Safe Sleeping for Infants Recommendations

  • Infants should be placed for sleep on their backs until they are one year old. Side sleeping is not safe and not advised.
  • Use a firm sleep surface: a firm mattress n a crib or bassinet covered by a fitted sheet.
  • Room-sharing without bed-sharing is recommended for the first year.
  • Keep all objects and loose bedding out of the crib to reduce the risk of sudden infant death syndrome, suffocation, entrapment and strangulation.
  • Pregnant women should receive regular prenatal care.
  • Avoid smoke exposure during pregnancy and after birth.
  • Avoid alcohol and illicit drug use during pregnancy and after birth.
  • Breastfeeding is recommended to reduce the risk for Sudden Infant Death Syndrome (SIDS).
  • Consider offering a pacifier at nap time and bedtime.
  • Avoid overheating.
  • Infants should be immunized in accordance with the recommendations of the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention.
  • Avoid commercial devices marketed to reduce the risk of (SIDS), including wedges, positioners, special mattresses and special sleep surfaces.
  • Do not use home cardiorespiratory monitors or any other electric monitors in the crib as a strategy for reducing the risk of SIDS.
  • Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly (flat-head syndrome)
These recommendations are based on the expanded guidelines (PDF) from the American Academy of Pediatrics, released in October 2011.

Who is at risk for sudden infant death syndrome (SIDS)?

SIDS is the leading cause of death for infants between 1 month and 12 months of age. SIDS is most common among infants that are 2-4 months old. However, babies can die of SIDS until they are 1 year old.

Did you know?

  • About one in five sudden infant death syndrome (SIDS) deaths occur while an infant is in the care of someone other than a parent. Many of these deaths occur when babies who are used to sleeping on their backs at home are then placed to sleep on their tummies by another caregiver. We call this “unaccustomed tummy sleeping.”
  • Unaccustomed tummy sleeping increases the risk of SIDS. Babies who are used to sleeping on their backs and are placed to sleep on their tummies are 18 times more likely to die from SIDS.
  • You can reduce your baby’s risk of dying of SIDS by talking to those who care for your baby, including child care providers, babysitters, family, and friends, about placing your baby to sleep on his back at night and during naps.
  • SIDS is not caused by Immunizations, vomiting or choking

What can I do before my baby is born to reduce the risk of SIDS?

  • Take care of yourself during pregnancy and after the birth of your baby.
  • Don’t smoke or expose yourself to others’ smoke while you are pregnant and after the baby is born.
  • Be sure to visit a physician for regular prenatal checkups to reduce your risk of having a low birth weight or premature baby. Breastfeed your baby, if possible, at least through the first year of life.

Baby sleeping alone, on his back and in his crib without improper items in the crib.

Where is the safest place for my baby to sleep?

The safest place for your baby to sleep is in the room where you sleep. Place the baby’s crib or bassinet near your bed (within an arm’s reach). This makes it easier to breastfeed and to bond with your baby. The crib or bassinet should be free from toys, soft bedding, blankets, and pillows.

Safe sleeping environments

Place your baby in a safety-approved crib with a firm mattress and a well-fitting sheet. Cradles and bassinets may be used, but choose those that are the Juvenile Products Manufacturers Association (JPMA) certified for safety.

    Openings that permit the passage of a child’s body but are too small for his or her head, can lead to entrap­ment and strangulation. Hazards include bunk beds, cribs, playground equipment, baby strollers, carriages, and high chairs. Use a crib that meets the safety standards of the Consumer Product Safety Commission (CPSC) and the Juvenile Products Manufacturers Association (JPMA). If you are getting a used crib, check to see if it has been recalled at Also, look for the following strangulation hazards:

    • Missing, broken or loose parts
    • Loose hardware
    • Cut out designs in the headboard or footboard
    • Crib slats more than 2 3/8 inches apart (width of a soda can)
    • Corner post extension over 1/16 of an inch high
    • Gaps larger than 2 fingers width between the sides of the crib and the mattress
    • Drop side latches that could be easily released by your baby
    • Do not have anything hanging on or above a baby’s crib on a string or cord.
    • Never place a crib, bed, high chair or playpen near windows, draperies, blinds, or wall mounted decorative accessories with cords.
    • If your child has a bunk bed, check the guard rails on the top bunk. Make sure that all spaces between the guardrail and bed frame and all spaces in the head and footboards are less than 3.5 inches so your child’s body cannot slide through.

    Place the crib in an area that is always smoke-free.

    Don’t place babies to sleep on adult beds, chairs, sofas, waterbeds, or cushions.

    Toys and other soft bedding, including fluffy blankets,comforters, pillows, stuffed animals, and wedges should not be placed in the crib with the baby. These items can impair the infant’s ability to breathe if they cover his face.

    Breastfeed your baby. Experts recommend that mothers feed their children human milk at least through the first year of life.

    Safe sleeping practices

    • Always place babies to sleep on their backs during naps and at nighttime. Because babies sleeping on their sides are more likely to accidentally roll onto their stomach, the side position is not as safe as the back and is not recommended.
    • Don’t cover the heads of babies with a blanket or over bundle them in clothing and blankets.
    • Avoid letting the baby get too hot. The baby could be too hot if you notice sweating, damp hair, flushed cheeks, heat rash, and rapid breathing. Dress the baby lightly for sleep. Set the room temperature in a range that is comfortable for a lightly clothed adult.

    Talk about safe sleep practices with everyone who cares for your baby

    When looking for someone to take care of your baby,including a child care provider, a family member, or a friend, make sure that you talk with this person about safe sleep practices. Bring this fact sheet along to help, if needed. If a caregiver does not know the best safe sleep practices, respectfully try to teach the caregiver what you have learned about safe sleep practices and the importance of following these rules when caring for infants. Before leaving your baby with anyone, be sure that person agrees that the safe sleep practices explained in this brochure will be followed all of the time.

    Is it ever safe to have babies on their tummies?

    Yes. You should talk to your child care provider about making tummy time a part of your baby’s daily activities. Your baby needs plenty of tummy time while supervised and awake to help build strong neck and shoulder muscles. Remember to also make sure that your baby is having tummy time at home with you.

    Tummy to play and back to sleep

    Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised. Babies sleep comfortably on their backs, and no special equipment or extra money is needed.

    “Tummy time” is playtime when infants are awake and placed on their tummies while someone is watching them. Have tummy time to allow babies to develop normally.

    Remember, if you have a question about the health and safety of your child, talk to your baby’s doctor.

    For more information

    For free educational materials

    Safe to Sleep Public Education Campaign
    National Institute of Child and Human Development