In my years working with families through their sleep issues, I’ve discovered that many don’t know the basics of safe sleep. There's a lot of conflicting info out there and, let’s be honest, safe sleep rules are a little confusing! I’m going to break down the basics of safe baby sleep here as well as providing some great resources for you to do more digging.

Why is safe sleep important?

But first! Why does it matter in the first place? Safe sleep reduces the risk of sudden infant death syndrome (SIDS) and other sleep related deaths like accidental suffocation & strangulation in bed (ASSB). In 2018, the CDC stated that there were about 3,500 of these sleep-related deaths in the U.S. per year.

Safe sleep matters. Even one death is one death too many. As you read further about safe sleep here and in other places, you may see some people claim that they didn’t follow safe sleep and their baby turned out just fine. You may even have experienced that yourself with a previous child.

This is called survivor’s bias and it does not make unsafe sleep safe. Take this car seat analogy as an example: When our parents were kids they didn’t have to sit in car seats and they obviously turned out fine and lived to tell about it. But now we know better so we do better. Same with safe sleep.

ABCs of Safe Sleep

Let’s get down to the basics so you can be informed and make the safest decisions for your family.

A is for Alone

Your baby should always sleep alone. Not with adults, siblings, pets, blankets, pillows, stuffed animals, or any other items. This also means that if you are holding your sleeping baby and there is even the slightest chance that you might fall asleep too, you need to transfer your baby before that happens.

B is for Back

Your baby should always be placed on their back for sleeping. Once your baby can roll, you should still start them on their back, but if they roll to their tummy or side, it is safe at that point to leave them be.

C is for Crib

The safest place for your baby to sleep is in a crib/bassinet/playard. These spaces have been tested and meet the necessary safety requirements and are flat & firm surfaces. If an item is not labeled as a crib, bassinet, or playard, it has not met these standards and is not safe. Look for these labels within the manual or on the actual product website: 

Bassinet/Cradle​: ASTM F2194, 16 CFR 1218

Playard​: ASTM F406-13, 16 CFR 1221

Crib​: ASTM F1169-13, 16 CFR 1220, 16 CFR 1500

Words & items to be on the lookout for when spotting unsafe sleep products:

Nests

DockATots

Co-sleepers

Swings

Sleepers

These are places that you might place your baby while awake and supervised, but should not be used for sleep.

I often get these questions:

1. What if they are asleep but I’m watching them? Unfortunately, sleep and death look very similar to a supervising parent so it is much safer and smarter to move your child to a safe sleep space if they fall asleep.
2. What if I use these unsafe sleep products but also use a baby breathing monitor? Doesn't that make it safe? The answer is still no. Relying on an unregulated piece of technology in order to practice unsafe sleep is not a good idea in any case.

Preventative vs Protective Factors

You’ve likely heard other things you can do to create a safer sleep environment so I wanted to break down preventative and protective factors.

Preventative factors are the ABCs that we mentioned above (Alone, Back, Crib). These are things that directly reduce the risk of SIDS and ASSB. 

Protective factors are things that can help. But it's important to understand that NOT using these protective factors does NOT increase the risk of SIDS.

Protective factors include:

Room sharing (not to be confused with bed sharing, which is unsafe)

Pacifier use

Breastfeeding

Again, these factors are protective which is the equivalent of wearing your seatbelt. Wearing your seatbelt will not prevent a car crash but it can help in the event of a car crash.

More Resources

I highly recommend checking out this great nonprofit which has additional resources https://www.safeinfantsleep.org/. This nonprofit also runs a Facebook community which is a great place to get evidence-based safe sleep information and advice. https://www.facebook.com/groups/SafeInfantSleep

For more child-proofing at all ages, check out this blog that I contributed to called Safeguarding Your Kids At All Stages.

safe sleep basics