.")
3. Make sure babies sleep on a firm surface. Cribs, bassinets, portable cribs, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC)are recommended. Also, it is recommended you use a tight-fitting, firm mattress and fitted sheet designed for the particular product you are using. Nothing else should be in the crib except for the baby. A firm surface is a hard surface; it should not indent when the baby is lying on it. Bedside sleepers that meet CPSC safety standards may be an option, but there are no published studies that have examined the safety of these products.4. Infants should sleep alone on their sleep surface. It is advised notlet your baby bedshare with adults or kids. This is especially important (because it is especially dangerous) in the following circumstances:
- Your baby was born prematurely
- Your baby was born with a low birth weight
- Your baby is less than 4 months old
- Someone in the bed is a smoker
- Someone in the bed has taken medication or drugs that may make it harder for him or her to wake
- The mother/surrogate smoked during pregnancy
- Someone in the bed may be impaired from alcohol consumption
- The bed or sleep surface is soft, is a water bed, or has blankets and pillows near where baby would sleep
5. Rather than bedshare, infants should room share. Infants should sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants. The AAP recommends room sharing because it can decrease the risk of SIDS by as much as 50% and is much safer than bed sharing. Room sharing also makes it easier for you to respond to baby's feeding, changing, and comfort needs. If you can room share for the first year, that is ideal. If not, doing so for the first 6 months is a recommended alternative.
6. Protect against overheating. Infants should be dressed appropriately for the environment. This may take some trial and error, depending on whether your infant sleeps hot or cold. Consider room temperature, air circulation, whether baby is sick, and warmth generated by his or her sleepwear. While the temptation is to bundle up a baby who is sick, it is usually better to put on less layers as fever spikes can cause overheating.
TIP: If using a heavier-weight sleep sack, maintain a cooler room temperature and use a lightweight pajama. For more information on safe temperatures for baby, click here. You can also check out this article by Whattoexpect.com.7. Do not allow smoke around your infant and minimize any alcohol or drug intake when breastfeeding.
TIP: If you have consumed alcohol, consider using a testing device such as UpSpring Milkscreen to ensure milk is safe for baby.8. Make sure all of your caregivers (family members, nannies, babysitters) know of your sleeping requirements and follow them.
TIP: Outline the safer sleep practices on a card to give to new caregivers. If you would like a free card with abbreviated version of this information on it, please contact email@example.com. We also include this card with every sleep sack we sell.
9. Stay up-to-date on the research.
In addition, the American Academy of Pediatrics notes that the risk of SUIDS decreases with breastfeeding, proper prenatal care, immunization consistent with their policies and those of the Center for Disease Control, and tummy time while the child is awake and supervised. It also cautions against using commercial devices that are inconsistent with safe sleep recommendations and at-home cardiorespiratory monitors.
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