Room-Sharing, Safe Swaddling and 6 Other Must-Know SIDS Prevention Tips - Promise
Room-Sharing, Safe Swaddling and 6 Other Must-Know SIDS Prevention Tips, by Michelle Karten, MD, Powered by Nemours Children's Health System

Room-Sharing, Safe Swaddling and 6 Other Must-Know SIDS Prevention Tips

Much of a baby’s early life is spent sleeping. In fact, newborns snooze 16 to 17 hours a day. It’s important that those hours be just as safe as those spent awake. After all, sudden infant death syndrome (SIDS) is the leading cause of death in infants 1 month to 1 year old. And 90% of those SIDS deaths occur in the first six months after birth.

Infant sleep safety made headlines a lot in 2016. But with so many do’s and don’ts floating around, it’s hard to keep track of what you should and shouldn’t do at baby’s bedtime. So we’ve tried to boil it down for you a bit. Here are the top tips to keep in mind to ensure that your baby’s sleep environment is as safe as possible.

1. Keep your baby in your bedroom — but not your bed.

The biggest infant sleep safety news this year: room-sharing (as in bedroom-sharing). In a recently updated policy, the American Academy of Pediatrics (AAP) recommended that infants sleep in the same bedroom as their parents (but not the same bed) for at least their first six months — and, ideally, up to their first year.

When sharing a bed (also called “bed-sharing”), parents can accidentally roll onto or push their baby, even if by accident in their sleep. Bed-sharing also significantly increases your baby’s chance of SIDS. A much safer alternative is room-sharing. That’s when your baby sleeps in the same bedroom — not in the same bed, but beside the bed in a crib, bassinet, or portable crib/playpen.

According to the AAP, parents who share a room with their baby can reduce the risk of SIDS by as much as 50%. Room-sharing allows your little one to be near enough to hear, smell, and sense you — and for you to be more aware and ready to help if your baby is in distress — but without the dangers of bed-sharing.

Room-sharing also makes it easier for moms to breastfeed, which (on its own) has been shown to decrease SIDS risk by 70%. Just remember to always return your baby to their own sleep space (outside of your bed) after breastfeeding.

Read the details of the updated AAP policy on infant sleep safety.

2. Swaddle your baby properly.

Swaddling — wrapping a baby snugly in a cloth or light blanket — can help calm babies and soothe them to sleep. But a recent study suggested that incorrectly swaddling may increase infants’ risk of SIDS by about one-third, sparking a national conversation about infant sleep safety.

The thing is, when performed correctly (and at the right age and stage) swaddling can be very effective — and safe. Babies just shouldn’t be swaddled after 2 months, as this is when some babies can start to roll over while swaddled.

Check out more important safety and how-to information from the AAP about swaddling.

And now, for the standard infant sleep safety recommendations all parents of infants should follow…

3. Place your baby on the back to sleep.

Never place your baby to sleep on the stomach or side. Babies put to sleep on their sides are likely to roll onto their stomachs. And babies who sleep on their tummies on are at an increased risk of SIDS.

Why? Well, some think this puts pressure on the baby’s jaw, which narrows the airways. Others think that the baby re-breathes exhaled carbon monoxide in this sleeping position. We don’t know a lot about this mysterious cause of death. But we do know that infants who are placed to sleep on their stomachs or sides have a much higher risk of SIDS.

Of course, babies often begin rolling over between 4 and 6 months old (and some may start as early as 2 months). If your baby rolls over onto the belly during sleep, you don’t need to roll them back over. But when first placing your down for a nap or at night, do continue to place your infant to sleep on the back until age 1. Your baby may still turn over during sleep — and that’s OK.

4. Buy a crib (or other sleep furniture) that meets safety standards.

Full-sized mattresses, couches, and armchairs are no place for babies to sleep — ever. Proper sleep furniture should meet Consumer Product Safety Commission (CPSC) standards. So make sure your infant is always sleeping in a safe:


Choose a sturdy one with fixed side rails (not adjustable) and slats that are 2 3/8 inches apart so your baby can’t fall out or get stuck.

Portable crib/playpen/play yard

Set up properly according to the manufacturer’s instructions and only use the mattress pad provided. Don’t add any extra padding.


Check that the bassinet has been approved by the Juvenile Products Manufacturers Association (JPMA) and is marked with their seal.

5. Buy new when you can, and double-check old.

Baby merchandise isn’t exactly cheap. So if you need to borrow or buy second-hand baby furniture and products, make sure to check the CPSC for safety recalls. But try to avoid hand-me-down or used cribs and other infant furniture/equipment that are more than 10 years old.

6. Find a firm, fitting mattress.

It should be firm because infants don’t have the strength to push away from a surface that’s soft and can block their breathing. Also, make sure to use:

  • a mattress that fits snugly in your baby’s crib, bassinet, or portable crib/play yard/playpen. Don’t use a mattress that’s too big or too small — it should fit just right. A mattress that doesn’t fit the frame of the crib or sleeping furniture can allow for the infant to become trapped between the two.
  • sheets that snugly fit the exact size of the mattress. Never use sheets that are too big (and too loose) or too small (and too tight).

7. Remove everything from your baby’s crib but the mattress and a snugly fitted sheet.

Your baby’s sleep environment should be completely bare. That means no pillows, blankets, stuffed animals, and/or toys — all of which could potentially suffocate your baby or block breathing. Also steer clear of products like positioners and wedges that are marketed to prevent SIDS — these have not been proven to be safe or effective.

And, years ago, baby bumpers were considered a must-have for new moms’ registries. But now those have now been deemed dangerous, too. So what you used for an older child may no longer be considered safe for a new baby.

8. Keep potential hazards out of your baby’s reach.

Place the crib, bassinet, etc. away from the window and any wall hangings (e.g., curtains, blinds, picture frames) that could be pulled down and could strangle or fall on your baby.

Learn More About SIDS Prevention

If you have any questions or concerns about your baby’s sleeping safety, talk to your child’s primary care doctor and/or check out these handy resources:

Michelle Karten, MD

About Michelle Karten, MD


Dr. Michelle Karten is a primary care pediatrician at Nemours duPont Pediatrics, Villanova in Villanova, Pa.