Simple and Important Ways to Keep Your Infant Safe While They’re Sleeping from Intermountain Health

New parents might worry about their newborn baby’s safety and the risk of Sudden Infant Death Syndrome or SIDS. But they can reduce the risk of SIDS by placing their baby on their back for sleep and by providing a simple and safe sleep environment.

The cause of SIDS is unknown, but research shows there are contributing factors. Soft surfaces, such as a couch, fluffy blanket, crib bumper pads, or a pillow, could block an infant’s airway. Overheating also can increase a baby’s risk of SIDS.

In the U.S. approximately 3,500 infants are victims of sleep-related infant deaths annually.

In a report published in 2022, the American Academy of Pediatrics (AAP) updated their safe sleep recommendations for infants.

The report highlights new findings that show:

1. There is a 67 times higher risk of sleep-related infant deaths when sleeping with someone on a couch, armchair, or cushion.

2. There is a 10 times higher risk of sleep-related infant death when sleeping with someone who is impaired due to fatigue, using sedating medications, or substances like alcohol, illicit drugs, or smoking.

3. As a baseline, the risk of sleeping on the same surface as someone else as an infant under 4 months of age increases infant death by 5 to 10 times.

Exhausted parents might be tempted to put baby in the bed with them, to help baby fall asleep. But newborn nurses and pediatricians at Intermountain Health say it’s best to let baby fall asleep on their own in a separate space to keep them safe.

New parents may be tempted to decorate their baby’s crib with stuffed animals, soft pillows, fluffy blankets and bumpers, but fluffy things in the crib can actually create a danger for infants.

Parents should always place a baby on his or her back to sleep to help reduce the risk of SIDS. Tummy time should be reserved for play when a parent or caretaker can engage with baby.

“Once you are home from the hospital, your baby only needs one more layer than what you are wearing. They don’t need to wear a hat indoors. That can make them overheated,” said Charity Huff, a nurse educator with Intermountain Health.

If your newborn baby looks tired, get them swaddled and into their crib or bassinet so they can learn to self-soothe and fall asleep on their own. Once baby can roll over, they no longer need to be swaddled.

“Babies often spit up. That’s because newborns babies have an immature sphincter in their esophagus and it opens and closes at random times. That’s one reason babies should sleep on their backs, becuase gravity works in their favor and baby’s airway anatomy and their gag reflex will keep that from happening,” said Charity.

“If a baby is lying on their tummy, gravity will take spit up down the trachea. As a baby gets older, the sphincter gets stronger and firms up and that means less spit up,” she added.

To reduce these risks of sleep-related infant death, the AAP recommends:

• Infant should sleep on a firm, flat, and non-inclined surface designed exclusively for sleep.
• Do not overdress baby for bedtime. Babies are comfortable at the same temperature as siblings and parents.
• Do not use sitting devices—car seats, strollers, swings, infant carriers, infant slings— for routine sleep.
• Parents should sleep in the same room, but not the same bed as baby.
• Breastfeeding for at least two months partially or exclusively reduces the risk of sleep related infant death.
• Avoid parent and infant exposure to illicit substances.
• Make sure baby is up to date on all their immunizations.
• Pacifier use is associated with reduced risk.
• Avoid use of commercial devices that claim to reduce risk of SIDS.
• Supervised tummy time is recommended while awake.

“Baby equipment can be expensive. Find out if a crib is up to current U.S. safety standards before using it for your baby,” said Huff.

Some baby equipment that’s been popular on baby registries the last few years may not be safe for infant sleep. According to the U.S. Consumer Product Safety Commission, sleep products for babies that incline more than 10 degrees are not safe. Inclined sleepers, car seats or swings can position babies in a chin-to-chest position, which can restrict their airway.

To find an OB-GYN or midwife or pediatrician visit intermountainhealth.org

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.