Setting Up a Safe Sleep Environment

AngelaRD, LDN, CBS

Read time: 4 minutes

What to know about the safety of your child’s sleep space

  • What are the American Academy of Pediatrics’ guidelines for a safe sleep environment?

  • Why is a safe sleep environment important?

  • How to adjust baby’s sleep environment as they grow

According to the American Academy of Pediatrics, setting up a safe sleep environment can reduce the risk of sleep related infant deaths and SIDS.1,2 Knowing that baby is sleeping safely can give you peace of mind so you can sleep better, too!3

Read on for answers to all your questions regarding safely setting up your baby and toddler’s sleep space.

What position should I put my baby down to sleep?

The American Academy of Pediatrics recommends that babies be placed on their back every time they sleep.4,5,6

Some parents worry that baby may choke while sleeping on their back, but according to the AAP, baby’s airway anatomy helps to keep their airway clear.4,7,8 And even babies who have GERD (Gastroesophageal reflux disease) should still sleep on their backs.9,10

Do babies have to sleep on their back when they start to roll over?

Around 4 to 7 months, many babies start to roll over on their own.11,12 A parent may be alarmed if they see their little one has rolled onto their stomach during the night. But if your baby is able to comfortably roll from their back-to-tummy and tummy-to-back, turning them onto their back again may not be necessary.5,13

Note that babies rolling into soft bedding is a risk factor for SIDS, so it is important baby’s sleep area is clear.1,4

Your little one’s pediatrician can guide you with what is safest for your little one.

Learn more here: What Sleep Positions are Safe for my Baby?

Can I share my room or my bed with my baby?

The AAP recommends sharing a room with baby for the first 6 to 12 months of life.1,14 It is especially important for the first 6 months of age when SIDS and sleep related deaths are the highest.1,4

Bed-sharing, however, is not recommended. Parents should be close enough to baby to see and reach them, without sharing a bed.5 Baby sleeping in a bed with others is not recommend by the AAP due to the risk of SIDS, suffocation, strangulation, parents rolling onto babies, or babies getting tangled in sheets or blankets.4,5

The risk of bed sharing increases if:

  • Baby is under 4 months old1,4

  • Baby was a preemie or born at a low birth weight4

  • A parent is a smoker4

  • Baby is sharing a bed with someone who is:

    • Not baby’s parent (e.g. sibling or caregiver)

    • Hard to wake up due to: fatigue, certain medications, or if they have consumed alcohol or drugs1,4

Babies should only be brought into a bed to be fed or for comfort.4 When you are ready to sleep, baby should return to their own sleep space.1,4,5

What if I fall asleep feeding my baby?

Parents are tired and may fall asleep while feeding their little ones.

If you think you may fall asleep, remove pillows, blankets or anything that could overheat baby or that may cover their face, neck, or head.1,4,5 Unfortunately, a large number of SIDS deaths involve babies having their heads covered by bedding.1

If baby falls asleep in one of these places, move baby to a safe sleeping space as soon as you can.5

Tips on how to keep your baby safe while they sleep

How to set up baby’s sleep surface

Your little one should have their own sleep space on a surface designed for a baby.1,4 The mattress should be in a safety approved crib, bassinet, portable crib, or play yard that meets the U.S. Consumer Product Safety Commission (CPSC) standards.4 Mattresses should be firm with a tight-fitting sheet.14,15,16

Sometimes babies fall asleep in places that aren’t recommend for routine sleep. This can be dangerous, especially if baby is under 4 months old.1 If baby falls asleep in one of these places, move baby to a safe sleeping space as soon as you can.4,5,17

Places that are unsafe for baby to sleep include:

  • Swings

  • Car seats

  • Stroller

  • Baby carriers or slings

  • Baby positioning gear like an inclined seat1,4,18,19,20

Learn more: How do I Teach my Baby to Sleep in Their Crib?

