Safe sleep

These recommendations come from the American Academy of Pediatrics (2022). They apply to every sleep, day and night, until your baby's first birthday. Every other tip in Chickpea comes second to these. (The "Signs to mention to your pediatrician" section below draws on a separate guideline rather than this 2022 policy, and says so where it applies.)

Every sleep

• On their back, for every nap and every night. Once your baby can roll both ways on their own, you don't need to turn them back, but always put them down on their back.
• A firm, flat surface that's level, not inclined, with only a fitted sheet: a crib, bassinet or play yard that meets current safety standards.
• Nothing else in the sleep space: no pillows, blankets, bumpers, stuffed animals or positioners. A wearable blanket (sleep sack) keeps your baby warm without loose bedding.
• Their own sleep space in your room, ideally for at least the first 6 months. Don't share an adult bed for sleep. It is riskiest if your baby is under 4 months or was born early or small, or if the adult smokes, has had alcohol or sedating medicine, or is very tired.
• Not too warm: dress your baby in no more than one layer more than you'd wear, with no hats indoors while they sleep.

Swaddling and sleep sacks

• If you swaddle, always place your baby on their back, and stop as soon as your baby shows signs of trying to roll.
• Don't use weighted swaddles, weighted sleep sacks or weighted blankets.

Places that aren't for sleep

• Sofas and armchairs are the most dangerous places to fall asleep with a baby. If you think you might doze off while feeding, do it in an adult bed with pillows and covers moved away, then move your baby back to their own space as soon as you wake. This is riskiest after alcohol, cannabis or a sedating medicine, or when you're very tired.
• Car seats, strollers, swings, bouncers and nursing pillows aren't for routine sleep. If your baby falls asleep in one, move them to a flat sleep space when you can.
• Inclined sleepers, and any product that holds a baby at an angle, aren't safe for sleep.

Other things that lower risk

• Breast milk feeding lowers risk.
• Once breastfeeding is going well, offering a pacifier at sleep time lowers risk. You don't need to put it back in once your baby is asleep.
• Keep your baby away from smoke and vapes, and avoid alcohol, cannabis and other drugs, especially around sleep and feeding, during pregnancy and after birth.
• Keep up with routine vaccinations.
• Supervised tummy time while your baby is awake builds strength and helps prevent flat spots.
• Monitors, including breathing or oxygen ones, are fine for peace of mind, but they don't lower the risk of SIDS. Don't rely on one instead of a safe sleep space.

Signs to mention to your pediatrician

• Under 12 months: noisy or labored breathing, gasps, or pauses in breathing.
• From 12 months: snoring on 3 or more nights a week, especially with gasping, snorting noises, pauses in breathing, or very restless sleep. Pediatricians screen for this at well visits (Marcus 2012 AAP guideline, which applies from age 1, not before).
• Being very hard to wake, or too sleepy to feed.
• Poor weight gain or feeding trouble.

Call emergency services if your baby stops breathing, turns blue or grey, or goes limp. If your baby has a pause in breathing, color change or floppiness, even if it ends on its own, get urgent care.