Safe Sleep Tips for Babies: A Parent's Guide to Creating a Safer Sleep Environment

Safe sleep is one of the most important things parents and caregivers can think about when preparing a baby's nursery. While there is no way to completely eliminate the risk of Sudden Infant Death Syndrome (SIDS) or other sleep-related infant deaths, following evidence-based safe-sleep recommendations can help reduce those risks.

The American Academy of Pediatrics (AAP) and the NIH's Safe to Sleep program recommend several straightforward practices, including placing babies on their backs for every sleep, using a firm and flat sleep surface, and keeping soft objects and loose bedding out of the baby's sleep area.

Here are the most important safe-sleep practices parents and caregivers should know.

1. Always Put Your Baby to Sleep on Their Back

One of the most important safe-sleep recommendations is simple: place your baby on their back for every sleep, including naps and nighttime sleep.

The Safe to Sleep program recommends back sleeping for all babies until their first birthday, including babies who were born prematurely and babies with reflux. Side sleeping is not considered a safe alternative because babies can more easily roll from their side onto their stomach.

Once a baby can independently roll from their back to their stomach and from their stomach to their back, parents do not need to continually reposition them if they change positions during sleep. However, babies should still always be placed on their backs when initially put down to sleep.

2. Choose a Firm, Flat, and Level Mattress

Your baby's sleep surface matters.

The recommended sleep surface should be firm, flat, and level, with a fitted sheet specifically designed for that mattress. The mattress should not be soft, cushioned, inclined, or hammock-like.

Before using a crib mattress, make sure it is specifically designed and approved for the crib, bassinet, or portable play yard you're using. The mattress should fit securely without dangerous gaps between the mattress and the sides of the sleep space.

This is one reason we believe choosing a quality crib mattress is worth taking the time to research. However, regardless of which mattress you choose, firmness, proper fit, and compliance with current safety standards should come before materials, brand, or other features.

3. Keep the Crib Free of Loose Items

A baby's sleep space should be surprisingly simple.

The AAP and Safe to Sleep recommend keeping pillows, blankets, stuffed animals, crib bumpers, quilts, comforters, and other soft or loose objects out of the sleep area.

For most babies, the safest setup is:

• A safety-approved crib, bassinet, or portable play yard with a firm, flat mattress
• One properly fitted sheet
• Your baby

That’s it.

Although decorative pillows, stuffed animals, and blankets may make a nursery look cozy, they can create risks for suffocation, entrapment, or strangulation.

4. Consider Room Sharing Without Bed Sharing

The AAP recommends that babies sleep in the same room as their parents, but on a separate sleep surface, ideally for at least the first six months.

For example, parents might keep a crib, bassinet, or portable play yard next to their bed.

Room sharing can make nighttime feeding and comforting easier while avoiding the risks associated with placing a baby in an adult bed.

Bed sharing can be particularly dangerous when a baby is very young, when an adult is extremely tired, when smoking is involved, or when alcohol, medications, or other substances may impair alertness.

5. Be Careful With Swaddling

Swaddling can help some newborns feel secure, but it needs to be done correctly.

A swaddled baby should always be placed on their back to sleep, and the swaddle should not be tight around the hips or chest.

Most importantly, stop swaddling when your baby begins showing signs of trying to roll. At that point, babies need to be able to move their arms freely.

An appropriately sized wearable blanket or sleep sack can be an alternative once a baby has transitioned out of swaddling.

Parents should also avoid weighted swaddles and weighted sleep products. Safe to Sleep specifically lists weighted blankets, weighted swaddles, and other weighted objects among items that should not be in a baby's sleep area.

6. Avoid Overheating

Babies don't need to be heavily bundled to sleep safely.

The Safe to Sleep program recommends avoiding overheating and keeping the baby's head and face uncovered during sleep. Signs that a baby may be too hot can include sweating, flushed or very hot skin, or a chest that feels hot to the touch.

Instead of adding loose blankets to the crib, parents can dress their baby appropriately for the room temperature using normal sleep clothing or a wearable blanket.

Also avoid putting a hat on a baby while they are sleeping indoors unless specifically instructed by a healthcare professional.

