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6 tips to help your infant sleep safely

Curtis McDonald, MD

Babies are precious beyond belief. Discover how to help them sleep safely, and learn why experts make the sleep recommendations they do, below:

  1. Put babies to sleep on their backs on a firm and flat surface. The annual Sudden Infant Death Syndrome (SIDS) rate has declined by 50 percent since the American Academy of Pediatrics started recommending back-sleeping in 1992. Researchers suspect one of the reasons this position is safer is because it allows infants to get more oxygen and avoid rebreathing air. What’s more, babies have an easier time swallowing spit-up while lying on their backs.
  2. Transfer sleeping infants out of swings, bouncers, sleepers, slings, and car seats. These devices do not meet U.S. standards for safe sleep. They are often built with inclines that can allow children’s heads to droop and airways to collapse. Some have an unsafe amount of padding or straps that can cause entanglements. Babies who fall asleep in them should be moved to their crib or bassinet. Car seats remain the safest place for children to be while on the road—and it’s fine if infants fall asleep while in the vehicle. Just move them once the destination has been reached.
  3. Allow infants to room-share, not bed-share. When infants room-share with a parent it decreases the risk of SIDS by as much as 50 percent. However, co-sleeping or bed-sharing is not recommended. Pillows, sheets, blankets, and soft adult mattresses pose a suffocation risk. Overheating is another concern. It’s also possible for adults to accidently roll on top of their babies. Bed-sharing is particularly risky if:
  • Babies are younger than 4 months old, born premature, or born at a low birth weight
  • Mothers smoked during pregnancy
  • Adults are overweight or obese
  • Adults smoke, drink alcohol, use drugs, or take prescription medications
  • Adults are not the parents.

Bring infants into an adult bed only to comfort or feed them. However, if parents believe they might possibly fall asleep, it’s better to take babies to bed—removing hazardous sheets, pillows, and blankets—than to fall asleep with them on a couch or chair.

  1. Keep toys and bedding out of the crib. Blankets, sheets, crib bumpers, stuffed animals, and toys pose a suffocation and strangulation risk. Use a wearable sleep sack to keep babies warm, choose a breathable mesh crib bumper—or none at all, and save the “luvies” for when babies are awake.
  2. Breastfeed, if possible. One study found that, compared with formula-fed babies, babies breastfed for at least two months had half the risk of SIDS. There could be a few reasons for this: Research shows that breastfed babies wake up more easily than formula-fed babies. Because an inability to wake up easily may be a contributing factor to SIDS, breastfeeding may be protective. Viral infections are also a SIDS risk factor. Breastfeeding boosts their immune system and keeps them from getting sick.
  3. Avoid relying on specialized monitors. Oxygen and heartrate monitors and motion sensors are not approved medical devices and may not provide accurate results. There’s also no evidence that they reduce the risk of SIDS. They aren’t harmful if used properly, however. The biggest concern with them is that parents may choose unsafe sleep environments based on the false belief that the device will protect their infants. Putting babies to sleep on their bellies is risky even with a monitoring device.

Other ways to keep infants safe during naps and at night include:

  • Making time for tummy time. Building strength during the day allows babies to more easily move out of unsafe situations during sleep.
  • Introducing pacifiers after breastfeeding is established. Pacifiers reduce the risk of SIDS.
  • Avoiding co-sleepers. Co-sleepers designed for bed-sharing may be unstable, may not properly protect infants from adult pillows and bedding, and may still allow adults to roll into a baby’s sleep space. Side sleepers may create gaps between the two mattresses, leading to entrapment.
  • Keeping current on well-child visits. Helping babies stay healthy, and vaccinating per the recommended schedule, means fewer illnesses and respiratory problems.

If you have questions about how to create a safe sleep space for your baby, talk to your pediatrician.

Dr. Curtis McDonald is a pediatrician at Vancouver Clinic and the father of four children. His goal as a provider is to empower moms and dads with information so that they can make the best choices for their families.