Sleep is one of the most pressing topics for parents of new babies and with so many sources of information, understanding what truly safe sleep looks like is important. Getting a baby to sleep can be tiring and there are going to be times where it’s harder to follow safe sleep practices. Our expert, Dr. Stephen Hawkins, MD, shares his guidance on how to create a safe sleep environment, avoid overheating during sleep and reduce the risk of sudden infant death syndrome, or SIDS.

What is SIDS and how can I reduce the risk?

Sudden infant death syndrome (SIDS) is one of three main types of sudden unexpected infant death (SUID) in babies under 1 year. The three main types of SUID are SIDS, unknown causes, and accidental suffocation or strangulation in bed.

Approximately 40% of SUIDs in the United States are due to SIDS and 30% are due to accidental suffocation and strangulation in bed. The most current data shows a concerning spike, where more than 1,500 infants died from SIDS in 2024.

Safe sleep can decrease sudden unexpected infant death from sleep-related causes in children under the age of 1 year. Below are some expert-recommended ways to create a safe sleep environment for your baby.

Follow the ABCs of safe sleep

Babies should always sleep:

• Alone
• On their back
• In a crib or other safe sleep surface

Falling asleep with your baby in your arms may feel like a loving way to bond, but it can actually put them in a dangerous position. Having your baby sleep alone eliminates the risk of rolling over onto babies or babies falling off of the sleeping surface. If you’re at risk of falling asleep while holding your baby, do your best to secure them in a safe sleeping space first.

Place your baby on their back for naps and bedtime. This significantly reduces the risk of suffocation by keeping airways open and reducing choking risks.

Finally, give your baby a safe, firm and flat place to sleep, such as a crib, bassinet, portable crib or play yard. The 2022 American Academy of Pediatrics (AAP) guidelines also note that parents should avoid inclined sleepers, nests, pods and loungers. Sleep surfaces that are inclined more than 10 degrees are unsafe for infant sleep because they can cause chin-to-chest airway obstruction.

These approaches to sleep can make a significant impact in reducing your baby’s risk of SIDS. For example, SIDS is 67 times more likely when infants sleep on couches, sofas or armchairs compared to a crib.

What’s safe for my baby to sleep with?

Babies sleep differently than adults. While we love to curl up with a pillow and blanket, these can be very dangerous for infants. Avoid putting pillows, blankets, toys, stuffies or bumper pads in your little one’s crib or sleeping surface until they are at least 6 months old.

How to dress a baby for sleep and avoid overheating

It’s important to keep your baby at a comfortable temperature while they sleep, but over-layering can lead to overheating. As a rule of thumb, our experts recommend babies sleep with just one more layer on than you.  Avoid hats and hoods for extra safety. Sleep sacks are a good option for keeping your baby at a comfortable temperature. It's also a good idea to monitor them for sweating or hot chests while they sleep, and be ready to help if you find they are getting too toasty.

What else helps reduce the risk of SIDS?

There are many research-backed ways to reduce the risk of SIDS, including:

• Breastfeeding your baby
• Getting all recommended childhood vaccines on time
• Using a pacifier during naps and sleep
• Avoiding smoking during pregnancy and after birth
• Giving your baby lots of supervised, awake tummy time.

Tummy time is especially important for babies, because it helps them develop important neck and upper body muscles and learn how to roll.

An ideal environment wouldn’t include any smoking, drinking, nicotine, opioids or medications, but if you aren’t able to eliminate these things completely, prioritize not having or using them around your baby.

Note that there is no evidence to support commercially available products, like home apnea or cardiorespiratory monitors, that claim to reduce the risk of SIDS. Even if they are FDA “approved” as a monitor, that doesn’t necessarily mean they make your baby safer.

Co-sleeping, bed-sharing and room-sharing: What’s the difference? What’s the safest?

Co-sleeping and bed-sharing are often used interchangeably and mean the same thing to pediatricians. These terms describe an adult and child sleeping together on the same sleep surface, such as a bed, couch or chair. While this sometimes feels unavoidable, especially during mornings, midday naps or late-night feedings, our experts do not recommend sharing any type of sleep surface with an infant under 1 year.

Instead, you might consider room-sharing for at least the first 6 months, and even up to a year, as recommended by the AAP. When you room-share, your baby sleeps in the same room as you in a bassinet, crib or other safe sleep surface. This makes it easier to feed your baby and respond to their needs during the night. Once your child gets a bit older or begins rolling or pushing up, experts recommend moving them to their own room and crib. Of course, you know your baby best, so the 6-to-12-month timeline can shift based on you and your child’s needs.

When a baby shares a sleeping surface with an adult, they are most often sleeping in an adult bed. These beds are not designed for babies and can pose many risks, including overheating. Additionally, an infant may suffocate in soft bedding or in piles of clothing or under an adult or older child.

The risk of death from co-sleeping or bed-sharing is even higher if the baby was born prematurely or is younger than 4 months of age. Additionally, the risk of death from co-sleeping or bed-sharing is higher when parents or caregivers smoke, drink alcohol or take any medications or drugs that make you sleepy.

What is a safe sleep surface for my baby?

Remember, safe sleep surfaces can include:

• Cribs
• Bassinets
• Play yards with a flat, firm mattress or pad, and a tight-fitting sheet

When it comes to sleep, avoid:

• Pillows
• Blankets
• Bumpers
• Toys
• In-bed sleepers
• Loungers
• Nursing pillows
• Swings
• Bouncers
• Positioning devices and other sleep products that do not meet the federal safety standards for infant sleep
• Weighted blankets or weighted sleep sacs

For more information like this, be sure to subscribe to infant and child product recalls.

If your baby falls asleep in a stroller, car seat or infant carrier when you are traveling, move them to a safe sleep surface as soon as you can.

If you’re worried about affording a safe sleep surface for your infant, there are many people and organizations ready to help. Start by reaching out to your pediatrician for assistance. They may be able to connect you to local organizations or groups who can help, including Cribs for Kids.

There are several websites that can help you ensure your infant’s sleep surface is safe. Visit the Consumer Product Safety Commission for reports on the safety of infant sleep products and education, as well as recall information for many consumer products, including infant sleep products. You can also check the safety of a crib, bassinet or play yard on the Consumer Product Safety Commission website. Additionally, a new safety standard recently went into effect ensuring that products marketed for infant sleep are safe.

When it comes to safety in infant sleep, “Boring is better.” There’s no denying babies need a lot of attention and love, but less can be more, and the simple solutions can lead to safer sleeping.