How to keep the place where your baby sleeps as safe as possible
Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Death in Infancy (SUDI) can be hard to talk about, because the thought of any precious little baby dying is distressing. But some things are important to know. You can find out why putting babies down to sleep on their backs matters so much here, and how to avoid baby overheating here.
Your baby is safest sleeping in the same room as you or another loving adult, day and night, for at least the first six months
Sleeping babies in the same room as their parents or carer for both daytime naps and night-time sleep is very protective against SIDS or SUDI throughout the first six months, and continues to offer protection until baby is 12 months old. It's ok to slip out of the room to go to the bathroom or to make a cup of tea. But what matters is that you are setting up a pattern of room-sharing over time, day and night.
Researchers think that sleeping in the same room day and night is protective because when you're in the same room, your baby is able to hear you, and you're able to hear your baby.
This exchange of sensory information between you and your baby occurs even when you're asleep or not aware of it. It seems as though we are biologically primed to notice on a subliminal level, where our brain still unconsciously processes information, if something is going wrong for our little one.
Up to two-thirds of families bring their baby into their bed, always or sometimes, which ( - as long as the surface is kept safe - ) may even offer special protection. For a small number of families, bedsharing is not safe. You can read about shared sleeping when you're mostly breastfeeding here, and when you're mostly formula feeding here.
How to keep the surface on which your baby sleeps as safe as possible
It's safest to sleep your baby on a sleep surface which is
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Horizontal (not inclined)
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Cleared
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Firm
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Flat.
The mattress needs to fit snugly into the base of the side-car, bassinet, cot, or travel cot, whichever you're using.
Parents often use bassinets and cots. Positioning your baby so that his feet are at the bottom (or foot) of the bassinet or cot helps protect him from becoming tangled up in bedding, or from having bedding covering his little head, which could affect breathing. This is also why you would tuck any blankets or sheets in firmly when you use them.
Many families like a side-car arrangement next to the parents' bed in the night. Below this picture of a side-car set-up, we look at places and surfaces that aren't safe for baby sleep.
Places where it's not safe to put your sleeping baby
It's not safe to sleep with your baby or place your sleeping baby on a couch or sofa or lounge chair, because sliding into cracks between cushions can cause forward bending of baby's neck, or put pressure on baby's chest, interfering with breathing.
Here are some other places that aren't safe for sleeping your baby.
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Bouncer (because baby slipping down can cause forward bending of the neck, interfering with breathing)
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Some kinds of slings (for the same reason. You can read about how to wear your newborn or baby safely here)
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Car capsule or car seat (for the same reason)
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Baby pods and nests, unless it's daytime and you're nearby (because the soft and puffy raised edges can interfere with baby's breathing)
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Hammocks (because baby's neck might bend forward, interfering with breathing)
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Water beds
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Bean bags
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Anywhere that can be reached by a pet (for obvious reasons).
Surfaces which are not safe for your sleeping baby
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Soft or saggy, including sheepskin (which can make it difficult for babies to breathe or to cool down)
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Edges to fall off
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Cracks to fall down (like a sofa or couch)
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Puffy or raised and cushiony areas (which can make it difficult for babies to breathe or to cool down).
Things that can be dangerous near your sleeping baby
As awful as it is to think about, babies have been strangled by or had their airways obstructed by
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Necklaces including teething necklaces
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Window cords
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Cords for electrical items
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Ribbons or decorations attached to toys or dummy
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Soft toys
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Pillows
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Doonas
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Sleep positioners
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Weighted bedding or products
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Hooded garment
You got through the safer baby sleep lists! Thank you for hanging in there. Those lists matter.
Acknowledgements
I have drawn from the UK Lulluby Trust's leaflet 'Safer sleep for babies: a guide for parents and carers', released in collaboration with BASIS and the UK Committee for UNICEF, in the writing of this article.
Recommended resources
The website Baby Sleep Information Source, by the Durham Infancy and Sleep Centre UK, is the world's leading source of information and photographs for parents about safer infant sleep.
You might be interested in a podcast conversation I had with Professor Helen Ball in which we discuss sleeping babies safely here.
Always put babies down to sleep on their backs (with a word about rolling and reflux, too)
When your breastfeeding or breast milk feeding baby comes into bed with you
When your formula-feeding baby comes into bed with you
When is bringing your baby into bed definitely too risky?
How to keep your baby at the right temperature in the night
Wrapping or swaddling your baby: how to do it safely and does it help with sleep, anyway?
Why is there so much conflicting advice about bringing your baby into bed?
Selected references
Cole R, Young J, Kearney L, Thompson JM. Infant care practices, caregiver awareness of safe sleep advice and barriers to implementation: a scoping review. International Journal of Environmental Research and Public Health. 2022;19:7712.
Queensland Clinical Guidelines. Safer infant sleeping. Guideline No. MN22.71-V1-R27. Queensland Health. 2022. Available from: http://www.health.qld.gov.au/qcg
