Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death are among the most feared risks for new parents. The good news: following evidence-based safe sleep guidelines dramatically reduces this risk. Here is everything you need to know.
The ABCs of safe sleep
The American Academy of Pediatrics (AAP) summarises safe sleep as Alone, on their Back, in a Crib (or safe sleep surface):
Alone: baby sleeps in their own safe sleep space, not in an adult bed, sofa, armchair, or with siblings.
Back: always place baby on their back for every sleep, until age 1. “Back is best” — this single change reduced SIDS rates by 50% after the Safe to Sleep campaign launched in 1994.
Crib (or bassinet, play yard): baby sleeps on a firm, flat surface with a fitted sheet. No soft bedding, bumpers, pillows, stuffed animals, or positioners.
What belongs in the sleep space (and what doesn’t)
Safe:
- Firm, flat mattress with a fitted sheet
- Pacifier (after breastfeeding is established — reduces SIDS risk)
- Baby in a sleep sack or swaddle
Not safe:
- Pillows, blankets, comforters
- Bumper pads (including mesh — no evidence of benefit, documented injury risk)
- Positioning wedges or anti-roll devices
- Inclined sleepers (recalled in many countries due to infant deaths)
- Soft mattress toppers
Room sharing: the recommended middle ground
The AAP recommends room-sharing (baby’s safe sleep surface in parents’ room) for at least the first 6 months, ideally the first year. Room-sharing without bed-sharing reduces SIDS risk by up to 50% while keeping baby accessible for night feeds.
Bedsharing: the nuanced reality
Bedsharing is practiced widely worldwide and is a complex topic. If you are considering bedsharing, the SAFE guidelines outline the safest possible conditions: breastfeeding, non-smoking household, sober parents, firm mattress, no soft bedding. Even under these conditions, the AAP does not recommend bedsharing due to risk. An informed choice requires understanding both the research and the risk reduction strategies.
Temperature and environment
Keep the room between 68-72°F (20-22°C). Overheating is a risk factor for SIDS. Dress baby in one layer more than you would wear. Check for sweating or flushed cheeks.
Tummy time during the day
Back to sleep doesn’t mean no tummy time. Supervised tummy time while baby is awake is essential for motor development, preventing flat spots on the head, and building the strength baby needs to eventually roll over. Aim for 30+ minutes spread throughout the day, starting from day one.
Building healthy sleep habits supports your baby’s development in every way. Our Intentional Play Guide includes calming routines and age-appropriate activities to support healthy sleep and development from birth to 18 months.
