Getting to meet your new-born baby is an exciting time. You’ll have an overwhelming urge to protect them from everything. As an anxious parent, you may be worried about safe sleep for your baby.
You may have heard of Sudden Infant Death Syndrome (SIDS) or ‘crib death’. It’s the sudden unexplained death of a baby as they sleep. It’s not known what causes SIDS and because of that, we can never truly prevent it. However, we do know what can do to reduce the chances of it happening to your baby.
This guide is for you to know the steps you can take to ensure safe sleep for your baby. You should follow this advice for all your babies sleep times, not just at night. The advice below will lower your baby’s chance of SIDS.
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11 Ways to Reduce Your Baby’s Risk of SIDS
1. Back to Sleep
Always put your baby down to sleep on their back. I can’t express enough how important this is to reducing their SIDS risk. If you only take away one tip from this article, make it this one. The ‘Back to Sleep’ campaign has lowered the figures of babies dying from SIDS since 1991.
Placing your baby on their front restricts their airway. Side sleeping also increasing the risk they roll into a front lying position.
Don’t worry about spit up or vomit. From birth to 6 months your baby has a reflex which helps them to cough out or swallow fluid near their airway.
Once your baby starts to roll from back to front, gently place them on to their back. You can stop this when they roll both ways without help. At this stage, they naturally reposition themselves to breathe easier.
2. Avoid Smoke
Keep your baby in a smoke-free environment as much as possible. That includes smoking in the home, car or around others who do smoke.
Even if you don’t smoke remember second-hand smoke is still risky for your baby. A smoking partner can increase the risk of SIDS. Even if they smoke outside, there is still a risk of third-hand smoke that stays on their breath, clothes, hands, and hair.
Baby’s from a smoking home are at 60% more likely to be at risk of SIDS. If you smoke 10 cigarettes a day in pregnancy your baby is 4 times more likely to die from SIDS, than if you don’t. It’s unknown the risk of e-cigarettes or vaping on baby’s health.
The safest option for you and baby is to give up smoking completely.
Breastfeeding is well known to be a protective factor against SIDS. It’s recommended you exclusively breastfeed (no formula) for the first 6 months. However, even small periods or combination feeding are linked with lower risks of SIDS.
Breastmilk itself is full of antibodies and immunity boosters that formula isn’t. This helps new-borns fight off infection quickly. It’s also known to be better for their airways and reduce their risk to allergy. The motion of breastfeeding also helps your baby coordinate their breathing/swallow reflex makes their airways develop quicker and stronger.
4. Room Share
Your baby is at the lowest risk of SIDS if they have their own bed in your room for at least 6 months. This can be a bassinet or crib ideally next to mom’s side of the bed.
For daytime naps, keep baby in their own sleep space in the same room you are in. The importance of this step is that the parent is close, not the bed your baby is in.
It means you can be responsive to your baby and give them the safety of their own sleep space.
If you are considering co-sleeping with your baby, check out our extra tips below to ensure safe sleep space. You can also read our safe co-sleeping guide here.
Whether using a bassinet or a crib a good mattress is essential. The mattress must be flat and firm. This is to help support babies head and keep their airways open. Any tilted or soft surface can cause your babies chin to tilt down and restrict their breathing.
A waterproof mattress is also needed so you can regularly clean it down. Keeping the mattress free from bacteria build up will reduce your baby’s risk of getting unwell.
We highly recommend using a new unused mattress rather than one which is second hand. This is particularly important if you are unaware of the hygiene and smoking status of the home the mattress is bought from.
If you can’t afford a new mattress, make sure to thoroughly inspect your second hand one. Check for any rips, holes, and areas of sagging. Give it a good clean down and airing before using and make up with fresh linen.
6. Room Temperature
A comfortable room temperature is essential for your baby’s sleep space. This means the room should not be too hot or cold. Overheating is known to be a big risk factor for SIDS.
The room temperature should always be 61-68⁰F (16-20⁰C). You can check this by using a room thermometer set up in the room your baby sleeps in.
A fan in your baby’s room can help cool a hot room, however, don’t point it directly at your baby. You might also want to open a window to allow heat to escape. Also, consider using a shade if your baby’s crib is in direct sunlight.
For a cold room, it is safe to use a heater. Make sure it positioned well away from baby’s crib. Never keep heating on at bedtime if your baby’s crib is positioned next to a fixed heater.
