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Creating a safe sleep environment

Every year around 3,500 babies in the United States die suddenly and unexpectedly while they're sleeping. Most of these tragic deaths are due to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or strangulation. Parents and caregivers can help reduce their baby’s risk of dying during sleep by creating a safe sleep environment for their infant and taking other actions.

Safe sleep is as easy as A, B, C

Alone - The safest way for babies to sleep is by themselves. Your baby should never share a sleep space or bed with another person, including on the couch or in a chair. Keeping the crib clear of all blankets, stuffed animals and toys is important to prevent accidental strangulation or suffocation. To keep your baby close, put his or her crib or bassinet next to your bed.

Back - When babies sleep on their tummies, they have more trouble breathing and are at higher risk of sleep-related death. Babies are also less likely to choke when lying on their backs because there is less risk of spit-up getting into the windpipe in this position.

In the picture on the left, an infant is lying on his back. The illustration includes a drawing of his trachea and esophagus. In the picture on the right, an infant is lying on his stomach. The illustration includes a drawing of his esophagus and trachea.

Crib – Sleeping on a firm, flat and level sleep surface, such as in a crib, bassinet or playpen, is the safest place for your baby. In doing so, you keep their airway safely open and prevent them from slumping or being in a position that can block their airway. Also, crib safety includes keeping it empty – except for a fitted sheet covering the mattress – so your baby does not accidentally suffocate. Crib bumpers are not recommended for use.

American Academy of Pediatrics safe sleep recommendations

To reduce the risk of all sleep-related infant deaths, the American Academy of Pediatrics offers Safe Sleep Guidelines for parents. These guidelines are based on research evidence and established standards to keep newborns safe and healthy.

8 steps to keep your baby safe and healthy

  1. Put your baby on their back to sleep until their first birthday.
  2. A baby should sleep in the same room as an adult but in their own crib. Never put your baby to sleep on a couch, chair, waterbed or other soft space.
  3. Don't put crib bumpers, blankets, pillows or toys in your baby's crib.
  4. The only thing in baby's crib should be a firm mattress and fitted sheet.
  5. Never put your baby to sleep in a crib made more than 10 years ago or that has missing or broken parts. Older cribs may not meet current safety standards.
  6. Don't make the room your baby sleeps in too hot. Dress your baby in no more than one additional layer than you are wearing.
  7. Always put your baby back in their crib after feeding.*
  8. Keep your baby away from smoke, alcohol, marijuana, opioids and illicit drugs.

*Human milk feeding has been shown to reduce the risk of SIDS.

For more information, check out the PA Safe Sleep brochure.

Cribs for Kids at Penn State Health Children’s Hospital

Penn State Health Children's Hospital is a Cribs for Kids community-based program. This program provides safe-sleep education to at-risk families and gives portable cribs to families who can’t afford a safe place for their babies to sleep. Contact us for more information.

Tummy time when baby is awake

Tummy time is for babies who are awake and being watched. Your baby needs this to develop strong muscles. The American Academy of Pediatrics recommends putting your baby on their belly to play and interact with you two to three times each day for about three to five minutes at a time. Your baby should always be awake for tummy time. You can start tummy time the day that your baby gets home from the hospital. As babies grow older and stronger, they need more time on their tummies to build their own strength.

For more information, check out this Tummy Time Brochure

Sleep sacks and swaddling

Babies may need comfort or warmth while sleeping. Sleep sacks or swaddling can be an effective way to soothe your infant.

Sleep sacks (also called wearable blankets) are preferred over blankets or other coverings to keep babies warm. They are designed to be worn, which prevents accidental suffocation. The American Academy of Pediatrics does not recommend weighted sleep sacks.

If you don’t use a sleep sack, you might want to dress your baby in layers or swaddle them. It is important to swaddle correctly to keep your baby safe. Be sure the baby’s breathing is not obstructed and keep the swaddling no higher than their shoulders. If your baby tries to roll over in a swaddle, it is a sign to stop swaddling. Swaddling should only be used on babies up to 2 months old.

Check the swaddle for tightness. You should be able to slide your hand between the blanket and your baby’s chest. You should still be able to bend your baby’s hips easily with room for the baby to move their hips or legs. If your baby is swaddled too loosely, the blanket can come undone and cause your baby to suffocate.

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