7. Keep Smoke and Vape Exposure Away From Your Baby

Smoking and nicotine exposure are important risk factors to consider.

The AAP recommends avoiding smoke and nicotine exposure during pregnancy and after birth. Safe to Sleep also recommends keeping babies away from secondhand smoke and vaping environments.

Creating a smoke-free home and car is an important part of creating a healthier environment for your baby.

8. A Pacifier May Help Reduce SIDS Risk

The AAP recommends offering a pacifier at nap time and bedtime because pacifier use is associated with a reduced risk of SIDS.

If you're breastfeeding, the AAP and Safe to Sleep recommend waiting until breastfeeding is well established before introducing a pacifier, unless your healthcare provider recommends otherwise.

There's also no need to force a baby to use a pacifier. If your baby doesn't want one, you don't need to make them take it.

9. Don't Rely on Baby Monitors to Prevent SIDS

Smart baby monitors and breathing or movement monitors can provide parents with useful information, but they should not be considered a replacement for safe-sleep practices.

The AAP specifically recommends not using home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.

In other words, a monitor doesn't make an unsafe sleep environment safe.

A baby should still sleep on an appropriate firm, flat surface without loose bedding or other hazardous items.

10. Give Your Baby Supervised Tummy Time While Awake

Safe sleep doesn't mean babies should spend all of their time on their backs.

Tummy time is important for development, but it should happen while your baby is awake and supervised. The AAP recommends supervised tummy time beginning soon after hospital discharge and gradually increasing it as the baby grows.

The important distinction is:

Back to sleep. Tummy to play.

11. Don't Use Inclined Sleepers or Positioners

Products marketed to help babies sleep at an incline or keep them in a particular position can be tempting, particularly when parents are dealing with reflux or difficulty settling a baby.

However, the Safe to Sleep program recommends a sleep surface that is firm, flat, and level and warns against inclined sleep surfaces and positioning products that can create risks for suffocation or airway obstruction.

If your baby has reflux or another medical condition that makes you concerned about sleep positioning, talk with your pediatrician rather than modifying the sleep surface yourself.

12. Move a Sleeping Baby From Sitting Devices to a Safe Sleep Space

Car seats, strollers, swings, and other sitting devices are not intended to be a baby's regular sleep environment.

If your baby falls asleep in a sitting or carrying device outside of the vehicle, the Safe to Sleep program recommends moving them to their regular safe sleep space as soon as possible.

This is especially important because a baby's head can fall forward when they're sitting, potentially affecting their airway.

Our Approach to Choosing Safe Sleep Products

When shopping for a crib mattress, crib, bassinet, play yard, sleep sack, or other baby sleep product, we recommend starting with safety rather than marketing claims.

Look for products that are appropriate for the baby's age and developmental stage and follow the manufacturer's instructions carefully. For sleep surfaces, make sure the product is designed for infant sleep and provides a firm, flat, level surface with a properly fitted sheet.

Features such as organic materials, breathability, waterproof covers, easy cleaning, or convenience can be useful considerations, but they should come after the basic safe-sleep requirements.

No mattress, monitor, swaddle, or other product can guarantee that a baby will not experience SIDS or another sleep-related death. Safe to Sleep specifically notes that no product can prevent SIDS.

Final Thoughts

Safe sleep doesn't have to be complicated. The most important habits are consistent: place your baby on their back for every sleep, use a firm and flat sleep surface, keep the sleep area free of loose items, avoid overheating, and keep your baby's sleep environment smoke-free.

It's also important that everyone who cares for your baby—including grandparents, babysitters, and other caregivers—understands these recommendations. Consistency matters because a baby can be exposed to unsafe sleep practices even when their parents are following the recommendations at home.

For questions about your individual baby's sleep, particularly if your baby was born prematurely or has a medical condition, talk with your pediatrician or other qualified healthcare professional.

Sources & Further Reading:
CDC – Infant Safe Sleep
American Academy of Pediatrics – Safe Sleep
NIH Safe to Sleep – Ways to Reduce Baby's Risk
NIH Safe to Sleep – Safe Sleep Environment
American Academy of Pediatrics – 2022 Safe Infant Sleep Policy Statement

This article is for general educational purposes and is not a substitute for medical advice from your baby's healthcare provider.