Implementing safe sleep practices is essential to protecting your baby from Sudden Infant Death Syndrome (SIDS) and other accidents. “Sleep-related deaths are a leading cause of death in children less than 1 year of age,” says Sarah Denny, MD, a pediatrician at Nationwide Children’s Hospital and an associate clinical professor of pediatrics at The Ohio State University School of Medicine. “Providing a safe sleep environment is the most important thing caregivers can do to prevent these tragic deaths.” If you have been wondering where your baby can sleep safely—as well as what locations are dangerous—we break down safe sleep guidelines for babies according to the American Academy of Pediatrics (AAP). Here is what you need to know about the best places and practices for putting your baby down to sleep through their first year.
Where Should I Put My Baby Down to Sleep?
According to the AAP, babies are safest sleeping in a standard-size crib, bassinet, portable crib, or play yard that meets the standards of the Consumer Product Safety Commission (CPSC). The CPSC issues mandatory safety standards for all of these products that are sold in the U.S. For instance, the CPSC recommends not purchasing cribs manufactured before June 2011 because they most likely do not comply with new safety standards. That means that antique cribs or cribs passed down from other family members are probably not a safe place for your baby to sleep. Babies should always be placed on a firm mattress that was specifically designed for the crib, bassinet, or play yard. Nothing else should be in the crib with them including blankets, stuffed animals, and toys. “The big thing is that we want to try to help protect our little babies from dangers like choking, suffocation, and SIDS,” explains Nikki Smith, MEd, NCC, NCSC, CSWC, a certified pediatric and adult sleep consultant. Every year, about 3,400 babies in the U.S. die suddenly and unexpectedly while sleeping. These deaths are often due to SIDS or accidental deaths caused by suffocation or strangulation. As for how you put your baby down, Dr. Denny indicates that parents should follow the ABCs of safe sleep, which means your baby should be alone, on their back, and in their own crib. Back sleeping reduces the risk of a baby suffocating or re-breathing exhaled air that is high in carbon dioxide and low in oxygen, Dr. Denny explains. Inhaling this kind of air may be one factor that leads to SIDS.
Cribs
One of the safest places for your baby to sleep is in their own crib. “It is also really important to make sure you are assembling the crib properly,” Dr. Smith says. “Follow the manufacturer’s instructions and make sure there are no gaps where there shouldn’t be and that everything is tightened properly.
Alone in their own crib or bassinet that is near their parent’s or caregiver’s bed On their back, not on their side or stomach On a firm sleep surface, such as a firm crib mattress covered with a well-fitted sheet Without any soft objects (pillows or stuffed animals) or loose bedding (blankets and sheets)
Don’t put anything other than a firm mattress with a tightly fitting sheet in or around the crib. “We want (babies) to be sleeping by themselves,” Smith says. “No bumpers, soft pillows, and soft toys. We also should avoid devices marketed as infant sleepers that have a cushy surrounding.” Additionally, your crib mattress should fit snugly against the inside of the crib. If you can fit two fingers or more between the mattress and the crib, it is not up to safety standards. Keep in mind, too, that the harder it is for you to put the crib sheet on the mattress, the safer it is for your baby. “Parents also should check the CPSC website to make sure that their crib, bassinet, or portable crib meets safety recommendations and has not been recalled,” Dr. Denny says.
Bassinets
Many parents opt for a bassinet, especially in the early newborn period. Not only are bassinets smaller and sometimes even portable, but they also allow you to keep your baby close by your bed without having them actually in the bed with you. Be sure to check the weight limit of your baby’s bassinet. Some bassinets have a weight limit of around 15 to 20 pounds, which means by the time your baby is 3 or 4 months old, it will be time to transition to a crib.
Portable Cribs and Play Yards
When using portable cribs or play yards, it is important that you only use the mattress that came with it. Keep in mind that when these products were evaluated by the CPSC for safety, they were evaluated only with the mattresses they are sold with. Likewise, you should only use sheets that were designed by the manufacturer and specifically made for your portable crib or play yard. In fact, you may not want to use a sheet with the play yard at all, especially if it did not come with one. Loose or bunchy sheets can obstruct your baby’s airway.
Where Should My Baby Not Sleep?
Although it can be tempting to leave a drowsy baby in their swing or car seat for their nap—especially after you get home from a long morning at the zoo—resist the impulse. The AAP, the CDC, and the March of Dimes advise that babies should only sleep on firm, flat surfaces that are designed for infant sleep and meet the CPSC guidelines. “We really don’t recommend babies, especially young infants, sleep anywhere other than their crib or bassinet—not in the car seat, stroller, swing, or infant sling,” explains Renee Turchi, MD, MPH, FAAP, medical director of the Pennsylvania AAPs Medical Home Program. “Little babies can get into positions where their head is stuck, where they suffocate, or where their airway is constricted and they cannot breathe. Babies are not able to push things away from their face or hold their head up.” Here is a closer look at unsafe sleep places for babies. You will want to steer clear of these options because they could put your baby at risk.
