Sleep Safety for SIDS Prevention

When we talk about sleep safety, we mean creating a sleep environment which reduces the risk of sudden infant death syndrome (SIDS). SIDS is exactly what it sounds like. It happens without warning, can occur at any age in the first year of life, and results in death. It only happens during sleep, but that includes daytime naps as well as overnight sleep.

There are many leading theories about why SIDS occurs, but unfortunately we do not know for sure. What we do know, however, is how to prevent it from happening. If you follow these recommendations closely, you can safely put this terrifying possibility out of your mind.

The ABCs of Safe Sleep

  • The ABCs should be followed for both daytime naps and overnight sleep.
  • The ABCs should be followed for the entire first year of life.
  • After 12 months of life, most experts believe these restrictions can be lifted.

A - Alone

  • Your child should be completely alone in the sleep environment.
    • Items such as teething necklaces, pillows, toys, stuffed animals, loose bedding (blankets, quilts, comforters, loose sheets), crib liners (even if advertised as “breathable”), wedges to keep your baby is a particular position, and bumper pads should never be present in the sleep environment.
    • This also includes caregivers. Co-sleeping (when both caregiver and baby are sleeping in the same place together, such as your bed, the couch, a recliner, etc) increases the risk of SIDS, separately from events where a child is accidentally suffocated or injured by a sleeping adult.
    • Put your baby in the same room as you, but not the same bed.
      • Sleeping in the same room as your baby is recommended for the first 6 months, as this has been shown to reduce the risk of SIDS. 
  • Only two items are safe for your baby to have during sleep:
    • Pacifier
      • The pacifier should not have anything attached to it (stuffed animals, strings/ropes). The pacifier should be inspected regularly for signs of wear and tear, and discharged if these are present.
    • Swaddle
      • A swaddle should be tight, and positioned low enough to see the top of the chest and shoulders.

B - Back

  • Always place your baby on their back for sleep.
  • If your baby has rolled from her back to her side or stomach on her own, she is safe to be left in that position, and does not need to be replaced on her back again.
  • Stop swaddling once your baby is 4 months old, or as soon as she can roll from her back to her belly on her own.

C - Crib

The sleep surface must be two things: Firm and Flat


  • Cribs, bassinets, portable cribs, or play yards are safe, provided they meet the current safety standards.
  • Cover the mattress with a tight-fitting sheet.
  • Measure the dimensions of this sheet to be sure it is the same size as the mattress.
  • Never put rolled blankets or pillows between the mattress and the sheet.


  • Never put your baby to sleep at an inclined position.
  • Swings, rockers, bouncers, floor chairs, sleepers, car seats, and cushions/pillows increase the risk of SIDS and are not safe for sleep.
  • If your baby falls asleep in any of these items, he should be moved to a safe sleep environment as soon as possible.
  • Sleeping in a car seat is safe for short periods of time while in a moving car. The exact amount of time has not been thoroughly studied, unfortunately. Nevertheless, it is always safer for your baby to be in a carseat while the car is moving.

Additional Prevention Strategies

Don't Overheat During Sleep

  • Overheating increases the risk for SIDS.
  • Set the thermostat between 68-72ºF.
  • Dress your baby is the same number of layers of clothing as you need to feel comfortable at that temperature.


  • Pacifiers have been show to reduce the risk of SIDS.
  • We recommend introducing the pacifier after 2 weeks of life, once breast feeding has been established.
  • If your baby is crying, offer more food before the pacifier. In the first 4 months, a crying baby is hungry until proven otherwise.

Breastfeed Your Baby

  • Breastfeeding has been shown to reduce the risk of SIDS.
  • If, for whatever reason, breastfeeding doesn't work out for your baby this time around, please don't worry. The prevention strategies outlined above will keep your baby safe from SIDS.