Herbie Murray
Creating a safe sleep environment for newborns is crucial to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths, such as accidental suffocation. The American Academy of Pediatrics (AAP) emphasizes the need for infants to sleep on their backs on flat, non-inclined surfaces without any soft bedding or other objects that could cause entrapment. This recommendation is based on years of warnings about the dangers of babies sleeping prone or on their sides, which can increase the risk of rebreathing expired gases, leading to hypoxia and hypercapnia, as well as overheating. Additionally, car seats, strollers, and sitting devices are not recommended as regular sleep spaces for newborns, and they should be moved to a flat, firm sleep surface as soon as possible if they fall asleep in these devices.
| Characteristics | Values |
|---|---|
| Safe sleep position | On their back |
| Safe sleep surface | Firm, flat, and level |
| Safe sleep environment | Crib, bassinet, or play yard |
| Safe sleep location | In their own crib, bassinet, or play yard in the parents' or caregivers' bedroom |
| Safe bedding | No soft bedding such as nests, bumpers, sheepskins, additional padding, additional mattresses, or pillows |
| Safe sleep practices | Avoid bed-sharing, sitting devices (e.g. car seats, strollers), and inclined surfaces |
| Risk factors | Positional asphyxia, suffocation, choking, aspiration, rebreathing expired gases, hypoxia, hypercapnia, and overheating |
| Guidelines | American Academy of Pediatrics (AAP), Australian and New Zealand Standards (AS/NZS 2172 and AS/NZS 2195) |
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What You'll Learn
Safe sleep environment
Creating a safe sleep environment for newborns is crucial to reduce the risk of sleep-related injuries and fatalities, including Sudden Infant Death Syndrome (SIDS) and accidental suffocation. Here are some detailed guidelines to ensure a safe sleep environment for your newborn:
Sleep Position and Surface
It is recommended that newborns sleep on their backs on a firm, flat, and level surface, such as a crib with a fitted sheet. This position helps prevent choking and reduces the risk of SIDS. Soft surfaces, inclines, and items like pillows, quilts, and blankets should be avoided as they increase the risk of suffocation and SIDS.
Sleep Space
The sleep space should be kept clear of any objects, including loose blankets, pillows, stuffed toys, and bumpers. Newborns should not sleep on adult beds, couches, or armchairs, or in sitting devices like swings or car seats (unless in transit). These environments can increase the risk of accidental suffocation or strangulation.
Room-Sharing
It is recommended that newborns share a room with their caregivers, as this has been shown to decrease the risk of SIDS by up to 50% and is safer than bed-sharing.
Additional Considerations
Breastfeeding, human milk feeding, and avoiding exposure to substances like nicotine, alcohol, and drugs are encouraged by organizations like the AAP to promote safe sleep and reduce the risk of SIDS.
By following these guidelines, you can help create a safe sleep environment for your newborn, reducing the risk of sleep-related injuries and fatalities.
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Safe sleep positions
Newborns and infants should always sleep on a flat surface, and it is recommended that they sleep on their back. Sleeping on the back on a flat, firm surface is thought to reduce the risk of choking, coughing, gagging, and aspiration. Sleeping on the back also prevents the rebreathing of expired gases, which can lead to hypoxia and hypercapnia, as well as overheating.
The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs on a firm surface that meets federal safety standards, with nothing else in the space. This means no soft bedding, nests, bumpers, pillows, or additional padding. The AAP also warns against bed-sharing, and babies should never sleep on an adult bed, couch, or armchair, either alone or with others. Couches and armchairs are particularly dangerous when an adult falls asleep on them while feeding or comforting the baby.
Babies should also not sleep in car seats, strollers, or sitting devices. If a baby falls asleep in one of these devices, they should be moved to their regular sleep space as soon as possible.
Swaddling is considered safe for newborns and can help them sleep, but once they start to roll, they should be out of the swaddle.
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Safe sleep surfaces
It is important to create a safe sleep environment for newborns to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths, such as accidental suffocation. Here are some guidelines for creating a safe sleep surface for your baby:
Firm and flat surface
It is recommended to place your baby on a firm, flat surface to sleep. This means choosing a firm mattress that returns to its original shape quickly when pressed on. The surface should be flat like a table, not a hammock, and level, not at an angle or inclined. A flat surface does not increase the risk of choking or aspiration, even if coughing and gagging may sometimes be mistaken for choking.
Crib, bassinet, or play yard
The safest place for a baby to sleep is in a crib, bassinet, or play yard with only a fitted sheet covering the mattress. Avoid using soft bedding such as nests, bumpers, sheepskins, additional padding, pillows, or extra mattresses. These soft surfaces can increase the risk of SIDS and other sleep-related deaths. Make sure to follow safety standards and guidelines when choosing a crib or bassinet.
Back sleeping position
It is recommended to always place your baby on their back to sleep, even if they change position on their own. Sleeping on the back reduces the risk of rebreathing expired gases, which can lead to hypoxia and hypercapnia, as well as overheating. This recommendation applies for the first year of your baby's life.
