Safe Sleep

SIDS is the sudden, unexplained death of a baby younger than 1 year of age. We have made great progress in reducing SIDS. Since awareness campaigns that stressed back sleeping for babies started in 1994, the SIDS rate in the United States has dropped by 50 percent. This decreased rate equals thousands of babies’ lives and is a result of parents and caregivers placing babies on their backs to sleep.

Babies who sleep on their backs are much less likely to die of SIDS than are babies who sleep on their stomachs or sides. Babies should sleep on their backs for all sleep times—for naps and at night. Babies who are used to sleeping on their backs but who are then placed on their stomachs to sleep, like for a nap, are at very high risk of SIDS.

Sleep surface matters. Babies who sleep on a soft surface, such as an adult bed, or under a soft covering, such as a soft blanket or quilt, are more likely to die of SIDS or suffocation.

Healthy babies naturally swallow or cough up fluids—it’s a reflex all people have. Babies might actually clear such fluids better when on their backs, so no need to worry about choking from sleeping on their backs.

Rolling over is an important and natural part of your baby’s growth. Most babies start rolling over on their own around 4 to 6 months of age. If your baby rolls over on his or her own during sleep, you do not need to turn the baby over onto his or her back. The important thing is that the baby start off every sleep time on his or her back to reduce the risk of SIDS, and that there is no soft, loose bedding in the baby’s sleep area.

There is no sure way to prevent SIDS, but parents and caregivers can take these steps to reduce the risk of SIDS and other sleep-related causes of infant death:

• Always place a baby on his or her back to sleep, for naps and at night. The back sleep position is the safest position for all babies, including preterm babies. Keep in mind that every sleep time counts.
• Use a firm sleep surface, such as a mattress in a safety-approved crib, covered by a fitted sheet.  Firm sleep surfaces can include safety-approved cribs, bassinets, and portable play areas. Do not use a car seat, carrier, swing, or similar product as baby’s everyday sleep area.
• Never place baby to sleep on soft surfaces, such as on a couch, pillows, quilts, sheepskins, or blankets. Keep soft objects, toys, crib bumpers, and loose bedding out of your baby’s sleep area. Evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries and even death.
• Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else.
• Room sharing—keeping baby’s sleep area in the same room where you sleep— reduces the risk of SIDS and other sleep-related causes of infant death. If you bring your baby into your bed to breastfeed, make sure to put him or her back in a separate sleep area in your room when you are finished. 

• Get regular health care during pregnancy
• Not smoke, drink alcohol, or use illegal drugs during pregnancy or after the baby is born and don’t allow anyone else to smoke around your baby.
• Breastfeed your baby. Breastfeeding has many health benefits for mother and baby.
• Give your baby a dry pacifier that is not attached to a string for naps and at night to reduce the risk of SIDS, but don’t force the baby to use it. If the pacifier falls out of baby’s mouth during sleep, there is no need to put the pacifier back in. Wait until baby is used to breastfeeding before trying a pacifier.
• Do not let your baby get too hot during sleep. Dress your baby in no more than one layer more of clothing than an adult would wear to be comfortable. Keep the room at a temperature that is comfortable for an adult.
• Follow health care provider guidance on your baby’s vaccines and regular health checkups.
• Avoid products that claim to reduce the risk of SIDS and other sleep-related causes of infant death. These wedges, positioners, and other products have not been tested for safety or effectiveness.
• Do not use home heart or breathing monitors to reduce the risk of SIDS. If you have questions about using these monitors for other health conditions, talk with your baby’s health care provider.
• Place babies on their stomachs (tummy time) when he or she is awake and when someone is watching. Supervised tummy time helps your baby’s neck, shoulder, and arm muscles get stronger. It also helps to prevent flat spots on the back of your baby’s head. Holding baby upright and limiting time in carriers and bouncers can also help prevent flat spots on the back of baby’s head.