Important Safe Sleep Guidelines for Newborns
The American Academy of Pediatrics (AAP) has developed a list of recommendations to reduce the risk of sleep-related infant deaths in the first year of life. It should be noted that, because there are no randomized controlled trials with regard to SIDS and other sleep-related deaths, case-control studies are the best evidence available.
DOs
Alone
Babies should sleep alone, in their own sleep space, to reduce the risk of entrapment and suffocation. With the exception of a pacifier, nothing else should be placed into the crib with the baby.
Keep soft objects, such as pillows, stuffed animals, quilts, comforters, mattress toppers, crib bumpers, and loose bedding, such as blankets and non-fitted sheets, away from the infant’s sleep area.
Back to Sleep
Babies should be placed on their backs for all naps and nighttime sleep. It is believed that babies not only clear their airways more easily while on their backs, they also rouse more easily from deep sleep when something is wrong.
Firm and Flat
Use a firm, flat, non-inclined sleep surface to reduce the risk of suffocation or wedging/entrapment.
Babies should be placed on a product that meets the safety standards of the Consumer Product Safety Commission (CPSC). This includes playards, bassinets and traditional cribs.
Breastmilk
Feeding of human milk is recommended because it is associated with a reduced risk of SIDS.
Room-Sharing
It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for at least the first 6 months.
Pacifier
Using a pacifier for naps and nighttime sleep has been shown to lower the risk of SIDS. This is because a pacifier can bring your baby's tongue forward and jaw to drop slightly, opening their airway a bit.
Prenatal Care
Regular prenatal visits can reduce the risk of SIDS by allowing healthcare providers to monitor the health of the developing baby, identify potential risk factors early on, and address issues like smoking or poor nutrition during pregnancy, which can significantly increase the likelihood of a baby being born prematurely or with a low birth weight - both major risk factors for SIDS; essentially, good prenatal care promotes a healthy pregnancy, leading to a healthier baby with a lower risk of sudden infant death syndrome.
Tummy Time
Supervised, awake tummy time is recommended to strengthen baby’s neck, shoulder, and arm muscles. Parents are encouraged to place their baby in tummy time while awake and supervised for short periods of time beginning soon after the umbilical cord stump falls off.
DON’Ts
Bed Sharing
The safest place for a baby to sleep is on a separate sleep surface designed for infants close to the parents’ bed.
However, the AAP acknowledges that parents frequently fall asleep while feeding the infant. Evidence suggests that it is less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair, should the parent fall asleep.
Tobacco, Alcohol and Other Substances
Avoid smoke and nicotine exposure, alcohol, opioids, and illicit drug use during pregnancy and after birth.
Overheating
Avoid overheating and head covering in infants.
While hats can be used for newborns in the first few hours after birth, especially in a hospital setting, it’s not recommended to put hats on newborns while they sleep as it can increase the risk of overheating and suffocation.
Heart-Rate Monitors
Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. Despite marketing language that implies increased safety, there's no medical evidence that consumer pulse oximeters like Owlet reduce the risk of SIDS.
If a baby is deemed to require a cardiorespiratory monitor, they will be sent home with one upon discharge from the hospital.
Unsafe Products
Avoid the use of commercial devices that are inconsistent with safe sleep recommendations. Don’t leave your baby unsupervised in products that aren’t designed for safe sleeping. Inclined products with an angle greater than 10º - such as rockers, gliders, and swings - should never be used for infant sleep.
Products that are marketed for infant sleep but not approved by the Consumer Product Safety Commission (CPSC) for safe sleep include Mamaroos, baby loungers (like DockATots), wedge pillows, etc.