Safe Sleep for Infants

The rate of Sudden Infant Death Syndrome (SIDS) has declined more than 50 percent since the 1994 Back-to-Sleep campaign was launched, encouraging parents to place infants to sleep on their backs. But, unfortunately, SIDS still remains the leading cause of death for babies from ages 1 month to 1 year, claiming more than 2,000 lives in the United States alone every year.

SIDS is the sudden and unexplained death of an infant. And though it is unpredictable, where in most cases the baby seems healthy yet death occurs quickly, there are steps you can take to help prevent it.

The American Academy of Pediatrics (AAP), the authority in SIDS prevention and safe sleep, states that a baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing). Avoiding bed-sharing reduces the risk of SIDS by as much as 50 percent.

Additional recommendations from the AAP to decrease the risk of SIDS include:

Always place your baby on his or her back for every sleep time, and make sure other caregivers and family members do the same.

  • Breastfeed your baby if possible.
  • Do not smoke during pregnancy or after delivery. Do not allow others to smoke around your baby.
  • Always use a firm sleep surface for your baby.
  • Do not use fluffy blankets or other soft materials under your baby when going to sleep, and do not use wedges or other sleep positioners.
  • Keep stuffed toys, bumper pads and pillows out of the crib.
  • Avoid overheating in the crib, keeping your baby warm but not too warm.
  • Offer a pacifier at bedtime or naptime.
  • Immunize your baby.

These are recommendations from evidence gained through research performed over the past 30 years, and are designed for healthy babies up to 1 year of age.

We understand that some cultures highly value the practice of bed-sharing and there are several popular parenting approaches, including attachment parenting, that encourage bed-sharing along with other specific parenting practices.

If you are an expectant or new parent and plan to share a bed with your infant, I hope you will reconsider and ultimately choose not to bed-share. The risks of suffocation, strangulation and SIDS are simply too great.

Room-sharing is an excellent modification of the practice and is shown to be just as beneficial to the infant as sharing a bed.

Note: In some instances, physicians may recommend that babies be placed on their stomachs to sleep if they have disorders such as gastroesophageal reflux or certain upper airway disorders, which make them more likely to have breathing problems while lying on their backs. Always follow the recommendations of your child’s physician.

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Michael K. Farrell, MD

About the Author: Michael K. Farrell, MD

Dr. Farrell is chief-of-staff at Cincinnati Children’s. He came to Cincinnati in 1974 for his pediatric residency on a “2 year plan” and nearly 40 years later, well, we're delighted he stayed a bit longer. He directed the pediatric residency program at Cincinnati Children’s for more than 20 years, where he guided his residents with his no-nonsense style and his mantra of “Before you can be a good gastroenterologist or cardiologist, you have to be a good pediatrician.” He is a parent and a grandparent who enjoys history, visiting museums and any sport “played with a round object.” He still spends about 25 percent of his time in clinic, doing what he’s always done best, taking care of kids.

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  1. Sandy Jessup June 03, 14:09
    This is offensive to millions who have safely practiced co-sleeping with infants and toddlers for years and is contrary to the open-minded approach I've come to expect from CCHMC. Instead of suggesting that parents go against cultural expectations or what they feel is best for their family, why not write an article about safe bed-sharing practices? Exhausted new parents often bring their infant into their bed in hopes of getting a bit more sleep. Articles like this tell them not to, but sometimes, the biological need for sleep takes over. These lives lost to SIDS in unsafe co-sleeping situations could be saved if parents were educated instead of shamed.
  2. Rebecca DeMent June 03, 14:15
    AS the mother of 8 children.......7 healthy and one with special needs i absolutely do not support the information in this article. Co sleeping beds are WONDERFUL for lets the baby be WITH you but not IN the bed with you where getting rolled on , etc. would be a danger. We used one with our 6th son and he was the best sleeping baby i think we ever had! Also wearing the baby in a sling type carrier makes for more happy and well adjusted babies.....there again i've done it both ways and the proof is in the pudding so to speak! Babies in carriers are NOT on their backs! they sleep great! ***HOWEVER the most important example i'd like to cite is our special needs daughter who will soon be 4 yrs old.....she was born with a birth defect of her jaw resulting in severe obstructive sleep apnea and required facial surgery to have her jaw moved while she was still in the NICU @ age 2 is a very invasive surgery and life SAVED her life. That said, she has ALWAYS slept on her face STRAIGHT DOWN in the mattress! She didn't have SIDS.......and had she NOT had the surgery and been kept on her back as you propose she would have died IN HER SLEEP WHILE ON HER BACK b/c though it was not readily apparent SHE COULD NOT BREATHE! Sleep scores should be under 5 ideally.......hers was 68! Just saying......sometimes the 'facts" aren't always true in every case! Also children with medical problems often need additional reaassurance and comfort and that comes from close proximity to their loving parents :)
  3. Kelly Arnette June 03, 15:37
    The article says there are some babies who will need t be placed on their abdomen to sleep. You have to treat each child as an individual and do what your pediatrician recommends. Most times the safest is back to sleep. Please never let your need for sleep to cause harm to your child! All new parents are sleep deprived, but most of us don't sleep with our newborns. The risk is too great. The suggestion that anyone is trying to offend someone's cultural practice is absurd. Children's hospital respects all cultures. The article just tells you the facts. Plain and simple. The safest thing for your newborn. As a special care nursery nurse I encourage you to put your baby BACK TO SLEEP, for their health and safety. Unless otherwise instructed by your doctor.
    • Shelly June 04, 12:54
      I think you would be surprised Kelly how many parents do sleep with their newborn. There are safe co-sleeping practices to avoid suffocation. I find this article misleading. Are the babies that are co-sleeping and dying in fact dying of suffocation or SIDS? Also everyone needs sleep, parents too. If I need to sleep with my baby so I can function well enough to care for him, my older son and my special needs child. We practice safe co-sleeping as outlined by Dr.Sears.