Safe sleep information for parents and caregivers

In Massachusetts, 30-40 babies die while sleeping every year. Creating a safe space where your baby can sleep is important for their health and well-being. Here are some tips to help you protect your baby during naps and at nighttime, so you both can rest easy.

Table of Contents

Infant sleeping. "Protected. By you."

Always put your baby on their back when they are sleeping

  • All babies should sleep on their back every time they sleep
  • Even if your baby spits up, they are still safer sleeping on their back
  • If you put your baby to sleep on their stomach, there is more of a chance that they will breathe in their spit up, which can stop their breathing
  • If you lay your baby on their side, they can accidentally roll on to their stomach, which puts them at risk for breathing in their spit up
  • If your baby has reflux, check with their doctor for advice on how they should sleep
  • Once your baby can roll from back to belly, and belly to back, they can sleep however they like. But continue to place them on their back to sleep for every sleep

Never smoke around your baby

  • Keep your baby’s sleeping area and your home smoke-free, including cigarette and marijuana smoke. Second and third-hand smoke can harm your baby
  • Change your clothes and consider taking a shower if you have been exposed to smoking of any kind

Don’t let anyone share a bed with your baby, but if you do, follow these tips

  • Parents often want to be close to their babies at night, but sharing a bed with your baby can be deadly. People and pets can accidentally roll over on your baby, or pillows and blankets can cover their face and stop them from breathing.
  • Keep everyone including adults, children, and pets, out of your baby’s bed, especially if those people:
    • Are not breastfeeding your baby
    • Are obese
    • Have drank alcohol, smoked marijuana, taken medication or other drugs that makes them sleepy
    • Are unusually sick or tired
  • It is especially important that no one sleeps in the same bed as your baby if your baby:
    • Is younger than 4 months old
    • Was born early, or weighed less than 5 pounds 8 ounces when they were born
    • Has a cold or is stuffed up
    • Has a birthmother who smoked or lived with someone who smoked while they were pregnant
    • Is exposed to cigarette or marijuana smoke regularly
  • Things that go in your bed for your baby to sleep in (sometimes called a co-sleeper, or an in-bed co-sleeper) have no safety standards. They are not safe for you to use with your baby.
  • Falling asleep with your baby on a sofa, futon, recliner or cushioned chair is very dangerous. There is a risk that your baby could get stuck between the cushions or pillows and suffocate, or fall off and get hurt.
  • If you or anyone else falls asleep with your baby, taking all the sheets, blankets, pillows and anything else off of the bed could keep your baby safer
  • If you or anyone else wakes up holding or sleeping in the same bed as your baby, immediately move your baby to their crib or bassinet. Make sure to put them on their back and take any blankets, toys, pillows, or anything else out of their crib or bassinet.

Keep your sleeping baby near you, in their own crib, with a firm mattress and tight-fitting sheet

  • Your baby should sleep on their back in a safety approved crib, bassinet, or Pack-n-Play that is completely free of toys, blankets, pillows and bumper pads
  • The mattress your baby sleeps on should be firm with a tight-fitting sheet. Adult mattress in the United States are too soft, and can be dangerous for your baby to sleep on.
  • Keep your baby’s crib close to where you sleep so you will know when they need you. If you are breastfeeding, sleeping near their crib makes it easier to feed them when they’re hungry and helps build a good milk supply.
  • Things that go in your bed for your baby to sleep in (called a co-sleeper, or an in-bed co-sleeper) have no safety standards. They are not safe for you to use with your baby.
  • Bedside sleepers, such as a bassinet that is attached to the bed, may be an option for some parents. If you choose to use a bedside sleeper, follow the CPSC safety standards. Be careful that the bedside sleeper has four sides and is up high enough so that nothing from your bed can fall into it.
  • If you need a safe crib or bassinet for your baby, consider reaching out to Cribs for Kids
  • Check to make sure that your baby’s crib is not broken or missing parts. Broken cribs or cribs missing parts are dangerous for your baby.
  • If you are worried about your baby getting stuck between the bars of the crib, remember that young babies can’t move around enough to hurt themselves, and the bars should be close enough together to prevent their head from getting stuck. Bumper pads can cover your baby’s mouth and nose, stopping their breathing, or get tangled around their neck.
  • Things like carriers, car seats, strollers, and swings should only be used for their intended purposes and not for everyday sleep. They can put your baby in a position that makes it hard for them to breathe.
  • If your baby falls asleep anywhere aside from their crib or bassinet, move them as soon as possible. If you can’t move them, watch them and make sure their neck is extended so they can breathe. Especially if they fall asleep in or on the following:
    • Soft surfaces such as sofas, futons, recliners or cushioned chairs
    • Carriers such as slings or Baby Bjorn
    • Car seats, strollers, bouncy chairs, or swings
    • Waterbeds
  • Visit the Consumer Product Safety Council or call at (800) 638-2772 to make sure the crib you have still meets safety standards and hasn’t been recalled. You can watch the Check Your Crib for Safety video for more information on safety standards.

