Cincinnati Children's Blog

Safe Sleep: How to Reduce The Risk of Sleep-Related Infant Deaths

Safe Sleep: How to Reduce The Risk of Sleep-Related Infant Deaths

The rate of sleep-related infant deaths 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. Unfortunately, sleep-related infant deaths still claim 3,600 lives in the United States every year.

In the past, sudden infant death syndrome, or SIDS, was most commonly talked about in relation to sleep-related infant deaths. Experts have begun classifying these deaths more specifically, in order to learn from them and help prevent them. The term now used to describe the range of sleep-related infant deaths is sudden unexplained infant death, or SUID. Falling under that umbrella include deaths due to:

  • Sudden infant death syndrome (SIDS)
  • Accidental suffocation or strangulation in bed (ASSB)
  • Unknown causes

While these deaths are unpredictable, you can take several steps to reduce the risk by following safe sleep practices.


The easiest way to remember safe sleep practices for your infant is to use the A-B-C acronym. Babies should sleep:

  • Alone
  • On their Backs
  • In a Crib

The American Academy of Pediatrics (AAP), the authority in SUID prevention and safe sleep, offers several additional recommendations for creating the safest sleep environment possible for your baby. Follow these guidelines to decrease the risk of sleep-related infant deaths:

  • Put your baby to sleep in the same room as you, but not in the same bed. In other words, share your room, but not your bed. Aim to do this for the first year of your baby’s life if possible, and for at least the first six months. Avoiding bed sharing reduces the risk of SIDS by as much as 50 percent.
  • Always place your baby on his or her back for every sleep time — both naptime and nighttime. 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, flat sleep surface for your baby, with a tightly fitted flat sheet.
  • 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. In general, babies need one more layer of clothing than you are comfortable sleeping in.
  • Know how to safely swaddle your baby.
  • Offer a pacifier at bedtime or naptime.
  • Immunize your baby.


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

Due to the risks of suffocation, strangulation and SUID, our recommendation is to avoid bed sharing entirely. If you do choose to bed share, talk with your child’s doctor about how to keep your baby as safe as possible during sleep.


These recommendations come from research done over the past 30 years. Many new parents envision their infant with soft blankets and cute stuffed animals — and that’s still OK, but not when your baby is sleeping. Research has shown that following these guidelines for healthy babies from birth to 1 year reduces the risk of sleep-related infant deaths.

It is important to note that due to some specific heath conditions, physicians may individualize recommendations for sleep. Work with your child’s doctor to create the safest sleep plan.

Editor’s note: Jessica Seeberger also contributed to this blog post. She is a safe sleep expert with Cradle Cincinnati, a network of partners dedicated to reducing preterm birth and infant mortality in Hamilton County.

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