Safe Sleep for Babies: A Complete Guide for New Parents

Few things feel more vulnerable than watching your tiny newborn sleep—and wondering if you're doing everything right to keep them safe. If you've found yourself checking on your baby multiple times a night, adjusting their blanket, or lying awake worrying, you're in good company. Safe sleep is one of the most important things you can do for your baby, and getting it right is simpler than you might think.

This guide will walk you through everything you need to know about creating a safe sleep environment, based on the latest recommendations from the American Academy of Pediatrics. AAP

The ABCs of Safe Sleep

The foundation of safe sleep can be remembered with a simple acronym: ABC. AAP

A - Alone: Your baby should sleep alone in their own sleep space. This means no toys, pillows, blankets, bumper pads, or other people in the sleep area. While it might seem lonely or cold, babies are safest with nothing but a fitted sheet in their crib.

B - Back: Always place your baby on their back for every sleep—naps and nighttime. Back sleeping has reduced SIDS rates by more than 50% since the recommendation began in the 1990s. NIH Once your baby can roll both ways on their own (usually around 4-6 months), you don't need to reposition them if they roll during sleep.

C - Crib: Use a firm, flat surface designed for infant sleep. This includes cribs, bassinets, portable cribs, and play yards that meet current safety standards. The mattress should be firm enough that it doesn't indent when your baby lies on it.

Creating the Safest Sleep Environment

Your baby's sleep space should be boring—and that's a good thing. Here's how to set it up: AAP

The mattress: Use only the mattress that came with your crib or bassinet. It should be firm and flat, with a tightly fitted sheet. Never add a mattress topper, memory foam, or any padding.

What to leave out: Remove all soft objects from the sleep area:

• Pillows and pillow-like toys
• Blankets, quilts, and comforters
• Bumper pads (including mesh ones)
• Stuffed animals and loveys
• Sleep positioners and wedges
• Loose bedding of any kind

Room temperature: Keep the room at a comfortable temperature—between 68-72°F (20-22°C) is ideal. If you're comfortable in light clothing, your baby probably is too. Overheating is a risk factor for SIDS. AAP

Room sharing: The AAP recommends that babies sleep in their parents' room, close to their bed, but on a separate surface for at least the first 6 months—ideally the first year. Room sharing (not bed sharing) can reduce SIDS risk by up to 50%. AAP

What Your Baby Should Wear to Sleep

Skip the blankets and opt for wearable blankets or sleep sacks instead. These keep your baby warm without the suffocation risk of loose bedding. AAP

Choosing sleepwear:

• Use a onesie or footed pajamas appropriate for the room temperature
• Add a sleep sack or wearable blanket if extra warmth is needed
• Avoid anything with hoods, strings, or ties
• Don't overdress—if your baby is sweating or their chest feels hot, remove a layer

Swaddling: Swaddling is safe for newborns who aren't yet rolling, but follow these guidelines:

• Stop swaddling when your baby shows signs of trying to roll (usually around 2 months)
• The swaddle should be snug around the chest but allow hip movement
• Always place a swaddled baby on their back
• Never use weighted swaddles AAP

Understanding SIDS and How to Reduce Risk

Sudden Infant Death Syndrome (SIDS) is the unexplained death of a baby under one year old, usually during sleep. While SIDS cannot be completely prevented, following safe sleep practices significantly reduces the risk. NIH

Key protective factors:

• Back sleeping for every sleep
• Firm, flat sleep surface with nothing in it
• Room sharing without bed sharing
• Breastfeeding (any amount helps)
• Pacifier use at sleep times (after breastfeeding is established)
• Avoiding smoke exposure during pregnancy and after birth
• Avoiding alcohol and drug use during pregnancy
• Keeping up with prenatal care and well-baby visits AAP

Risk factors to be aware of:

• Premature birth or low birth weight
• Sleeping on soft surfaces or with soft bedding
• Overheating
• Exposure to cigarette smoke
• Sleeping on stomach or side

Bed Sharing: What You Need to Know

The AAP recommends against bed sharing due to the risks of suffocation, strangulation, and entrapment. The risks are particularly high if: AAP

• Either parent smokes (even if not in bed)
• The mother smoked during pregnancy
• Either parent has consumed alcohol or sedating medications
• The baby was premature or low birth weight
• The baby is under 4 months old
• The sleep surface is soft (couches and armchairs are especially dangerous)

If you're breastfeeding at night: Many parents bring baby into bed to nurse. If you fall asleep, the risk is lower if you're breastfeeding, baby is healthy and full-term, there's no soft bedding, and neither parent has consumed alcohol or sedating substances. But the safest practice is to return baby to their own sleep space after feeding.

Couch and armchair sleeping: Never fall asleep with your baby on a couch, armchair, or recliner. These are the most dangerous places for a baby to sleep, with suffocation risk up to 50 times higher than a crib. AAP

Common Safe Sleep Questions

"My baby only sleeps on their stomach/in their swing/on me—what do I do?"

Many babies prefer positions or places that aren't safe for sleep. This is normal but needs to be addressed. Try:

• Swaddling (if not yet rolling) to help baby feel secure on their back
• Warming the crib sheet before placing baby down
• Putting baby down drowsy but awake to get used to the crib
• Using white noise to help the transition
• Being patient—it may take time for baby to adjust

"Can my baby sleep in a car seat, swing, or bouncer?"
These are not safe for unsupervised sleep. If your baby falls asleep in one, transfer them to a flat, firm surface as soon as possible. Car seats should only be used for travel. AAP

"What about inclined sleepers and baby loungers?"
Inclined sleepers have been recalled due to infant deaths and should not be used. Baby loungers (like the Dock-a-Tot or Snuggle Me) are not safe for sleep—they're designed for supervised lounging only. CPSC

"When can I add a blanket or stuffed animal?"
The AAP recommends waiting until at least 12 months to add soft objects to the sleep space. By this age, most babies have the motor skills to move away from objects covering their face.

Signs of a Safe Sleep Setup

Do a quick check of your baby's sleep space:

✓ Baby is on their back
✓ Mattress is firm and flat
✓ Sheet is tight-fitting
✓ Nothing else is in the crib (no toys, pillows, blankets, bumpers)
✓ Room is at a comfortable temperature
✓ Baby isn't overdressed
✓ Sleep space is in your room but on a separate surface

When to Call Your Pediatrician

Contact your doctor if you notice:

• Your baby has difficulty breathing during sleep
• Your baby is consistently hard to wake
• Your baby seems to stop breathing during sleep
• You have concerns about your baby's sleeping patterns or positions
• Your baby was premature and you need guidance on safe sleep modifications

The Bottom Line

Safe sleep doesn't have to be complicated. Remember: Alone, on their Back, in a Crib. Every sleep, every time. While it might feel hard to resist adding a cozy blanket or snuggly toy, a bare crib is the safest crib. Trust that your baby has everything they need—a safe place to sleep and you nearby.

If you have questions about your specific situation or your baby's sleep, Clara is here to help you think through it.