Car Seat, Infant Carriers, and Strollers
Babies love movement, so it is not uncommon for them to fall asleep while riding in the car or a stroller. And while there is no need to wake them immediately, it is important that you move them to a safe sleep surface as soon as possible. “It’s OK if your baby falls asleep in the car, but once you arrive home you need to remove them from the seat and transfer them to their crib,” Dr. Turchi says. One study found that a small percentage of sleep-related infant deaths occurred in car seats. That doesn’t mean that you shouldn’t put your baby in a car seat when you are driving in the car. But once the car is stopped and you remove the infant carrier from the car, you should place your baby in safe location like a crib, bassinet, or play yard.
Baby Swings, Bouncers, and Sleep Positioners
If your baby falls asleep in a swing, a bouncer, or another piece of baby play equipment other than a CPSC-certified play yard, it is important to move them to a safe sleep surface as soon as possible. You also should avoid using sleep positioners. These are sometimes called nests or anti-roll pillows that are designed to keep your baby in place. But these products can hinder babies’ breathing.
Parent’s Bed or Other Soft Surfaces
You may want to sleep with your baby in your bed or nap with them on the couch. Don’t. Babies are at risk of rolling off and getting injured or suffocating in an adult’s arms on these soft surfaces. “Dangerous sleep surfaces include a caregiver’s bed, couch, sofa, armchair as well as any shared surface,” says Dr. Denny. “[One of the reasons] couches, sofas, and armchairs are dangerous is due to the risk of entrapment.” While you can bring your baby into your bed to feed them or for comfort, you should return them to their own sleep surface afterward. You, other children, or even pets can accidentally roll over onto the baby, causing them to suffocate. “Additionally, your baby can get entrapped between the bed frame and the mattress or the wall and the mattress,” says Dr. Denny. “Plus, adult beds have loose blankets, softer surfaces, and pillows, all of which pose a risk of suffocation and strangulation.”
Baby Sleep Safety Tips
Aside from choosing an appropriate sleep surface and following the ABCs of safe sleep, you should consider these other tips to keep your baby healthy while sleeping.
Consider the Room Setup
Where you place the crib and how you set up your baby’s room are important. Even if they will be sharing a room with you for the first 6 months to 1 year, you need to consider not only where you are placing the crib but also what is nearby. “You do not want to place the crib close to windows, blinds, or monitor cords,” Smith explains. “There is a risk of strangulation with cords if the baby is able to pull these things into the crib. Even when you are setting up a toddler’s bed, you need to make sure it is far enough away from the way. There is a risk of your toddler getting stuck between the wall and the bed.” You also should keep the room temperature around 68 to 72 degrees Fahrenheit. If you feel like your baby might be too warm, feel the nape of their neck. If they are sweating or clammy, they are probably too warm. “It is important to avoid overheating,” Dr. Turchi says. She advises dressing babies with a layer that would feel the right temperature to you, plus one more light layer, like a sleep sack. “Unfortunately, parents and caregivers have a tendency to bundle babies up and that is not good,” she says.
Create a Safe Environment
In addition to making sure that you are setting up your baby’s room in the safest way possible, it is also important to make sure the environment in your home is also safe. For instance, refrain from using alcohol and drugs while your baby is in your care. Keep your baby away from smokers as well as secondhand smoke. Babies who live with smokers are at an increased risk of SIDS. You also could consider giving your baby a pacifier. There is some evidence that they can protect against SIDS. Of course, if you are breastfeeding, you may want to wait until your baby is at least 3 or 4 weeks old before offering a pacifier. If your baby has no interest in a pacifier, though, do not force it. And never hang a pacifier around your baby’s neck or attach it to their clothing. Doing so poses a risk of strangulation.
A Word From Verywell
When it comes to your baby’s sleep, safety should be your primary concern. The safest place for babies to sleep is on a firm mattress in a crib, bassinet, or play yard. You also should make sure they sleep alone—with no stuffed animals, loveys, or caregivers—and on their back. You might even consider putting their crib or bassinet in your room so that they are nearby but still sleeping in their own safe, contained space. If you have additional questions or concerns about where your baby should sleep or how to put them down when they’re tired, talk to your baby’s pediatrician. They will be able to answer your questions and offer advice so your little one can sleep safely (and you can rest easy).
