Safe Sleep for Babies

In November 2016, the American Academy of Pediatrics (AAP) updated their recommendations for a safe sleep environment for infants (birth to one year of age). While it is impossible to eliminate all risk, the AAP has issued the following recommendations for healthy, full term babies. If your infant is premature, or has a special health need, please consult with your physician for additional guidance.

  • Hold your baby skin-to-skin for the first hour after birth.
  • Whenever you are not holding your baby and you need to sleep, or take care of other needs, place your baby on his or her back on a flat, firm surface with no loose pillows, blankets, bedding, soft objects, or bumper pads. Infants, especially if younger than 4 months of age, should not routinely sleep in car seats, stroller, swings, or baby carriers.
  • Breastfeeding is associated with a decreased risk of Sudden Infant Death Syndrome (SIDS). Your baby is most protected when you breastfeed exclusively (or feed pumped milk) for six months. The protective effect of breastfeeding increases with exclusivity, however, ANY breastfeeding is shown to be more protective against SIDS than NO breastfeeding.
  • Have your baby sleep in your room, close to your bed, but not in your bed, for at least the first six months, and ideally the first year. If you bring your baby into your bed to feed or comfort, return your baby to his or her own bed when you are ready to return to sleep. This is especially important if your baby is younger than 4 months old. If you are drowsy and may fall asleep, avoid feeding your baby in an armchair/recliner or sofa - it is safer to feed your baby in your bed and then move your baby to his or her own sleep surface as soon as you awaken. Do not bring your baby into a water bed or into a bed with multiple people or anyone who smokes or is using alcohol or illegal drugs.
  • Consider offering a pacifier at sleep times once breastfeeding is firmly established. Do not tie or attach the pacifier to your baby or attach it to a stuffed animal.
  • Avoid maternal and infant exposure to smoke, alcohol and illegal drug use during pregnancy and after your baby is born.
  • Avoid over-heating and over-dressing your baby.
  • Mothers should receive regular prenatal care and infants should receive recommended immunizations.
  • Avoid any commercial devices that are inconsistent with safe sleep recommendations. Do not use home cardio respiratory monitors as a strategy to reduce the risk of SIDS.
  • Give your baby tummy time when your baby is awake and you can observe your baby. Tummy time avoids head flattening and promotes upper body strength.
  • Lay a swaddled baby ONLY on their back. Swaddling should be snug around the chest, but allow for ample room at the hips and knees. Once your baby is trying to roll over to his or her stomach, do not swaddle your baby. Do not swaddle your baby if they are in bed with you.

Safe sleep measures are not meant to interfere with breastfeeding. Breastfeeding improves the health of your baby, and decreases your baby’s risk of SIDS. MilkWorks encourages parents to understand the AAP safe sleep recommendations so that you and your baby can get the sleep that you need in a manner that is as safe as possible. For more detailed information on the AAP guidelines visit:

March 2017