All Health Topics

Safe sleep

Apr 1, 2014

Sudden Infant Death Syndrome (SIDS) is the leading cause of death for babies up to 1 year of age in the United States.

The American Academy of Pediatrics (AAP) Task Force on SIDS has national guidelines to lower the risk of SIDS and other sleep-related deaths, such as accidental suffocation. The SIDS task force at University of Iowa Stead Family Children’s Hospital supports the AAP guidelines as the safest sleep environment for babies.

Cribs and kids hospital certification seal that is gold

ABC’s of safe sleep

A - Alone in crib
B - Back to sleep
C - Crib empty of all objects 

Infant sleeping in crib

To lower the risk of SIDS and other sleep-related deaths:

  • Always lay your baby on their back for sleep, at naps and at night.
  • Baby should sleep in a safety-approved crib, bassinet, or pack-n-play with a fitted sheet.
  • Keep soft objects, toys, crib bumper pads, and loose bedding out of the sleep area.
  • Dress your baby in a sleeper or sleep sack for comfort and warmth during sleep.
  • Keep baby’s crib in your bedroom, close to your bed for at least the first 6 months.
  • Do not smoke while you are pregnant. 
  • Do not smoke or let others smoke near your baby.
  • Feed your baby breast milk for at least the first 2 months or longer if you wish.
  • Give your baby a pacifier for naps and at bedtime.
  • Do not let your baby get too hot during sleep.
  • Get your baby routine vaccinations and health checkups.
  • Only do tummy time when baby is awake and you are watching closely.
  • Avoid commercial products that claim to lower the risk of SIDS.

Remember tummy time

Put a thin blanket on a clean floor. When baby is awake and someone is watching, place baby on his or her stomach.

Tummy time is important because it:

  • Helps prevent flat spots on back of baby’s head
  • Makes neck and shoulder muscles strong so baby can start to sit up, crawl, and walk. Develops coordination and motor skills.
  • Helps baby learn to play and interact with his or her surroundings

Blankets are for tummy time, NOT FOR SLEEP.

Not all safe sleep products are safe for infants

Many products are marketed for “safer sleep” or to reduce the risk of SIDS. However, products without the AAP endorsement have not been shown to be safe for infants and are not recommended.

Products and practices considered unsafe by the AAP:

  • Wedges/positioners: The AAP strongly recommends placing infants on their backs to sleep on a firm surface. Side sleeping and positioning are not advised. Wedges and positioners are not recommended by the AAP.
  • Bumper pads: Bumper pads and mesh bumpers have been implicated as factors contributing to infant deaths from suffocation, entrapment, and strangulation. 
  • Baby boxes: These are not regulated by the Consumer Product Safety Commission (CPSC) and have not been tested to meet mandatory crib safety standards. Families at UI Stead Family Children’s Hospital who are unable to provide a safe crib for their infant after discharge may be eligible to receive a free play yard.
  • In-bed co-sleeping: Evidence shows that room-sharing without bed-sharing decreases the risk of SIDS by as much as 50 percent. However, bed-sharing – or co-sleeping – is a leading risk factor for SIDS and sleep-related infant death in the U.S. This practice is not recommended.

Products for which the AAP remains neutral:

  • Special crib mattresses: Some manufacturers claim that certain mattresses aid in the dispersion of carbon dioxide in situations where an infant rolls onto their belly while sleeping. The AAP asserts there is no data to support this claim, however there is no harm in using CSPC-approved crib mattresses as long as safe sleep practices are maintained.
  • Monitors: There is no evidence that cardiorespiratory monitors decrease the incidence of SIDS. The use of these monitors should not decrease the adherence to safe sleep practices.
    • Smartphone-integrated home baby monitors that measure vital signs are popular with parents, but they are not FDA-regulated. A study tested two of these monitors for accuracy and were found to perform inconsistently when reporting babies’ heart rate and oxygen saturation. Researchers advised caution in using the data provided by unregulated vital sign monitors.

Safe sleep Facebook LIVE

The safe sleep experts at University of Iowa Stead Family Children's Hospital answer viewers' questions during Facebook LIVE sessions.

Published on

Safety Store

Safe sleep products can be purchased from the UI Stead Family Children’s Hospital Safety Store. The trained Safety Store staff is also available to provide education on how to use safety products. For more information, visit https://uihc.org/childrens/locations/safety-store.

Helpful resource