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Safe Sleep

Stephanie C. Chiang, M.D., MPH

Stephanie C. Chiang, M.D., MPH

Palo Alto Medical Foundation

Sleep is an important part of your baby’s development, and good sleep habits can be a blessing for both babies and parents alike. It is also important to know how to create safe sleep for babies. According to the Centers for Disease Control and Prevention, Sudden Infant Death Syndrome (SIDS) is the leading cause of death for infants between 1 month and 1 year of age. Stephanie C. Chiang, M.D., MPH, a pediatrician at the Palo Alto Medical Foundation, offers the following simple tips for ensuring safe sleep for babies. 

Safe Sleep Practices

  • To reduce the risk of SIDS, always place your baby to sleep on his or her back.
  • Dress your baby lightly for sleep. Sleep clothing, such as sleepers, sleep sacks and wearable blankets are better options than blankets.
  • Set the room temperature in a range that is comfortable for a lightly clothed adult.
  • Avoid letting your baby get too hot. Signs of this are sweating, damp hair, flushed cheeks, heat rash and rapid breathing.

Tips for Creating a Safe Sleep Environment

  • Because of the increased risk of SIDS when bed sharing, the American Academy of Pediatrics recommends against having your baby sleep in your bed.
  • Once your baby is able to roll over at approximately 4 months of age, he/she has enough head and neck control to turn to their side or stomach when sleeping.
  • The safest place for your baby to sleep is in a room where you sleep.
  • Place the baby’s crib or bassinet within arm’s reach of your bed for easier breastfeeding.
  • Use a crib or bassinet with a firm mattress and a well-fitting sheet.
  • Cribs and bassinets should be certified for safety by the Juvenile Products Manufacturers Association (JPMA).
  • Place the crib or bassinet in an area that is always smoke-free.
  • Do not put fluffy blankets, comforters, pillows, stuffed animals, bumpers, sleep positioners or wedges in the crib.
  • Don’t place your baby to sleep on adult beds, chairs, sofas, recliners, waterbeds or cushions. Your baby may fall or get trapped between cushions.

What About Swaddling?

Swaddling is a technique that is often used to calm babies and help them develop settled sleep patterns.

  • A swaddled infant should always be placed on his or her back.
  • Swaddling should not be used after the infant turns 2 month old.
  • Swaddling may increase the risk of head covering, strangulation and overheating. Extra caution should be taken to swaddle your baby in a manner that avoids these risks.
  • Ensure that all Velcro or other fasteners are attached securely.
  • Tight swaddling of the hips can lead to hip dysplasia or dislocation- it is important to swaddle your baby so that there is plenty of space for his or her legs to move up and out.
  • Swaddling does not decrease the need for a safe sleep environment. Follow the tips above for a safe sleep environment, even if your baby is swaddled.

Sudden Infant Death Syndrome (SIDS)

SIDS is the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation. Although physicians and scientists do not know what causes SIDS, they have determined that there are some things parents can do to reduce the risk of SIDS:

  • Put your baby to sleep on his/her back.
  • Breastfeed your baby.
  • Maintain a smoke-free house and car.
  • Use a firm mattress for your baby's crib.
  • Use tight fitting crib sheets.
  • Keep your baby’s sleep area warm, but not overheated. (Keep it at a temperature comfortable to you.)
  • Think about using a clean, dry pacifier when placing the infant down to sleep. Do not force the baby to take it. If you are breastfeeding your baby, wait until your child is at least one-month old before using a pacifier.
  • Do not place pillows or stuffed toys in the crib.

Once you have done what you can to reduce your baby’s risk of SIDS, do not let the fear of SIDS spoil your joy and delight of having a new baby. For more information about SIDS, contact the SIDS Alliance at (800) 221-7437 or www.sidsalliance.org.

For more information about the importance of placing your baby on his/her back to sleep, call “Safe to Sleep” at (800) 505-2742 or visit https://safetosleep.nichd.nih.gov/.

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