Good sleeping habits are important for your baby’s physical and emotional well-being. An important part of establishing good sleeping habits is the sleep environment – where your child sleeps, the kind of crib or bed, the type of mattress, and so on.
Creating a safe sleep environment will also reduce the risk of sudden infant death syndrome (SIDS), which is when a baby younger than one year of age dies unexpectedly while sleeping. Putting your baby to sleep on his back reduces the risk of SIDS.
The Canadian Paediatric Society recommends that babies under one year of age sleep on their backs in cribs that meet Canadian Government safety standards. Babies should not sleep in their parents’ bed, which is called bedsharing. Adult beds are not safe for babies. Many large-scale studies have shown that bedsharing can put babies at greater risk for entrapment and suffocation.
If you want your baby to be near you during the night, you can put a crib in your room, next to your bed. This is called the cosleeping. Many mothers find that this makes night-time breastfeeding easier. This type of sleeping arrangement may also further reduce the risk of SIDS.
Whatever you choose, here are some things you should know to help you and your baby get a good and safe night’s sleep.
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What is safe sleep?
Safe sleep means putting your baby to sleep in ways that can help protect him from dangers, like choking and suffocation (not being able to breathe), and sudden infant death syndrome (also called SIDS). SIDS is the unexplained death of a baby younger than one-year-old. SIDS usually happens when a baby is sleeping. It’s sometimes called crib death because the baby often dies in his crib.
How much sleep does your baby need?
Newborns sleep about 16 hours a day, usually in 3- to 4-hour periods. Your baby needs to eat every few hours, which is why she doesn’t sleep for longer periods of time. Your baby may get cranky or overtired if she doesn’t get enough sleep.
Don’t be surprised if your baby can only stay awake for an hour or two. Over time, her body gets into a sleep pattern. She starts sleeping for longer stretches, even during the night. If you’re worried about your baby’s sleep, talk to her health care provider.
Where should your baby sleep?
The safest place for your baby to sleep is by herself in a bassinet or crib. If you have multiples (twins, triplets or more), put each baby in his bassinet or crib. Here are some dos and don’ts about making your baby’s sleep space safe:
- Do put your baby to sleep on his back on a flat, firm surface, like a crib mattress covered with a tightly fitted sheet. Use only the mattress made for your baby’s crib. The mattress should fit snugly in the crib, so there are no spaces between the mattress and the crib frame. The mattress shape should stay firm even when covered with a tightly fitted sheet or mattress cover.
- Do put your baby to bed in his crib or bassinet. Don’t bed-share. This is when babies and parents sleep together in the same bed. Bed-sharing is the most common cause of death in babies younger than three months old. Keep your baby’s crib close to your bed so your baby’s nearby during the night. The American Academy of Pediatrics (also called AAP) recommends that you and your baby sleep in the same room, but not in the same bed, for the first year of your baby’s life but at least for the first six months.
- Do make sure your baby’s bassinet, crib or play yard meets current safety standards. Visit the US Consumer Product Safety Commission (CPSC) to learn more about product safety standards or product recalls.
- Do remove hanging window cords or electrical wires near where your baby sleeps. Babies can get tangled in them and choke.
- Do keep the room at a comfortable temperature. If your baby is sweating or his chest feels hot, he may be overheated.
- Don’t use sleep positioners. These sometimes are called nests or anti-roll pillows. They often are mats or wedges with pillows on either side to help keep your baby in place. The Food and Drug Administration (also called FDA) warns that sleep positioners can cause babies to die because of suffocation.
- Don’t let your baby sleep in a carrier, sling, car seat or stroller. Babies who sleep in these items can suffocate. If your baby falls asleep in one, take her out and put her in her crib as soon as you can.
- Don’t put your baby to sleep on soft surfaces, like a waterbed, sofa, soft mattress or cushion.
- Don’t keep crib bumpers, loose bedding, toys or other soft objects in your baby’s crib. They put your baby in danger of being trapped, strangled or suffocated.
- Don’t use cribs with drop-side rails. Don’t put portable bed rails on a regular bed. Babies can get stuck in rails and choke. Don’t try to fix a crib that has broken or missing parts.
All babies under one year old are at risk for sudden infant death syndrome (SIDS), especially those younger than six months. It has been called crib death because it occurs while the baby is sleeping in the crib. An infection or a medication doesn’t cause it, and it can’t be spread. It’s listed as the cause of death if there’s no other explanation. Certain things increase the chances of it. These include:
- Premature birth
- Exposure to alcohol or drugs before birth
- Exposure to smoking before or after birth
It’s unclear if having a sibling who died of SIDS increases the risk.
