Frequently Asked Questions
We know there are a lot of questions surrounding how babies should sleep, especially for grandparents and older caregivers. Until the mid-1990s, it was recommended to place babies on their stomachs to sleep.
In 1993, nearly 4,700 U.S. infants died from SIDS.
Research found that if infants were placed on their stomachs to sleep, their risk of dying from SIDS increased two-fold.
The “Back to Sleep” Campaign was initiated in 1994 by the National Institute of Child Health and Development, the American Academy of Pediatrics, the Maternal and Child Health Bureau of the Health Resources and Services Administration and SIDS groups.
The campaign encouraged parents to put their babies to sleep on their backs in order to reduce the risk of SIDS. Research showed that between 1993 and 2010 the percent of infants placed to sleep on their backs increased from 17% to 73%. In 2010, 2,063 U.S. infants died from SIDS.
I put my baby to sleep on his back, but he rolls over in the middle of the night. Do I have to get over and roll him back to his back?
The short answer is: no. Safe sleep is all about the simplicity of the sleep environment. The "back to sleep" message refers to placing your baby on their back to sleep until 12 months of age; it's not about forcing them to stay on their back.
So what's the deal when they can roll? The American Academy of Pediatrics says, "once an infant can roll from supine [back] to prone [front] and from prone to supine, the infant can be allowed to remain in the sleep position that he or she assumes." NICHD says, "If your baby rolls over on his or her own during sleep, you do not need to turn the baby back over onto his or her back." Both emphasize the importance of a safe sleep space free of soft objects, loose bedding, bumpers, toys, etc. and a firm mattress.
What is safe for a baby to sleep in?
It is not just about whether something is flat. In the U.S. to be a safe sleep surface for an infant, the sleep product must pass the standard for a bassinet, crib, cradle, or PNP. Anything that isn’t designated by the manufacturer as being one of those these types of surfaces is unsafe as that means it didn’t pass safety testing. If a product doesn’t pass those standards, a manufacturer will label it as a sleeper, napper, or cosleeper on it and sell it even though it’s not safe.
Here's what to look for:
Bassinet/Cradle: ASTM F2194, 16 CFR 1218
Playard: ASTM F406-13, 16 CFR 1221
Crib: ASTM F1169-13, 16 CFR 1220, 16 CFR 1500
Is is safe for my baby to sleep on a supplemental mattress?
Supplemental mattresses are mattresses that are sold separately from playpens and play yards. Often parents will find these marketed for pack and plays. Instructions for these products are clear that only the mattress that comes with the playpen or play yard is to be used.
My baby's legs are getting stuck inside the slats in his crib. Why can't I use mesh bumpers?
Bumper pads and other similar products were originally intended to prevent injury or death attributable to head entrapment. New standards for cribs are now in place and the slats on the crib must be closer together to prevent head entrapment. However, bumper pads have been implicated as a factor contributing to deaths from suffocation, entrapment, and strangulation. Because they are not necessary to prevent head entrapment, the Consumer Product Safety Commission does not recommend them for infants.
Additionally, the American Academy of Pediatrics says there is no published data that support claims that products that attach to crib sides or slats protect infants from injury.
My baby has reflux, she has to sleep in an inclined position.
Evidence shows that sleeping in an inclined position actually makes reflux worse. The AAP, CPSC, and FDA specifically warn about using wedges and other similar products to prop babies up, as these products have been linked with deaths.
If your baby has a rare medical condition where an incline is recommended by a specialist, we recommend having them put into writing why there’s a need to go against the safe sleep guidelines and ask if a medical grade monitor is necessary.
My grandfather made a beautiful crib for my baby to sleep in. Is it safe?
How lovely that your grandfather took the time and energy to make a special item for your baby! Unfortunately, homemade products like cribs and cradles haven't passed testing responsible for dictating whether an item is safe for a baby to sleep in. Defective cribs, especially hand-me-down and homemade models, can pose serious hazards to young children, including strangulation, entrapment and overheating. Government manufacturing standards set in 1973 have greatly improved crib safety, yet defective cribs continue to be responsible for the highest child injury rates of any nursery item. In fact, approximately 50 infants each year are killed and another 9,000 are injured in crib-related accidents in the U.S.
I'm so tired. My baby sleeps better when she's next to me. When is it safe for my child to sleep in my bed?
There is no evidence on an age when it becomes safe for a child to sleep in an adult bed. We do know an adult mattress is not safe for a child under two years old. When searching through 8 years of records, 515 deaths of children younger than 2 years old were placed to sleep on adults beds. Of those deaths, 121 were reported to be due to the parent, other adult or sibling laying on top of that child, and 394 were due to entrapment in the bed structure. Most of these deaths seem to have resulted from suffocation or strangulation caused by entrapment of the child's head in various structures of the bed.
I have tried everything. My baby just won't sleep!
We've been there ourselves. We know how hard it is.
Many babies have to be taught now to sleep flat and away from you after being curled up inside the womb for so long. It is one of the first things you will teach your child that they will use for the rest of their life. Consistency is key as well as a little trickery. Rubbing the sheet or swaddle/sleep sack on yourself so it smells like you and warming the sleep space up slightly before putting them down can help your baby make the transition to sleeping in their own safe space. Methods like Shush/pat and pick up, put down can be helpful as well.