Keep your baby’s sleep area empty, especially before their first birthday

  • Make sure nothing, especially the following items, is in your baby’s crib or bassinet
    • Blankets, comforters, pillows or other soft bedding items
    • Bumper pads or portable bed rails
    • Wedges or positioning devices
    • Stuffed animals or toys
    • Plastic sheets or plastic bags
    • Strings, cords, or ropes

Keep your house, baby’s room, and your baby at a comfortable temperature

  • Your baby is sensitive to heat and can overheat quickly, which can be deadly
  • Never put your baby’s crib or bassinet near a furnace, space heater, or another heating device
  • The best room temperature for your baby is between 68 and 72 degree s Fahrenheit (20 to 22 degrees Celsius)

Dress your baby in a sleep sack or one piece sleeper to keep them warm and safe while they sleep

  • Wrapping your baby in a sleep sack or swaddle is a way to help them calm down before and feel comfortable while they sleep. If your baby can sleep without a swaddle or a sleep sack, they don’t need to wear one.
  • Place your baby to sleep on their back for every sleep, especially when they are swaddled or wearing a sleep sack
  • A sleep sack is preferable to a swaddle because there is no chance of a sleep sack unraveling and becoming a suffocation hazard
  • If you choose to swaddle your baby, make sure that it is done correctly. If a swaddle is too loose, it can unravel and become a suffocation hazard. If it is too tight on the hips and knees, it can cause hip dysplasia.
  • You can add extra clothing under your baby’s sleep sack or swaddle if you are worried they will be cold
  • Never add a blanket to your baby’s crib, they can suffocate or strangle on loose bedding like blankets and flat sheets
  • Keep in mind that your baby is sensitive to heat. If their chest is hot to the touch, or they are sweating or red, cool them down by taking some of their clothes or swaddle off. Try to keep the room cooler than 72 degrees. And remember, if you would be hot in their outfit, they will be very hot in their outfit, which is dangerous.
  • You can keep your baby’s arms in or out of their swaddle or sleep sack, whatever you and they prefer
  • As soon as your baby shows any signs of rolling over or trying to roll over, stop swaddling or using sleep sacks with their arms tucked in immediately

If you are able to, breastfeed your baby

  • Breastfeeding has many health benefits for babies, and can reduce the risk of sudden infant death syndrome (SIDS). We recommend that if you are able to, you breastfeed your baby.
  • If the baby falls asleep during or after breastfeeding, place your baby in their own crib or bassinet
  • If mom is sleepy during and after breastfeeding, moving to an adult bed that is clear of blankets, pillows, loose sheets, and other objects, is safer for your baby than a sofa, futon, or an armchair
  • If you fall asleep while breastfeeding, but then wake up, move or your baby to a safer place immediately

Give your baby plenty of tummy time when they are awake

  • Place your baby on their tummy while they are awake and alert every day
  • Make sure an adult is always watching the baby during tummy time
  • Tummy time will help your baby’s neck, arms and shoulder muscles get stronger and avoid head flattening

Give your baby a pacifier to help them sleep, after you have established breastfeeding

  • Pacifier use can be a protective factor against Sudden Infant Death Syndrome (SIDS) and should be used when your baby is asleep
  • Make sure your baby’s pacifier is not attached to a cord or a stuffed animal when they are sleeping. This can help prevent choking or suffocation.

Read about Safe Sleep and tell others what you learn!

The Infant Safe Sleep program in the Division of Violence Injury Prevention strives to educate parents, caregivers, and providers about how to ensure babies (up to 1 year of age) have a safe and secure environment in which to sleep.

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