Sometimes a baby’s airway becomes blocked while he sleeps. This can lead to sudden unexpected infant death (SUID).
The American Academy of Pediatrics now says babies should sleep in their parent’s room for the first six months, or better yet, until their first birthday. New statistics say room-sharing can lower the risk of SIDS by as much as 50%. It’s easier to keep an eye on your baby, comfort, and feed him. But he needs his own safe space: A bassinet, crib, or co-sleeper (a separate sleeping area that attaches to your bed). Babies should not sleep in the bed with their parents. That increases the risk that the child’s breathing could get cut off, and it’s even more dangerous if you smoke, drink, or take drugs (even some prescription meds.)
How do you put your baby to sleep safely?
Here’s how to help keep your baby safe when you put her to sleep:
- Put your baby to sleep on his back every time until he’s one year old. It’s not safe for a baby to sleep on his side or tummy. If your baby can roll from his back to his side or tummy and back again, it’s OK if he changes positions while sleeping.
- Dress your baby in light sleep clothes. Remove any strings or ties from his pyjamas and don’t cover his head. A blanket sleeper can help keep your baby warm without covering his head or face. It’s safe to swaddle your baby for sleep until he can roll over onto his tummy. But once he can roll over, stop swaddling. A swaddled baby who is placed on or rolls onto his tummy while sleeping may be more likely SIDS. Swaddling is when you snugly wrap a light blanket around your baby so that it covers most of his body below the neck.
- Give your baby a pacifier. Pacifiers may help protect against SIDS. If you’re breastfeeding, wait until your baby is 3 to 4 weeks old or until she’s used to breastfeeding before giving her a pacifier. If your baby doesn’t take a pacifier, don’t force it. It’s OK if the pacifier falls out of your baby’s mouth during sleep. Don’t hang the pacifier around your baby’s neck or attach the pacifier to your baby’s clothing or a stuffed animal. Give your baby a pacifier for naps and at bedtime.
- Don’t use home cardiorespiratory monitors as a way to reduce the risk of SIDS. These monitors track a baby’s heart rate and breathing. Some babies need this kind of monitor because of medical problems, but this is rare. There’s no evidence that the monitors help reduce the risk of SIDS in healthy babies.
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How does breastfeeding affect safe sleep?
Breastfeeding for at least the first 6 of your baby’s life can reduce your baby’s risk of SIDS.
It’s OK to breastfeed your baby in your bed. Before you start feeding, move any bedding and pillows from your bed in case you fall asleep. If you do fall asleep, move your baby to his crib or bassinet as soon as you wake up. Breastfeeding your baby in bed is safer than on a sofa or cushioned chair.
Babies often fall asleep while breastfeeding, especially when they get full. If you think your baby’s asleep and hasn’t finished feeding, try to wake him gently by rubbing his back, tickling his feet, burping him or switching him to the other breast. If your baby’s not latched on correctly, he may fall asleep. You can break the latch by putting your pinky finger in the side of his mouth. Ask your lactation consultant to help you make sure your baby has a good latch. The latch is when your baby’s mouth is securely attached to the area around your nipple for breastfeeding.
Are there other ways to help reduce your baby’s risk of sleep dangers, including SIDS?
Yes. Here’s what you can do:
- Make sure your baby gets all her vaccinations. These shots help protect her from serious childhood diseases and may help prevent SIDS. All children should be vaccinated for their health, and so they don’t spread infections to others.
- Don’t smoke and keep your baby away from other smokers and secondhand smoke (smoke from other people’s cigarettes, cigars and pipes). Babies who live with smokers are at increased risk of SIDS. Keep your home and your car smoke-free.
- Don’t smoke, drink alcohol or use harmful drugs during pregnancy. Babies of mothers who do these things are at increased risk of SIDS.
- Go to all your prenatal care checkups during pregnancy. Babies of mothers who don’t get regular prenatal care are at increased risk of SIDS.
- Can a bedtime routine help your baby sleep?
- Yes. Your baby’s sleep schedule changes over time, but sticking to a routine can make bedtime easier for the both of you. Start setting a bedtime routine when your baby’s around 4 to 6 months old.
Here’s how to get your baby ready for bedtime:
- Wind down any playtime fun.
