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The ultimate guide to safe sleep

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In an effort to reduce the risk of SIDS (sudden infant death syndrome), here are some safe sleep recommendations.

Top tips for safe sleep

  • Place baby to sleep on his or her back on a firm sleep surface, such as a safety-approved crib mattress (crib that meets CSPC guidelines).
  • Ensure that baby’s crib or bassinet has no bumpers (including mesh), stuffed animals, pillows, or blankets. Just baby in the crib. Baby can wear a swaddle, wearable blanket, or just footie pajamas for comfort. Remove the swaddle once baby shows signs of rolling over.
  • If baby is in any other space besides this, they need to be monitored AT ALL TIMES. Unattended sleep = you taking a nap also, leaving the room to shower, etc. If baby is in a swing, lounger, etc., and you need to do something, the best practice is to move them to a safe sleep environment.
  • Place your baby in his or her sleep space. Bring them to you for feedings or comfort. If there is a possibility you might fall asleep, put baby back into their sleep space. Make sure your bed as NO PILLOWS, BLANKETS, or any other items that could cover your baby’s face. Make sure to move baby back to an independent sleep space as soon as you can for reduced risk.
  • Keep baby in your room for the first 6 months—this is highly recommended if baby is premature or if anyone smokes in your house. Speak to YOUR child’s clinician on further guidance on when to move baby out of the room, as in many cases, we are okay with moving out earlier.
  • Keep the temperature comfortable and avoid overheating with too many layers. Use the neck test to check temperatures. If the back of their neck is sweaty, they are too warm. Consider using a fan or air conditioner to keep air circulating and NOT stagnant.
  • Do not use cords/blinds near the baby’s crib – they can grab and get tangled in them!
  • Consider the use of a pacifier, as this has been shown to reduce the risk of SIDS. If the pacifier falls out or your baby doesn’t use one, DO NOT PANIC. There are other safety measures above that you can use!

Commonly asked questions

  • What about pillow-like loungers like the DockATot? Babies may roll over in these or push their face to the sides. This is why it’s recommended to not use these for unattended sleep. If you are AWAKE and with baby at all times, it’s an option, but please understand the benefit and risk of these items. I personally did use a DockATot however I was ALWAYS right by our son when in use. And when I say always, I mean ALWAYS.
  • What if baby rolls? Do I need to roll them back? Once baby rolls THEMSELVES, baby can be left in this position. Always place baby on their back to sleep even if they immediately roll themselves.
  • What about wedges and positioners? These are unsafe in sleep spaces and should be avoided.
  • What about home monitors for SIDS? These should not substitute safe-sleep practices. If they stop working or are inaccurate, it can mean devastating circumstances. Follow safe-sleep guidelines and use only if you find this beneficial for your anxiety. Remember, there are reports of localized burns from these items, so please weigh risk and benefit.
  • Where do you see the most concerns of SIDS due to unsafe sleep practices? The largest mistake I see is falling asleep on the couch or in an armchair with baby. This is usually an overtired parent who has baby who falls asleep on their chest. Please move baby as SOON as you can to a safe sleep space.

When can I lower my baby’s crib?

  • Most cribs have three levels.
  • When baby is beginning to sit, it’s time to move it down a notch (middle setting). This can happen anywhere from 4-7 months.
  • When baby is beginning to pull to stand, it’s time to move it all the way to the bottom level (bottom setting). This can happen anywhere from 6-9 months.
  • An infant’s head is much heavier than their body, so if the top rail of the crib is lower than their chest, they can fall over.
  • You can move it all the way DOWN when they start sitting to avoid needing to lower it again.

What about bed-sharing?

Bed-sharing is done in many cultures, but through research in the U.S., we are concerned of an increased risk of SIDS. It’s important to know the risks of this to make a decision that is safest for baby.

Bed-sharing is riskier if:

  • Baby is younger than four months old
  • Baby has premature/low birth weight
  • Anyone in the house is a smoker
  • Any adult in the bed drinks alcohol
  • You are not the baby’s parent
  • You are using a soft surface like a sofa or waterbed
  • There is soft bedding like pillows or blankets on the bed

I don’t discuss or promote co-sleeping or bed-sharing, as I believe this is a discussion that should be had with a family and THEIR licensed health care provider for their child, weighing risks and benefit.

Download this guide to get a a safe sleep checklist and answers to commonly asked safe sleep questions, so you can rest easy knowing that your little one is safe!


Dr. Mona Admin

Hi there!

I’m a Board Certified Pediatrician, IBCLC, and a mom of two.

I know the ups and downs of becoming a mom and raising kids.

I help moms ditch the worry and second-guessing so you can find more joy in motherhood.


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