Avoid bed-sharing
Babies should never sleep on an adult bed, couch, or armchair, either alone or with others. Couches and armchairs are especially dangerous when an adult falls asleep while feeding or comforting the baby. Instead, place your baby in their own safe sleep space as soon as possible.
Swaddling
Swaddling is considered safe for newborns and can help them sleep safely on their backs. It replicates the feeling of being in the womb and can be continued until the baby shows signs of rolling. However, once the baby starts rolling, it is important to stop swaddling to avoid restricting their movement.
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Safe bedding
Newborns should always sleep on their backs on a firm, flat, and level surface, such as a crib, bassinet, or portable play yard. This is because soft surfaces, such as couches, sofas, waterbeds, memory foam, air or pillow-top adult mattresses, quilts, blankets, and sheepskins, are associated with a higher risk of SIDS and other sleep-related deaths. Soft bedding can cause accidental suffocation and strangulation, and the American Academy of Pediatrics (AAP) recommends keeping soft objects and loose bedding away from infants.
According to the AAP, babies should sleep in a separate sleep space made for infants, such as a crib, bassinet, or portable play yard, in the same room as parents or adults. Room sharing without bed sharing reduces the risk of SIDS by as much as 50% compared to sharing an adult bed or sleeping in a separate room. It is important to keep the baby's sleep area clear of any items that could pose a danger, such as pillows, stuffed toys, and loose bedding.
To create a safe sleep environment for newborns, follow these guidelines:
- Use a firm, flat, and level sleep surface: The sleep surface should be firm enough to return to its original shape quickly when pressed on and flat like a table, not a hammock. It should also be level, not at an angle or inclined.
- Avoid soft bedding: Do not use blankets, quilts, pillows, or other soft objects in the baby's sleep area. These can increase the risk of suffocation and strangulation.
- Create a safe sleep space: Remove all items and bedding from the area if you plan to bring the baby into your bed. This includes pillows, blankets, and unfitted sheets to reduce the risk of suffocation and strangulation.
- Room-sharing is recommended: The baby should sleep in the same room as the parents or adults, but in their own sleep space, such as a crib, bassinet, or portable play yard.
- Follow safety standards: Ensure that any baby products used for sleep meet federal safety standards and are approved by reputable organizations like the AAP.
By following these safe bedding practices, you can help reduce the risk of SIDS and create a safe and comfortable sleep environment for your newborn.
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Safe sleep spaces
Creating a safe sleep environment for your newborn is crucial to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths, such as accidental suffocation. Here are some detailed guidelines to ensure your newborn has a safe sleep space:
Sleep Position
The recommended sleep position for newborns is on their backs on a firm, flat surface. This position is emphasised by the American Academy of Pediatrics (AAP) and other health organisations. Sleeping on the back reduces the risk of rebreathing expired gases, which can lead to hypoxia and hypercapnia, as well as overheating.
Sleep Surface
The sleep surface should be firm, flat, and level. A crib, bassinet, or play yard with a fitted sheet is recommended. The surface should quickly return to its original shape when pressed on and should not be soft or inclined. Soft surfaces, such as couches, sofas, waterbeds, memory foam, and adult mattresses, are not safe for newborns as they increase the risk of suffocation.
Sleep Location
It is recommended to place your newborn in a crib, bassinet, or travel cot that meets current safety standards. Bassinets can be used in the parents' or caregivers' bedroom for the first few months. If using a bassinet, follow the guidelines from the relevant consumer safety commission. Car seats, strollers, and sitting devices are not recommended for regular sleep or naps.
Bedding and Surroundings
The sleep space should be clear of any objects, including soft bedding, nests, bumpers, pillows, additional padding, or rolled blankets. These items can increase the risk of suffocation or entrapment. Swaddling is considered safe for newborns until they show signs of rolling. It replicates the feeling of being in the womb and helps newborns sleep safely on their backs.
Other Considerations
It is important to note that the newborn curl, where newborns naturally curl to their side in a fetal position, is a normal physiological response and not a cause for anxiety. Additionally, human milk feeding, tummy time, and the use of a pacifier are encouraged by the AAP to reduce the risk of SIDS.
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Frequently asked questions
Yes, newborns should sleep on a firm, flat surface. Soft surfaces or surfaces that elevate the baby's head and feet are not safe for newborns to sleep on.
A firm, flat surface for sleeping does not increase the risk of choking or aspiration. Sleeping on a flat surface also lowers the risk of rebreathing expired gases, which can lead to hypoxia and hypercapnia, as well as overheating.
Safe sleep environments for newborns include a crib, bassinet, or play yard with a firm, flat surface and nothing else in the crib. Newborns can also sleep in a cot or travel cot that meets the current Australian and New Zealand Standards (AS/NZS 2172) and AS/NZS 2195).
Unsafe sleep environments for newborns include soft surfaces such as couches, sofas, waterbeds, memory foam, air or pillow-top adult mattresses, quilts, blankets, and sheepskins. Car seats, strollers, and sitting devices are also not recommended as regular sleep spaces for newborns.