- Turn off the phone, television, etc.
- Give your baby a warm bath.
- Softly stroke your baby’s back.
- Give your baby a pacifier.
- Sing to your baby or play soft music.
- Read your baby a bedtime story.
- Stick to your baby’s sleep routine as much as you can. Plan if your baby’s routine may need a temporary change, like if you’re going out of town travel or attending family parties. Change his bedtime the best you can but try to get back to his schedule and routine as soon as possible.
What is tummy time?
Tummy time is when you put your baby on her stomach while she’s awake. It can help make your baby’s neck, shoulder and arm muscles stronger. It also helps prevent flat spots on the back of your baby’s head that she may get from sleeping on her back. Always watch your baby during tummy time or make sure an adult who is awake is watching your baby.
Make a Safe Place to Sleep
Always place your baby on their back at bedtime and at nap time.
- Do not put your baby to sleep on their side. Your baby will not choke if they spit up. See more information in this video about safe sleep at
- Always place your baby on a firm mattress in a safe crib with a tightly fitted sheet. A safe crib is a bassinet, play-yard or crib that has the spindles no wider than 2-3/8 inches apart and sides that do not dropdown.
- Never use soft bedding, comforters, pillows, loose sheets, blankets, sheepskins, toys, positioners or bumpers in the crib or sleep area. These could cause your baby to suffocate.
- If your baby changes positions in their sleep, let them stay where they are.
- Decorate your baby’s room as you choose, but leave the baby’s sleep space empty.
- Babies should not sleep on adult beds, couches, armchairs or other soft sleep surfaces – they should be on a firm mattress in their own sleep space.
- Babies should not sleep in car seats or swings, as they may not be able to keep their airway open if they fall asleep while in a car seat or swing, move them to a safe sleep place.
- Always put your baby to sleep in a separate, but close-by, safe place to sleep.
- DO NOT bed share. It can increase your baby’s chance of SUIDS. Adult beds and bedding are soft and can cause the baby to suffocate, or an adult can roll over on the baby, causing suffocation.
- Bed-sharing includes:
- Your baby sleeping in bed with you
- Your baby sleeping in bed with other children
- Your baby sleeping in bed with pets
- DO room share if you can. It can help prevent SUIDS. Room sharing is when your baby sleeps in your room, on a separate, safe surface, like a bassinette, crib or portable play yard.
- Breastfeeding has been shown to decrease the risk of SUIDS. You may breastfeed your baby in bed with you, but always remember to put them back in their separate safe place to sleep when you are finished nursing if you fall asleep while nursing, put your baby back into their bed as soon as you wake up.
Make a Safe Home Environment
Never let anyone smoke around your baby. SUIDS occurs more often in babies who are around smoke than in babies who have a smoke-free environment.
Pacifier use can help prevent SUIDS.
- Offer a clean, dry pacifier to your baby at sleep times.
- Do not force your baby to use a pacifier.
- If the pacifier falls out while the baby is sleeping, you do not need to put it back in the baby’s mouth.
- Do not attach a pacifier to your baby’s clothing, prop the pacifier or use pacifiers attached to stuffed animals.
Keep sleeping rooms a comfortable temperature.
- If you are comfortable in the room, then your baby will be, too.
- Do not overheat your baby. Overheating may cause problems with the control the baby’s brain has over-breathing and waking up. Do not over-bundle your baby. They should not feel hot to the touch.
- Babies need one more layer of clothing than adults. You can put an Onesie under the pyjamas, or dress your baby in warmer pyjamas than you would wear.
- Use a sleep sack or wearable blanket instead of loose blankets to keep your baby warm.
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Ask your baby’s health care providers about over-the-counter products.
- Do not use products that claim to reduce the risk of SUIDS, such as wedges, or baby positioners. These products have not been tested for effectiveness or safety.
- Do not use non-prescription home monitors for your baby to reduce the risk of SUIDS. If your baby has a medical reason for a monitor, the doctor will prescribe a medical home monitor for them.
When babies are young, their heads are still very soft. Sleeping on their backs can sometimes make the backs of their skulls a little bit flat over time. This is called positional plagiocephaly. It normally gets better without any medical help by the time babies are 12 months old.
If it’s worrying you, you can gently alternate the tilt of your baby’s head each time you put your baby into bed to sleep. But always put your baby on their back to sleep. Then keep your baby off the back of their head as much as possible when awake. Tummy time can help you do this.