Sweet slumber: a guide to infant safe sleep

Newborn Baby In Cot

Ask any mother if she ever crept into the nursery to check to see if her infant was breathing and she will most likely admit that she did.

Sleep is one of the biggest concerns for most new parents—whether it’s the baby getting enough sleep or the parents getting enough sleep, or the nagging worry about whether or not your child is safely asleep.

And the last one is a biggie—we’ve all heard stories about “crib death,” but you don’t need to have anxiety over your baby’s slumber.

Here’s what parents and caregivers need to know in order to provide a safe sleeping environment for infants:

Back to sleep is safe to sleep

In 1994, Sudden Infant Death Syndrome claimed the lives of 4,073 infants in the United States.

SIDS—or “crib death”—is not a new phenomenon.

Throughout history, parents and grandparents have retold heartbreaking stories of putting a seemingly healthy infant to sleep and finding the child had died sometime in the night or during a nap.

Only more recently, however, have researchers begun to piece together information on when, if not why, SIDS was more likely to occur.

Acting on studies that showed a link between stomach sleeping and SIDS, the National Institute of Child Health and Human Development, along with the American Academy of Pediatrics and other health organizations, recommended that infants be placed to sleep only on their backs.

Between 1994—the launch of the “Back to Sleep” campaign—and 1999, the number of SIDS deaths in the United States decreased by almost 50 percent.

Since then, placing a baby on his or her back to sleep has been the standard recommendation to parents and caregivers.

In October 2016, the AAP released updated recommendations for infant safe sleep environments:

Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a taut sheet.

Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare.

Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns 1 but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.

Avoid baby’s exposure to smoke, alcohol and illicit drugs.

Skin-to-skin care is recommended, regardless of feeding or delivery method, immediately following birth for at least an hour as soon as the mother is medically stable and awake, according to the report.

Breastfeeding is also recommended as adding protection against SIDS. After feeding, the AAP encourages parents to move the baby to his or her separate sleeping space, preferably a crib or bassinet in the parents’ bedroom.

“We know that parents may be overwhelmed with a new baby in the home, and we want to provide them with clear and simple guidance on how and where to put their infant to sleep,” physician Rachel Moon explained in a recent press release from the AAP. Moon is the lead author of a report on SIDS published in the November 2016 issue of Pediatrics. “Parents should never place the baby on a sofa, couch or cushioned chair, either alone or sleeping with another person. We know that these surfaces are extremely hazardous.”

Moon also cautioned that while infants are at heightened risk for SIDS between the ages 1 and 4 months, new evidence shows that soft bedding continues to pose hazards to babies who are 4 months and older.

Additional recommendations include:

Offer a pacifier at nap time and bedtime.

Do not use home monitors or commercial devices, including wedges or positioners, marketed to reduce the risk of SIDS.

Infants should receive all recommended vaccinations.

Supervised, awake tummy time is recommended daily to facilitate development.

“We want to share this information in a way that doesn’t scare parents but helps to explain the real risks posed by an unsafe sleep environment,” Moon said. “We know that we can keep a baby safer without spending a lot of money on home monitoring gadgets but through simple precautionary measures.”

Is there any time a child should be placed on his or her side or stomach to sleep?

“Any change in sleep position is a recommendation a doctor would make, not something a parent should decide on their own,” said James Mosher of JDC Pediatrics in Camp Hill.

Safe crib, safe baby

Keeping soft bedding out of baby’s crib is a best practice for safe sleep—again, that means no comforters, pillows, stuffed animals or crib bumpers.

But even when choosing a crib, parents need to stay up-to-date on ever-changing safety guidelines.

In 2010, the U.S. Consumer Product Safety Commission approved new mandatory standards for full-size and non-full-size cribs. New standards prohibited the manufacture and sale of drop-side cribs (cribs with a side that lowers). The standards also provided strict requirements for manufacturing stronger mattress supports and more durable crib hardware.

First Candle, a non-profit organization dedicated to reducing SIDS deaths, offers this advice on choosing a crib:

Check for recalls. Even the crib you used for a slightly older grandchild may already be out of date or may have been recalled by its manufacturer.

Drop side cribs, which were very common several years ago, are now illegal to manufacture, sell, or even donate in the US — new or used.

To be sure your crib or play yard meets the most current safety standards, visit the Juvenile Products Manufacturer’s website at

SIDS and safe sleep resources for parents and caregivers

Safe crib, safe room

In the United States, about 3,500 infants die from Sudden Unexpected Infant Death. Of that number, 1,500 are SIDS deaths. But 31 percent of SUID deaths are due to strangulation and suffocation.

For complete sleep safety, parents need to carefully assess the area beyond baby’s crib.

Do not place the crib near a window. Babies can get tangled in cords on window blinds. Also, a toddler can easily push through a window screen.

Remove mobiles from cribs once baby can move around.

Keep all other cords away from the crib. This includes cords on lamps, phones, baby monitors and fans.

Be cautious with pets and babies at naptime and bedtime. If your cat or dog is likely to jump into the crib, make sure your pet has no access to your baby’s sleeping area.


Josette Plank is assistant editor of Central Penn Parent.

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