How Should Babies Sleep?
by Maria I. Diaz, MD, FAAP
Unfortunately, in the U.S. more than 3,500 babies die every year suddenly and unexpectedly while sleeping, often due to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or strangulation. Last year, the American Academy of Pediatrics updated its policy statement and recommendations on how to create a safe sleep environment in an effort to decrease the risk of all sleep-related infant deaths.
These are the recommendations:
- Until their first birthday, babies should sleep on their backs for all sleep times… for naps and at night. Babies who sleep on their backs are much less likely to die of SIDS. Some parents worry that babies will choke when on their backs, but the baby’s airway anatomy and the gag reflex keep that from happening. 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. 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.
- Use a firm sleep surface. A crib, bassinet, or play yard that meets the safety standards is recommended along with a firm mattress and fitted sheet. Nothing else should be in the crib except for the baby.
- Room share – keep baby’s sleep area in the same room where you sleep for the first 6 months or, ideally, for the first year. The AAP recommends room sharing because it can decrease the risk of SIDS by as much as 50%. In addition, room sharing will make it easier for you to feed, comfort, and watch your baby.
- Only bring your baby into your bed to feed or comfort. If there is any possibility that you might fall asleep, make sure there are no pillows, sheets, blankets, or any other items that could cover your baby’s face or overheat your baby. As soon as you wake up, be sure to move the baby to his or her own bed.
- Never place your baby to sleep on a couch, sofa, or armchair. These are extremely dangerous places for your baby to sleep.
- Bed-sharing is not recommended for any babies. Bed-sharing increases the risk of SIDS. It is even more dangerous if your baby is younger than 4 months old, was born prematurely, or was born with low birth weight. Also, if you or any other person in the bed is a smoker (even if you do not smoke in bed), you drank alcohol, or you have taken any medicines or drugs, it might make it harder for you to wake up.
- Keep soft objects, loose bedding, or any objects that could increase the risk of entrapment, suffocation, or strangulation out of the baby’s sleep area. These include pillows, quilts, comforters, sheepskins, blankets, toys, or bumper pads. If you are worried about your baby getting cold, you can use infant sleep clothing, such as a wearable blanket.
- It is fine to swaddle your baby. However, make sure that the baby is always on his or her back when swaddled. The swaddle should not be too tight or make it hard for the baby to breathe or move his or her hips. When your baby looks like he or she is trying to roll over, you should stop swaddling.
- Try giving a pacifier at nap time and bedtime. This helps reduce the risk of SIDS. It’s OK if your baby doesn’t want a pacifier. You can try offering again later, but some babies simply don’t like them. If the pacifier falls out during sleep, you don’t have to replace it.
If you have any other questions, ask your provider. Remember… back to sleep, tummy to play!