Tiny Sleep guides

Safe sleep for babies: the basics every caregiver should know

Place your baby on their back for every sleep, on a firm, flat surface with only a fitted sheet. Keep pillows, blankets, bumpers, and toys out of the sleep space, and share a room, but not a bed, for at least the first 6 months. These steps from the American Academy of Pediatrics lower the risk of SIDS and accidental suffocation.

Why it matters

About 3,500 babies in the United States die each year from sleep-related causes, including sudden infant death syndrome (SIDS) and accidental suffocation and strangulation in bed¹. There is no guaranteed way to prevent SIDS, but a safe sleep environment lowers the risk, and it helps prevent accidental suffocation². Unless noted, these recommendations apply until your baby's first birthday².

On the back, for every sleep

Put your baby on their back for naps and at night. Babies who sleep on their backs are much less likely to die suddenly and unexpectedly than babies who sleep on their stomachs or sides. The side position is as risky as the stomach². Babies will not choke on their backs; their airway and gag reflex protect them. Even babies with reflux should sleep flat on their backs².

Once your baby can roll both ways on their own, you don't need to keep turning them back over. Keep placing them on their back to start, and keep the sleep space bare².

A firm, flat, bare surface

• Use a crib, bassinet, portable crib, or play yard that meets Consumer Product Safety Commission standards, with a mattress that fits tightly².
• The surface should be firm (it doesn't dent under your baby) and flat. Anything inclined more than 10 degrees isn't safe for sleep².
• Use a fitted sheet only. Keep out pillows, quilts, comforters, blankets, bumper pads, and toys².
• Don't use weighted blankets, weighted sleep sacks, or weighted swaddles. A plain sleep sack (wearable blanket) is fine².
• If your baby falls asleep in a car seat, stroller, swing, carrier, or sling, move them to a firm, flat surface on their back as soon as you can².

If you're worried about your baby getting cold, dress them in layers or a wearable blanket instead of loose bedding².

Share a room, not a bed

Keep your baby's crib or bassinet in your room, close to your bed but separate from it, for at least the first 6 months²³. The AAP says room-sharing can lower the risk of SIDS by as much as 50 percent, and it makes night feeds easier². The AAP recommends against bed-sharing in any circumstance, including with twins².

Never fall asleep with your baby on a couch, armchair, or cushion. The risk of a sleep-related death is up to 67 times higher there². If you bring your baby into your bed to feed or comfort them, put them back in their own space before you sleep. If you might doze off, clear pillows and blankets away from your baby first, and move your baby back as soon as you wake². Sharing a bed is especially risky if you have had alcohol, marijuana, or medicines that make you sleepy, if anyone smokes or vapes, or if your baby is younger than 4 months or was born early².

Comfortable, not hot

Overheating raises the risk of SIDS. Dress your baby in no more than one layer more than you would wear, watch for sweating, a hot chest, or flushed skin, and skip hats indoors once you're home from the hospital².

Other ways to lower the risk

• Feed breast milk if you can; it lowers the risk of SIDS².
• Offer a pacifier at naps and bedtime. If you're breastfeeding, wait until feeding is going well. It's fine if it falls out²³.
• Keep your baby away from smoke and vapor, and avoid alcohol, marijuana, opioids, and other drugs during pregnancy and after¹².
• Go to well-child visits and keep up with vaccines¹².
• Give your baby supervised tummy time while awake every day².
• If you swaddle, always place your baby on their back, and stop when they start trying to roll, often around 3 to 4 months².
• Don't rely on products that claim to prevent SIDS, including home heart and breathing monitors. They don't replace safe sleep¹².

Make it everyone's routine

Safe sleep only works if every caregiver follows it every time: grandparents, sitters, and child care too³. Walk new helpers through your routine before their first nap.

This is general information, not medical advice. Ask your baby's doctor about your own baby.