Mary Bridge Children's Hospital

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Center for Childhood Safety For information, call 253-403-1234

Infant Sleep Safety

Create a Safe Crib Environment

The ABC's of Safe Infant Sleep

It is a parent’s worst nightmare: they check on their sleeping baby, only to find the infant unresponsive. How does this happen? Sadly, each year approximately 4500 babies die unexpectedly in the United States, often during sleep. Sometimes we know why (suffocation by fluffy bedding or a sleeping adult, for example) but in more than half of these cases, even a thorough investigation leaves us with no answers.Those unexplainable infant deaths are called “Sudden Infant Death Syndrome” or SIDS.

But even when we don’t know exactly “why” a baby has died, investigators have found the risk factors to be consistent – the same steps that decrease the risk of suffocation have the added benefit of decreasing the risk of SIDS as well.

For the best protection, create a safe sleep environment for your baby. Start with the ABC’s of Safe Sleep: babies should sleep ALONE, on their BACK, in a CRIB. The following guidelines from the American Academy of Pediatrics have been shown to reduce the risk of both suffocation and SIDS for babies under one year:

  • Back to sleep, for every sleep. Babies should never be put to sleep on their tummy or side.
  • Baby must always sleep on a firm surface, like a crib or bassinet with a tightly fitted sheet. Never on an adult bed, couch, chair or pillow – due to risk of suffocation and entrapment.
  • Keep soft objects and loose bedding out of the crib. Remove blankets, pillows, bumpers, and toys. Dress your baby in a sleep sack or footed pajamas for warmth and safety.
  • Room-share, but don’t bed-share. We all want our babies close by at night, but many have suffocated when sleeping next to a well-intentioned parent, sibling, or pet – don’t risk it. Enjoy cuddling with your baby when breastfeeding or awake, but return them to their own crib when it’s time to sleep.
  • Breastfeed your baby for the best protection. Breastfeeding reduces the risk of SIDS and many other health problems, every bit helps.
  • Offer a pacifier when putting baby down for sleep. Don’t force the pacifier, if your baby doesn’t want it. And when it falls out during sleep, there is no need to put it back in. Breastfeeding babies should wait until they are fully accustomed to nursing, around 3-4 weeks.
  • Avoid overheating and over bundling. Dress your baby in light sleep clothing and keep the room at a temperature that is comfortable for an adult.
  • Keep your baby’s environment smoke-free. For help quitting, go to
  • Avoid alcohol and illicit drug use during and after pregnancy. Both increase your child’s risk of SIDS.
  • Avoid devices marketed to reduce SIDS, including wedges, positioners, special sleep surfaces, and home monitoring equipment. There is no evidence that they are safe or effective.
  • Encourage supervised “tummy time” when baby is awake. This will help to strengthen your child’s upper body, and minimize flattening on the back of the head.
  • Keep up-to-date on your child’s immunizations.