Keep baby safe from overheating

Your baby’s room should be a comfortable temperature.5 While there isn’t a recommendation for an exact room temperature, most experts advise to keep their room about 69 degrees F.33

In general, to keep baby warm but not overheated, they should be wearing one more layer than you are.1,5 The AAP suggests a wearable blanket like a sleep sack, which is made to cover baby’s body without covering their head.5

You can tell that your little one may be too warm if they are sweating or if they feel hot when you touch them.1,22

Keep baby’s crib free from clutter

Nothing should be in baby’s crib, except for baby.3,4,23

Check your baby’s sleep environment each time you put them to sleep for a nap or for the night. Baby’s sleep area should be free of hazards like dangling cords, wires, window-covering cords, and other objects such as:

  • Soft or loose bedding

  • Pillows

  • Comforters

  • Blankets

  • Quilts

  • Toys

  • Bumper pads

  • Non-fitted sheets1,5,6,17,23,24

Can I use a bedside or in-bed sleeper?

Right now, there isn’t enough research about the impact of bedside or in bed sleepers on SIDS, injury, or death for the AAP to recommend for or against using them.1,4,5

Bedside sleepers that meet CPSC standards may be an option, but there are no CPSC standards for in-bed sleepers.1,5 The good news is that as of mid 2022, all infant sleep products on the market must meet specific federal safety standards set by the U.S. Consumer Product Safety Commission.17

Are there products that can reduce SIDS risk?

There are many products on the market that claim to reduce SIDS risk, such as:

  • Wedges

  • Positioners

  • Devices for an adult’s bed to help position or separate baby from the adult

  • Specialty mattresses designed to break up carbon dioxide in case a baby ends up on their tummy1,25,26

However, there isn’t any current evidence to support that these products reduce SIDS risk.1

Should I use a breathing monitor for my baby?

A monitor that tracks baby’s breathing and heart rate while sleeping can be understandably appealing to worried parents. According to the AAP, they haven’t been found to reduce SIDS risk and most newborns don’t need them.1,5

These devices may cause unnecessary anxiety, false alarms, and tired parents could lose more sleep.27 They are appropriate for a baby with serious breathing problems or if baby needs oxygen at home.

Chat with your baby’s healthcare provider if you are concerned or considering using one of these devices.

Older baby and toddler sleep safety tips

As your little one gets older and more adventurous, different actions are needed to continue to keep them safe.28 Toddlers may escape and wander.

Here are some tips to make your toddler’s sleeping space as safe as possible:

  • Safety gates: Use one at the top of the stairs and one at their bedroom door28

  • Clear the space: Move furniture or large toys that could injure your little one if they fell on them28

  • Childproof latches: Use these on dresser drawers so they can’t be used as stairs to climb28

  • Lock it down: Use locks on the windows and bolt furniture to the walls to prevent it tipping over29,30

  • Safety outlets: Cover outlets to prevent electrical injuries31

  • Crib mattress height: Lower the crib mattress even before baby can sit, pull to their knees, or stand32

  • Toddler bed transfer: Once baby is 35 inches tall, baby is climbing out of the crib or when the crib side rails reach lower than ¾ of their height, it is time for a toddler bed29,32

When can my child sleep with a blanket or pillow?

Research hasn’t shown when it is 100% safe to have items like blankets and toys in a crib.5 Most experts agree that they are of little danger to healthy little ones after 12 months old.5 Your child’s pediatrician can guide you with what is safest for your child.

Consider continuing to keep the crib clear for older babies and toddlers. Mobile toddlers can manipulate anything to help them climb out of their cribs and risk falling.

Tell anyone watching your child (grandparents, babysitters, day care providers) about the safe sleep environment guidelines. You will all want to be on the same page for safe sleep!

Read more:

How can I help my toddler sleep through the night?

What are Typical Sleep Patterns for Toddlers?

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For more on this topic, check out the following articles:

How to Help Your Older Baby Sleep Well at Night

How Can I Help My Newborn (0-12 weeks) Sleep Well At Night?

What are Sleep Regressions?

What are Typical Sleep Patterns for 4 to 12-month-old Babies?

What are Typical Sleep Patterns for Newborns (0 - 12 week olds)?