safe sleep for babies
Sleep Tips

The Critical Role Parents Play in Ensuring Safe Sleep For Babies

Released in the form of a report from the American Academy of Pediatrics, an important  study of babies' nighttime sleep environments sheds light on just how well new parents are (or are not) faring when it comes to keeping their slumbering babies safe. And, the results are clear: there's definite room for improvement.

U.S. Parents Have Room for Improvement on Sleep Safety


For many, myself included, the over-arching conclusion that babies are still not being put in safe sleep environments comes as a bit of a surprise. After all, longstanding pediatric and public education efforts have been in place for nearly 25 years to actively promote safe sleep in the parenting world — efforts now known as  The Safe to Sleep campaign that date back to the early 1990s. The fact of the matter is that we now have decades' worth of knowledge and evidence about how to keep babies safe and significantly decrease the likelihood that tragedy will strike in the form of Sudden Infant Death Syndrome (SIDS) and/or accidental suffocation or strangulation.

So, what was the reason for the “room for improvement" rating? Unlike the many studies that have come before it, this new infant sleep study didn't involve just  asking parents about their babies' bedtime routines and sleep habits. Rather, parents were actually  videoed in their homes on three separate nights (when their babies were 1, 3 and 6 months of age) as they went about their parenting business of putting their babies to sleep for the night. What researchers witnessed was that despite being aware that they were being recorded, a majority of parents nevertheless ended up putting their babies at risk by putting them to sleep in unsafe environments. From the use of soft bedding and bumpers to unsafe sleep surfaces and unsafe sleep positions (putting babies down on their side or stomach instead of on their back), the findings were both disconcerting and dangerous.

7 Principles for Safe Sleep for Babies

So, how should babies sleep? Beyond all else, babies should sleep safely. However, it's clear that something more is needed to help all parents not only understand, but then  put into practice all of the many safe sleep recommendations we now have available to us. For my part, however, the results nevertheless compel me to make very sure that everyone is aware of the following  Safe to Sleep principles so critical to keeping babies safe. These recommendations include:

1. Back to sleep.

Over two decades worth of research confirms that of all the baby sleeping positions, babies sleep safest on their backs. Be aware that sleep positioners and/or wedges are not considered to be safe and should not be used. Also, remember that this “back to sleep" rule specifically applies to times of  sleep. In contrast, babies benefit from being given plenty of supervised time on their tummies while awake. Time spent on their stomachs during waking hours allows babies to strengthen their head and neck muscles and also helps minimize their chances of developing a flat head (from spending so much time on their backs).

2. Nothin' But Baby

As boring as it may seem, it's also simple to remember: nothing (but baby, of course) has any place in a safe sleep environment. The fact of the matter is that the safest sleep environment for babies is one that has no bumpers, no baby sleeping pillow, no blankets and no toys.

3. Treat Nap-time and Nighttime the Same

SIDS and/or suffocation risks are the same regardless of time of day. Be aware that naps are no exception to the safe sleep rules. It's just as important to ensure a safe sleep environment during the day as it is the night.

4. Share a Room, Not a Bed

It's especially important to recognize that co-sleeping and/or room-sharing are not the same thing as bed-sharing. While room-sharing is encouraged, sharing a bed with an adult puts babies at greater risk of SIDS and/or suffocation. That's why babies should always sleep in their own safety-approved crib, bassinet, play-pen or co-sleeper.

5. Start Babies Out on “Solid" Ground

Some may wonder how long can a baby sleep in a bassinet, and this can vary for each child (depending on weight, age and growth). However, it's important to know that when babies sleep on soft surfaces such as beds, pillows or couches, all pose a very serious risk to safe sleep. For safety's sake, babies need to sleep on firm sleep surfaces — ideally in the form of a safety-approved  crib mattress covered by a well-secured fitted sheet.

6. Don't Go Soft on Safety

When it comes to creating a safe sleep environment, anything soft and fluffy should signal cause for concern. On the list for exclusion from the crib are pillows, quilts, sheepskins, and yes — even crib bumpers and baby blankets. As a comforting alternative to blankets, parents can consider a sleep- or swaddle-sack, and simply dress babies for bedtime in the desired number of layers (typically recommended as just one layer more than an adult would wear).

7. Make Sure Everyone Plays by the Same Rules


Whether a family member, friend or child care provider, anyone and everyone responsible for putting a baby down to sleep should commit to playing by the same safe sleep rules.

In addition to making sure the conditions are right and committing to having babies sleep in safe sleep environments each and every time they go to sleep, it's also worth remembering that there are several other measures parents can take to significantly reduce the risk of SIDS. They include breastfeeding, quitting smoking (or at least making sure babies aren't exposed to second hand smoke by avoiding smoking indoors, in the car, or anywhere else where babies spend their time). And finally, since knowing what to do is clearly different from actually knowing how to do it, as a pediatrician and as a mom I encourage everyone to ask for help, tips and/or tricks to ensure safe sleep for babies!

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