A super scary fact of parenthood is that sleep-related infant death remain the leading cause of death for infants under 12 months of age*.
For the majority of us, getting our babies to sleep (and feed) well is probably the main focus of our parenting skills in the first months of our little ones’ lives.
We are tormented not only by sleep deprivation, but also by the possibility that our precious babies may unexpectedly and unexplainedly perish in their sleep. Adding insult to injury, an exhausted parent is more likely to engage in unsafe sleep practices.
That’s really messed up!!!
Well, here at Mayu we favor a more positive, guilt-free approach to parenting, which applies to sleep and safe sleep recommendations.
In this article, we will walk you through the most up-to-date safe infant sleep guidelines, without freaking you out to full-blown insomnia!
First thigs first…
Is sleeping dangerous?
No! Absolutely not!
Let us quantify this risk then. In 2009, the reported rates of Sudden Infant Death Syndrome (SIDS), were the lowest in Japan at 0.09 per 1000 infants (or 0.009%) and the highest in New Zealand at 0.8 per 1000 infants (or 0.08%).
Those numbers are REALLY LOW!
And rates have been steadily declining since the 1990’s and the “Back to Sleep” campaign.
So, the likelihood of this tragedy happening to you or to someone you know is extremely low.
That being said, another important fact is that the vast majority of SIDS deaths are preventable.
We now know this is a multifactorial condition, in otherwise healthy infants correlated primarily with accidental suffocation, and that taking a few very simple steps can greatly improve the safety of babies’ sleep environment and reduce the likelihood of SIDS occurrence to even closer to Zero!
The following guidelines are based on the most current recommendations by the American Association of Pediatrics (AAP).
1) Place Baby on their Back to Sleep
During the first year of life, always place your baby to sleep on their back for all naps and at bedtime.
Side and tummy position are not safe.
This measure alone will go a long way in reducing the risk of SIDS. Therefore, this is the highest priority recommendation by the AAP.
Some parents fear that placing a baby on their back may increase the risk of chocking or aspiration, but evidence does not support this fear at all. Healthy infants are perfectly capable of swallowing or coughing up fluids.
This applies to babies with reflux (GERD) as well.
Swaddling can be an effective way to calm a fussy baby and encourage the supine sleep position. Never place a swaddled baby face down to sleep.
More on SWADDLES & SIDS.
2) Use a Firm & Dedicated Sleep Surface
Use a firm sleep surface in a safety-approved crib or bassinet.
Soft mattresses greatly increase the risk of SIDS. The mattress should be firm, flat, sized appropriately to the crib (there must be no gaps between the mattress and the sides of the crib), and covered only by a fitted sheet.
Never let your baby sleep in a water mattress, couch or armchair. These are all unsafe sleeping environments.
Sitting and carrying devices, such as car seats, strollers, swings and bouncing chairs are not advised for routine infant sleep. This practice is particularly dangerous for infants younger than 4 months of age. The AAP recommends that a sleeping infant be removed from the product and placed on an appropriate sleep surface as soon as it is safe and practical.
3) Ditch any Soft or Loose Bedding
Do not use blankets, comforters, pillows, crib rail bumpers, soft toys (including loveys) until your baby is at least 1 year old.
Soft or loose bedding continued to be a primary risk factor for SIDS.
Babies should sleep swaddled (babies younger than 6 months and that cannot roll over yet) or in a sleep bag.
Make sure the baby’s head and airways are not covered by anything during sleep.
4) Share a Room not a Bed
Room sharing is protective and safer than solitary sleep or bed sharing, and recommended for at least the first 6 months.
Bed-sharing is a highly controversial topic because of the practical aspect for exhausted parents who must feed and comfort their babies in the middle of the night, and conflicting research suggesting bed-sharing may be beneficial for breastfeeding.
Nevertheless, the vast majority of experts agree that the benefits of bedsharing don’t outweigh the risks and discourage this practice.
Keep your baby close to you in your room and consider a bedside sleeper or crib (next-to-me style), but avoid bringing your baby to your bed if there’s the risk you may fall asleep too.
Bed-sharing devices marketed as “safe” have not been properly studied regarding their efficacy and safety.
5) Avoid Overheating
Being a little cold may make your baby uncomfortable and wake her up when sleep is lighter, but overheating can increase the risk of SIDS.
Keep your baby’s room cool (18º to 21ºC) and dress your baby appropriately, using layers and a swaddle or a sleep bag, depending on your baby’s age.
Check out our BABY SLEEP SOLUTIONS!
6) Offer a Pacifier
Offering a pacifier at the beginning of naps and bedtime has been shown to decrease the risk of SIDS in as much as 50%.
Pacifiers are extremely soothing for babies as they satisfy their innate sucking reflex.
Furthermore, evidence does not support the concern that pacifiers may interfere with breastfeeding, provided it is well established, typically 3-4 weeks after birth.
7) Be Wary of Products Marketed as SIDS Safe
The majority of products marketed as reducing the risk of SIDS have not been adequately tested. This includes monitors, safe cribs, positioners, sitting and other devices.
Be sensible and avoid commercial products that are inconsistent with the safe infant sleep guidelines.
8) Allow Supervised Tummy Time
Offer your baby ample opportunities to practice their motor skills and encourage “tummy time” when the baby is awake and supervised. This will help her strengthen her neck and back muscles.
9) Avoid Smoking, Alcohol and Drugs
Do not expose your baby to cigarette smoke and avoid alcohol and illicit drugs during pregnancy and after the baby is born.
10) Provide Healthcare
Take your baby to the pediatrician for her scheduled well-child visits and immunize according to current recommendations.
- American Association of Pediatrics (2016) SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 138(5), e20162938.
- Hitchcock SC (2017). An Update on Safe Infant Sleep. Nursing for Women’s Health, 21(4), 307–311.
- Kinney HC, Thach BT (2009). The Sudden Infant Death Syndrome. New England Journal of Medicine, 361(8), 795–805.
* In the United States, and third leading cause of infant mortality overall.