You can check your baby’s temperature by feeling their tummy or neck. If they feel hot and sweaty remove a layer of clothing. If they are too cold, try some skin the skin then add a layer. Don’t put a hat on your baby to sleep as it prevents them regulating their heat.
It’s important to keep a close eye on your baby if they are unwell. Fevers cause a rise in temperature meaning an unwell baby needs fewer layers. Wrapping baby up too much will cause them to overheat.
7. Clear Crib
A clear crib is a safe crib. That means you should have no unnecessary item in your crib including:
- Crib Bumpers
- Sleep Positioners
Extra items in the crib increase the risk of baby accidents becoming entangled, trapped, choking or restricting baby’s breathing. It’s well known that a baby whose head is covered is at higher risk of SIDS. Any loose item can cover your baby’s head, especially if they wriggle or roll around.
The AAP now strongly recommends parents do not use crib bumpers. There is no evidence they protect baby from injury. In fact, they create a bigger risk of strangulation and suffocation caused by tie or baby caught in the fabric. Crib bumpers are currently illegal to buy in Ohio, Chicago, Maryland, and Watchung, New Jersey. More states are likely to follow with the ban.
Never leave a bottle in your baby’s crib for during the night. It’s a choking hazard for a baby to drink lying flat. The bottle itself can also cause a suffocation risk.
The right bedding is essential for a safe sleep space. Avoid soft, bulky bedding such as duvets or quilts or fleece blankets. This type of bedding poses many risks for your baby. First, they usually result in overheating. Second, they can cause your baby to become trapped underneath and restrict their airflow.
Never use pillows for a baby. They pose the same problems stated above, plus they create a poor sleep position for baby. A pillow tilts your baby’s head forward, tilting their chin and restricting baby’s airway.
The best bedding to use is cotton cellular blankets. These blankets allow airflow should they go over babies head when they move. Baby sleep sacks are ideal to prevent blankets moving over babies head. Always make sure you have the correct fit for your baby’s age range.
Note on Swaddling
There is some controversy regarding swaddling and SIDS. There is no evidence to suggest it increases the risk. Some parents find it helps to settle baby better. Keep this advice in mind when you swaddle your baby to sleep for naps or night time:
- Use thin lightweight fabric such as muslin cloths
- Don’t swaddle tightly
- Never swaddle above baby’s shoulders
- Never place baby to sleep on their front
- Keep a close eye that they are not overheating
9. Crib Set up
Make sure you are familiar with all the feature on your crib before you use it with your baby. Modern-day cribs often have extra features such as lowering sides or tilting legs. Whether you buy the crib new or second hand, make sure its set up correctly. If you opt for a second-hand crib do not buy unless you have access to the instruction manual from the seller or online.
Make sure you know how to apply any safety locks or attachment harnesses. Ensure they are all in good working condition and cannot be operated by a curious baby.
The mattress should always be a flat surface to ensure good airflow for baby. The mattress should be suitable to use with the crib. That means the correct fit without spaces or upturned sides.
10. Sleep position
When you put a baby in a crib they look tiny in a huge space. The best way to position baby is with their feet to the bottom of the crib. Blankets can be tucked into the edges of the crib. This prevents the blankets becoming loose. Also, baby cannot wriggle down the crib and under the covers.
When the blankets are in place they should not cover further than babies shoulders. Again remember not to put a hat on your baby. This keeps your baby at a comfortable temperature without the risk of overheating.
Note for Twins
If you are using a smaller bassinet each twin should have one each. This will prevent your babies overheating.
Twins can sleep side by side if they are in a larger crib, even from birth. The ideal position is to have them in one crib with feet to the bottom at one end each. Once they start to roll and move about, they need to move to separate cribs to prevent the risks posed by extra bedding and their sibling.
11. Pacifier Use
There is mixed evidence on whether a pacifier can reduce SIDS. Some good evidence to suggests it does, whereas others found no link. There is also the issue that pacifier use can interfere with breastfeeding. It is recommended you only start using one once breastfeeding is established around 4 weeks old.
If you do you a pacifier, it’s important to be consistent and use it at all sleep times. Babies who regularly use a pacifier can be at greater risk of SIDS if they go to sleep without one.
The best way to introduce a pacifier is by making it part of your baby’s sleep routine. Whether it’s a nap or night-time, use the pacifier consistently until your baby is 6 months old.
