What Are the Basics of Safe Sleep for Infants?

A Healthier Michigan

| 3 min read

According to a 2022 study, around 3500 infants die of sleep-related deaths every year in the United States. The primary dangers related to sleep for infants and risk factors for sleep-related infant deaths involve the positioning of a child while sleeping, where the child is sleeping and what is around them, temperature, items that could interfere with breathing and choking hazards. There are a few basic standards or rules to go by when making sure your infant has the optimal environment for safe sleep.

Safe Sleep Recommendations for Infants

The American Academy of Pediatrics provides safe sleep recommendations to avoid Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS):
  • Infants should sleep on their back, alone in their own sleep space
  • Infant should sleep in a crib or bassinet with a firm, flat sleeping surface with a fitted sheet
  • Infant should not be surrounded or accompanied by loose blankets, bumpers, pillows, stuffed toys, or other soft, loose items
  • Infant should not wear head coverings or an abundance of clothing
  • Never hang pacifiers or other items around an infant’s neck
  • Breastfeed if possible
  • Avoid smoking 

What is the Right Sleep Position for a Baby?

After making sure the sleep environment and crib mattress are safe, the next step is making sure the infant is in a proper sleeping position. Here are some more guidelines for the best, safest sleep position for babies and infants, from the US Department of Health and Human Services:
  • Have the baby sleep on their back exclusively until they are one year old.
  • Do NOT place the baby on their side or their stomach to sleep.
  • If a baby usually sleeps on their back, sleeping on their side or stomach can increase SIDS risk by up to 45 times.
  • When babies begin to roll from back to stomach on their own, start them sleeping on their back.
  • If they cannot yet roll back over onto their back, you can reposition them after they roll to their front.
  • Bed sharing is not recommended as a safe infant sleeping practice.

What Other Conditions Affect Safe Sleep for Infants?

Besides the sleeping room, surface, extra items in the sleeping area, and the positioning of the sleeping infant, there are other conditions or factors that affect sleep safety for infants.

Use of a Pacifier

Some research has shown that using a pacifier (not on a cord or around the infant) can help promote safe sleep and self-rousing. The 2022 update to the Pediatrics study on safe sleep recommends offering a pacifier at sleep and naptime to reduce the risk of SIDS.

Immunizations for Infants

The same study recommends that infants be immunized and vaccinated in accordance with AAP and CDC guidelines. Vaccinations or immunizations may help protect against sleep-related infant deaths, according to a study published in the Archive of Disease in Childhood.

Tummy Time

While sleeping on the stomach or tummy is not recommended for safe sleep, tummy time while awake and supervised is important for infants to develop motor skills and strength. It also can help increase self-rousing impulses and may result in better sleep for the infant. If your child falls asleep during tummy time, gently and carefully roll them on their back.

Avoid Swaddling Especially After 3 Months

While swaddling can help to calm and relax a baby, being tightly wrapped even in thin and soft cloths is a risk factor for suffocation, SUID and SIDS. If your infant is swaddled, setting them down is not recommended, but if you do it must be on their back. Swaddling is not a safe practice for infants at all after 3-4 months.

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