Safe Sleep: What Every New Parent Should Know About Infant Sleep

Few things make a new parent more anxious than sleep.

You may spend hours researching bassinets, swaddles, sleep sacks, monitors, and mattresses, wondering whether you've created the safest possible place for your baby to sleep.

The good news is that safe sleep doesn't require a complicated setup.

The most important recommendations are surprisingly simple: where your baby sleeps, how your baby is positioned, and what is—or isn't—in the sleep space.

Always put your baby on their back

The most important safe-sleep recommendation is also one of the simplest:

Place your baby on their back for every sleep—naps and nighttime.

Research has consistently found that placing infants on their backs is associated with a substantially lower risk of sudden infant death syndrome (SIDS) and other sleep-related infant deaths than placing them on their stomachs or sides.

And this recommendation applies even if your baby seems to sleep more soundly on their stomach.

Once a baby can independently roll from back to front and front to back, parents generally don't need to continually reposition them. But until then, every sleep should begin with baby on their back.

Give baby their own sleep space

The safest place for an infant to sleep is a separate, firm, flat sleep surface designed for infants.

That could be a crib, bassinet, or portable play yard that meets applicable safety standards.

Room-sharing—having your baby's sleep space in your bedroom—is recommended because it allows you to keep your baby nearby while avoiding the additional risks associated with bed-sharing.

This distinction is important:

Room-sharing is not the same thing as bed-sharing.

Having your baby close to you can make nighttime feeding and comforting easier without putting the baby on the same sleep surface.

Keep the sleep space boring

When it comes to infant sleep, boring is good.

The sleep surface should be firm and flat, with a fitted sheet designed for that particular mattress.

That's it.

Avoid adding pillows, blankets, stuffed animals, bumpers, wedges, positioners, or other soft objects to the sleep space.

These products may look cozy, but an infant's ability to move away from an object that obstructs breathing is limited.

A minimalist sleep space isn't about aesthetics.

It's about reducing hazards.

What about swaddling?

Swaddling can help some newborns feel secure and may reduce startling during sleep.

But it needs to be done safely.

A swaddled baby should always be placed on their back, and swaddling should stop as soon as the baby shows signs of trying to roll.

Once a baby begins attempting to roll, they need to be able to move their arms freely.

Sleep sacks that allow the baby to move their hips and legs freely can be an alternative to loose blankets.

What about sleeping in a car seat?

Car seats are designed for transportation—not routine sleep.

If your baby falls asleep during a car ride, that's completely understandable. But once you're no longer traveling, move the baby to a safe, firm, flat sleep surface as soon as reasonably possible.

The same principle applies to other sitting devices.

A product can be perfectly appropriate for its intended purpose without being an appropriate place for unsupervised sleep.

What about overheating?

Babies don't need to be bundled excessively for sleep.

Overheating has been associated with increased risk of SIDS, so dress your baby appropriately for the room rather than relying on heavy blankets.

As a general rule, your baby usually needs only about one additional layer compared with what a comfortable adult would wear in the same environment.

What about breastfeeding and safe sleep?

Breastfeeding is associated with a lower risk of SIDS, although researchers are still studying exactly why.

That doesn't eliminate the need for safe sleep practices.

Breastfeeding and safe sleep work together.

If you bring your baby into bed for feeding or comforting, the safest practice is to return the baby to their own sleep space when you are ready to sleep.

This is particularly important because exhausted parents can unintentionally fall asleep while feeding.

The bottom line

Safe sleep doesn't require buying every product marketed to new parents.

In fact, the safest sleep environment is often the simplest one:

Baby on their back.

Firm, flat sleep surface.

Their own sleep space.

No pillows, loose blankets, stuffed animals, or other soft objects.

Room-share rather than bed-share.

Keep the baby's sleep environment comfortably cool rather than overheated.

Parents are often told that good parenting means anticipating every possible danger.

When it comes to sleep, you don't have to create a perfect environment.

You need to create a simple, consistent, evidence-based one.

And sometimes the safest nursery is the least exciting one.

Sources & Further Reading

The American Academy of Pediatrics' evidence-based safe-sleep recommendations provide detailed guidance for parents and clinicians.

Moon RY, et al. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics. 2022.

A systematic review of infant sleep position research found evidence supporting the supine (back) sleeping position as the safer position for infants.

For parents, recommendations can change as new evidence emerges, so current guidance from organizations such as the American Academy of Pediatrics and the U.S. Consumer Product Safety Commission should be consulted when making decisions about a baby's sleep environment.