Many new parents tell me the hardest part of the first months is not the feeds or the nappies. It is lying awake, checking that the baby is still breathing. October is SIDS Awareness Month, so here are the simple, proven steps that make sleep safer.
Quick answer: Put your baby to sleep on their back, for every nap and every night, on a firm, flat surface with nothing else in it. Keep their cot or bassinet in your room, next to your bed, but not in your bed. Avoid smoke, don’t let your baby get too warm, and breastfeed if you can.
What is SIDS?
Sudden infant death syndrome (SIDS) is the sudden, unexplained death of a healthy-seeming baby under one year old, usually during sleep. The NHS notes that it is rare and most likely in the first six months. We don’t know exactly what causes it, and nothing can guarantee prevention, but we do know which habits lower the risk. The same habits also prevent accidental suffocation in bed. Babies born early or small (under 2.5 kg) and babies under four months need extra care.
Seven safe sleep steps
- Back to sleep, every time. Side-sleeping is as risky as tummy-sleeping, because babies roll from the side onto the tummy easily.
- Firm and flat. Use a cot or bassinet with a well-fitting mattress and only a fitted sheet. The American Academy of Pediatrics (AAP) says any surface tilted more than 10 degrees is not safe for sleep.
- Share the room, not the bed. The AAP advises room-sharing for at least the first six months; it can lower SIDS risk by as much as half. If you feed your baby in bed, put them back in their own space before you fall asleep.
- Clear the cot. No pillows (including small “head-shaping” pillows), quilts, bumpers, soft toys or rolled towels. If your baby feels cool, add a layer of clothing or use a wearable sleeping bag.
- Don’t overheat. Dress your baby in just one layer more than you are wearing, and skip the cap indoors once you’re home. Feel the chest or back of the neck: sweating or a hot chest means too warm. Cool hands and feet are normal.
- Smoke-free, always. No smoking or vaping during pregnancy or anywhere near your baby, even outdoors.
- Breast milk and a dummy. Breastfeeding lowers SIDS risk, and so does a pacifier (dummy) at sleep time once breastfeeding is going well.
Common situations at home
Babies often doze off in a car seat, stroller, cloth jhoola or swing. That is fine while you are watching, but move them to a flat cot on their back as soon as you can. Never sleep with your baby on a sofa or armchair; the AAP warns the risk can be up to 67 times higher. And bed-sharing is especially dangerous if anyone in bed smokes, has had alcohol or takes medicine that causes drowsiness, or if your baby was premature. For preemies, the NHS advises following safe sleep advice for a full year from the due date. (More on caring for preterm babies.)
Keeping up with routine vaccines, like the polio doses, also matters: the AAP notes that infant vaccinations may help protect against SIDS. During the day, give plenty of supervised tummy time to build strength and prevent a flat head. Share these rules with grandparents and nannies too; the US Safe to Sleep campaign has simple checklists.
When to seek care
Call an ambulance (108) or go to emergency immediately if your baby stops breathing, will not wake, is struggling for breath, turns blue, grey or very pale, or becomes limp and floppy. See your pediatrician soon if you’re worried about your baby’s breathing, feeding or weight gain. If you’d like help planning a safe sleep space for a newborn or a preemie, you’re welcome to book a visit with me.
Key takeaways
- Back to sleep, on a firm, flat surface, for every sleep.
- Room-share close to your bed, but don’t bed-share.
- Nothing in the cot but your baby and a fitted sheet.
- Keep your baby smoke-free and not too warm.
Frequently asked questions
Won’t my baby choke if they sleep on their back?
No. The American Academy of Pediatrics explains that a baby’s airway anatomy and gag reflex protect them on their back. Even babies with reflux should sleep flat on their backs unless your pediatrician advises otherwise.
Can I use a small pillow to give my baby a round head?
Please don’t. Pillows of any kind in the sleep space raise the risk of suffocation. Supervised tummy time while your baby is awake, building up to 15 to 30 minutes a day by about 7 weeks, is the safe way to prevent a flat spot.
My baby has started rolling onto the tummy at night. What should I do?
Always put your baby down on their back. Once they can roll both ways on their own, you don’t need to keep turning them back, as long as the cot has nothing in it but a fitted sheet.
Is swaddling safe?
Swaddling is fine if your baby likes it, but it does not lower SIDS risk. Keep a swaddled baby on their back, leave room for the hips to move, and stop swaddling once your baby shows signs of trying to roll, often around 3 to 4 months.
Disclaimer: This article is for general information and does not replace a medical consultation. Please see your pediatrician for advice about your child.
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