Safe Sleep for Infants

In the past, sudden infant death syndrome, or SIDS, was most commonly talked about in relation to sleep-related infant deaths. Experts have begun classifying these deaths more specifically in order to learn from them and help prevent them. The term now used to describe the range of sleep-related infant deaths is sudden unexplained infant death, or SUID. Falling under that umbrella includes infant deaths due to:

  • Sudden infant death syndrome (SIDS)
  • Accidental suffocation or strangulation in bed (ASSB)
  • Unknown causes

While these deaths are unpredictable, you can take several steps to reduce the risk by following new safe sleep guidelines that were released in 2022 by the American Academy of Pediatrics (AAP).

The updated AAP safe sleep guidelines below can help reduce the risk of all sleep-related infant deaths such as sudden infant death syndrome (SIDS) or accidental strangulation and suffocation.

  • Place on back to sleep for every sleep until the child reaches 1 year of age.
  • Use a firm, flat sleep surface with no incline to reduce the risk of suffocation or wedging and entrapment. The AAP recommends that infants sleep in their parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for at least the first 6 months.
  • Evidence suggests that sleeping in the parents’ room but on a separate surface decreases the risk of SIDS by as much as 50%.
  • A firm crib, bassinet or playpen mattress covered with a fitted sheet is the best sleeping surface. Never put a baby down to sleep on a sofa, waterbed, adult bed, car seat, bouncer or swing.
  • It is recommended that weighted blankets, weighted sleepers, weighted swaddles or other weighted objects not be placed on or near the sleeping infant. Rather, dress your infant in layers of clothing to keep them warm while reducing any chance of entrapment. Wearable blankets may also be used.
  • Car seats, strollers, swings, infant carriers and infant slings are not recommended for routine sleep, says the AAP, particularly for infants less than 4 months of age. If your infant falls asleep in one of these devices, move them to a crib or other appropriate flat surface. Also, keep in mind that car seats and similar products are not stable on any elevated surface. Never leave a baby unattended in a car seat or similar product.
  • When using an infant sling or cloth carrier, ensure the infant’s head is up and above the fabric, the face is visible, and the nose and mouth are clear of obstructions.
  • Feeding of human milk is recommended as it is associated with a reduced risk of SIDS.
  • Avoid infant overheating and head covering.
  • Infants should be lightly clothed for sleep and their bedroom temperature should be kept comfortable for an adult who is lightly clothed. The AAP does not recommend babies wear hats beyond the first few hours of life.
  • There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.
  • Swaddling is often used to calm an infant and encourage use of the supine position (face up, on their back). However, if the baby then rolls to their tummy, there is an increased risk of suffocation. When an infant starts to show signs that they are ready to roll, swaddling should no longer be used.
  • Offering a pacifier at naptime and bedtime is recommended to reduce the risk of SIDS.
  • Wearable heart rate and pulse oximetry monitoring devices are not recommended to reduce the risk of SIDS, since data is lacking. If used, continue to follow other safe sleep practices.
  • Because baby sleeps on their back, Tummy Time is essential! The AAP recommends supervised, awake tummy time to foster infant development and lower the risk of positional plagiocephaly, which is a condition in which areas of an infant’s head develop a flattened shape and appearance.

The easiest way to remember safe sleep practices for your infant is to use the A-B-C acronym. Babies should sleep:

  • Alone
  • On their Backs
  • In a Crib

If you need a safe sleep space for your baby or know someone who does, please reach out to the distribution site near you. Cribs for Kids | Health and Human Services North Dakota

If you would like to order Safe Sleep educational materials, click here.