You don’t need to replace the pacifier if it falls out of your baby’s mouth. Also, never use any type of holder or pacifier cord when your baby is sleeping, as it presents a strangulation risk to your baby.
The AAP states the Bed sharing remains the biggest risk for sleep-related infant deaths. However, it’s still an option many parents explore to survive the exhaustion of sleepless nights. In fact, countries where co-sleeping is the norm, they have lower rates of SIDS than the USA.
The reason is they know how to safely co-sleep with their baby. This advice is extra if you wish to co-sleep with your baby.
Know Your Risk
There are certain situations which put your baby at much greater risk of SIDs if they co-sleep.
For babies this includes:
- Breathing conditions
- Neurological conditions
For parents this includes:
- Drug use (illegal and some prescription)
- Sleep conditions
If any of these apply to you or your baby we strongly recommend you do not co-sleep together. You are putting them at greater risk of SIDS or suffocation when bed-sharing.
A lot of the statistics from SIDS linked to co-sleeping is by parents who never intended to co-sleep. Sometimes parents can become so exhausted by frequent night waking that they take the baby into bed as a last resort.
The problem is that if you never intend to co-sleep your bed space will not be suitable for co-sleeping. This means your baby is at greater risk of overheating, suffocation, entrapment or strangulation by loose bedding.
Sofa sleeping is another cause for high co-sleeping and SIDS statistics. You should never sleep with your baby on a sofa even for a nap. It’s common for parents to place baby on their tummy to sleep on a sofa. This is the riskiest position for SIDS.
The second risk of sofa sleep with baby is that they slip down the sides and become trapped between parent and sofa back or cushions. Again this situation is very common with parents who are exhausted and do not intend to co-sleep with the baby.
Safe Sleep Space
I cannot stress enough, the importance of a safe co-sleeping space. Check out our article on safe co-sleeping and setting up a safe area for baby.
Ideally, your baby should have its own sleep space in a co-sleeper crib. This ensures baby is on mom’s side and away from the risk of suffocation by your partner. It’s important to keep pets and siblings away from baby to prevent further risk of suffocation.
Now that you know what increases or reduces your baby’s risk of SIDS it’s easier to know what sleep products are safe for baby. Apart from a safe crib, mattress and bedding you do not need anything else for baby to sleep.
Never trust a product that claims to prevent SIDS. No sleep product can prevent your baby from SIDS. Some products help make it easier for you to follow safe sleep advice. These are products which can help you set up a safe sleep environment for baby without increasing the risk of SIDS.
A co-sleeping crib is an ideal compromise for those who want co-sleep but are worried about the risk. They provide a safe space for baby with the closeness you want. They are perfect for moms who have had a C-section or are breastfeeding. Our favourite is the Arms Reach Clear Vue. You can check out our co-sleeper buying guide for more great options.
A sleep monitor will not prevent SIDS; however, it can give you an early alert if something does happen to your baby. These monitors detect changes in your babies breathing whether that’s movement or their oxygen saturation. The owlet sock is highly recommended for giving anxious parents peace of mind.
It’s important to note that sometimes these monitors can give false readings which set alarms off, causing anxiety in parents. Do consider this if you are thinking about buying one.
A room thermometer is essential to making sure your baby is at a comfortable temperature as they sleep. I love the Gro Egg thermometer, as it shows you at a glance if the room is safe or not. It simply glows one of four colors depending on whether the room is cold, hot or just right. Plus it acts as a soothing nightlight for baby’s room when they get older.
Blankets can be a big worry for parents. How many to use? Are they safe to swaddle? Will they become loose? A baby sleep sack is a great way to provide baby with warmth overnight, allow room to cool down and prevent the blanket moving around.
The Halo sleepsack is the most popular one in the USA. The company committed to helping reduce SIDs. Their sacks are even embroidered with a ‘back is best’ motto to promote safe sleep positions for baby.
Mesh Crib Bumper
We’ve already discussed crib bumpers and how they can increase SIDs. The fact of the matter is that regardless parents still want to use them to prevent baby limbs getting caught in the crib slats. Breathable mesh crib bumpers are an alternative if you are determined to use a bumper. Use these with extreme caution, they take away the risk of restricted airflow, but can still pose other risks. Make sure any ends are tucked in to prevent baby’s head being caught between fabric and slats. Opt for one without tie fastenings as these can cause a choking or strangulation risk to your baby.