Infant Sleep Safety Guidelines

What you need to know to create a sleep environment for your baby’s first six months!

Information about babies and sleep is confusing. You probably get totally different stories from your doctor, your neighbor, your parents, and other sources. It’s hard to be sure what is best when it comes to where baby sleeps for naps and nighttime.

The truth is, different arrangements work for different families. Decisions of where, when, and how your baby sleeps are up to you and your baby. This brochure describes basic sleep safety so that you can make safer choices about the way your family sleeps.

Experts promote creating strong parent-child bonds; one way to do this is by helping parents create a nurturing and careful sleep environment for their children. Together, we want to make sure that you have the most up-to-date safety information no matter which sleeping arrangements you choose.

Cosleeping is recommended because it supports breastfeeding and bonding in the first six months of life and beyond—both very important for baby’s physical and emotional health. Attachment Parenting International supports sleeping arrangements that enable parents to be emotionally responsive to their infant while protecting baby’s physical safety.

What is Cosleeping?

Cosleeping commonly refers to parents and child sleeping in the same bed, also known as bedsharing, the family bed, or sharing sleep. Cosleeping is recognized more broadly to also include “sleeping close by,” or within arm’s reach, placing a crib or bassinet in the adult bedroom, or safely securing a “sidecar” or bedside sleeper to the adult bed to be able to easily attend to the baby.

Many families practice a form of cosleeping at one time or another, whether as a regular sleeping arrangement or just occasionally to meet the needs of the baby or circumstances.

Whatever your sleep preference or need may be, actively create a nighttime parenting plan that follows infant sleep safety guidelines. Additional resources are available on this topic to help you, including the website links listed in this brochure as well as from other respected sources. Unfortunately, no matter what precautions are taken, no crib or bedsharing environment can guarantee against infant loss due to SIDS.

Benefits of Cosleeping

Parents who share sleep with their babies can take care of them more easily and without anyone fully waking. Everyone can get more and better sleep this way. Parents feel more connected to their baby and the baby benefits physically, emotionally, and even intellectually.

Here’s why:

Baby feels warm and secure, and therefore cries less.
Babies naturally sleep more lightly than adults—and that’s a good thing! Studies have shown that baby’s light sleep helps keep their heart rate and breathing calm and steady and decreases baby’s risk of SIDS.
Parents report that they get more sleep with fewer interruptions.
Mother’s breastmilk supply increases and night nursing is easier.
Parents don’t have to get out of bed.
Mothers worry less at night knowing they can quickly reach out to touch or comfort baby.
Both parents report they feel a closer bond with their baby.

For more information on the benefits of cosleeping and how families practice it, visit www.attachmentparenting.org.

When You Should Not Bedshare

Parenting and infant care should focus on both health and safety. Bedsharing with an infant is healthy and safe in most cases, but there are situations that require parents to use a bassinet or crib instead.

You should NOT share a bed with an infant if:

You use alcohol or drugs – Using any substances that interfere with your judgment or level of consciousness at night will interfere with your ability to be aware of your baby. These substances include over-the-counter medication such as sleep aids or cold medication.
You smoke – A higher risk of SIDS has been associated with parental cigarette smoking and bedsharing.
You are extremely obese – A higher risk of SIDS has been associated with parental obesity and bedsharing.
Your baby is premature, low birth weight, or has a high fever.
There are older children or animals near – The family bed should not include older children next to the baby who will not be as aware of the baby in bed.

Remember: Bedsharing is only for a firm bed – Sharing sleep with your baby should not be done on a couch, recliner, water bed, or any location where the infant could become wedged.

Creating a Sleep Environment

API recommends the following research-based guidelines that, when followed, allow parents and infants to share sleep in the safest way possible.

Important guidelines to follow:

Place your baby to sleep on her back. This helps protect your baby from Sudden Infant Death Syndrome (SIDS).
Choose a firm mattress, without bed covers that could cover the head, bumpers, and stuffed animals. Never place your baby—or fall asleep with your baby—on a couch, recliner, beanbag chair, fold-out or pull-out couch, inflatable bed, or waterbed to sleep.
Keep baby cool. Adjust clothing and room temperature to keep baby from overheating. UNICEF recommends a temperature of between 60 and 64 degrees Fahrenheit for nighttime sleep.
Use a fan in the room where baby sleeps to help circulate air and maintain a cooler environment.
Baby should not be left to sleep alone on an adult bed, even during naps. If parents do not have access to a crib or bassinet for naps, place a smaller mattress or futon on the floor, and make sure the room is child-proofed. An infant carseat should not be used for naps or nighttime.

... and if your baby sleeps with you:

Breastfeed your baby. Breastfeeding mothers spend more time in lighter stages of sleep, making them more aware of their baby. They also tend to sleep in a protective position (with knees bent upward) that prevents baby from moving down under the covers.
Place baby next to Mom, rather than between mother and father.
Use approved side rails or bed extenders when placing baby in the family bed. Fill in any crevice between the bed and walls, headboard, footboard, or furniture with a rolled-up baby blanket or towel. Placing the adult mattress or futon on the floor away from a wall avoids both the risk of falls or creating crevices. The CPSC has not set safety guidelines for cosleeping bassinets.
Be mindful about sharing sleep and settle the baby safely next to mom in a planned environment rather than falling asleep from exhaustion on the couch, a recliner, beanbag chair, or other unsafe place to share sleep.
Only primary caregivers should sleep with an infant. Do not allow babysitters or older siblings to sleep next to the baby.

... and if your baby sleeps in a crib:

Cribs must meet CPSC safety guidelines, including:

Slat spacing of less than 2-3/8” that are not loose or broken
The headboard and footboard must not have cutout designs
Corner posts should be no more than 1/16” higher than other rails

Attachment Parenting International would like to thank the following Infant Sleep Safety Guidelines sponsors for their commitment to providing families with necessary safety information:

AskDrSears.com
Dr. James J. McKenna, Ph.D., Director, Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame
La Leche League International
Amby Baby
Arm's Reach Cosleeper

For additional support on infant sleep and bedtime arrangements, be sure to visit these sites:

Help us spread the word!

If you agree that parents need this important safety information, help us spread the word. Consider printing the brochure and taking it to your local doctor’s office, infant supply retailer, childbirth educator, or maternity ward. For more information, see Attachment Parenting.org/infantsleepsafety.

Disclaimer: Attachment Parenting International (API) urges parents to use good sense regarding the safety of their children. API publishes this information knowing that parents are engaged in the use of cribs and cosleeping in all its forms, and as such API is committed to keeping children safe and healthy by providing the most current safety information available. API, its Support Groups, its sponsors, and its partners assume no liability in the event of infant, child, or parent harm and are held harmless from any harm, loss, or legal liability arising from information they provide.

AP in the News