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A Child safe sleep, A parent sound sleep

“I slept like a baby last night.”
Carnie Lazarre, MD,MPH, Nora Siegler MD/MPH Candidate. With Julie Belkowitz, MD, MPH, Lyse Deus, and Oneith Cadiz, MD


Anyone who has had a baby would find the irony in this sentence. Having a newborn is not easy. They wake up often crying, needing to be fed, and certainly do not follow the idea of “sleeping like a baby.” All new parents want to make sure their babies are safe, but it can be very stressful for many new parents because they feel exhausted as they try to keep up with the newborn schedule. The challenges can sometimes lead to practices that are not safe and may lead to sudden unexpected infant deaths (SUIDS).
SUIDs are unexpected deaths in babies less than a year old and the reason for the death is not known. According to the American Academy of Pediatrics, 3,500 sudden unexpected infant deaths occur in the United States each year. Although some of the causes are not known, there are many things that can be done to prevent these tragedies. Here is how you can make sure that your infant is sleeping safely:
  • Put your baby on their back to sleep until their first birthday. This allows the baby to breathe better. This way, they are less likely to breathe in the air that they just exhaled, which is high in carbon dioxide and low in oxygen.
  • Make sure that your baby is sleeping on a firm, flat surface, not on an incline. Surfaces at an angle are not safe for sleep because they may slide down into an unsafe position.
  • Choose a safe sleeping space for your baby. Make sure that the slats are not more than 6 cm (about 2 inches) apart, so their limbs or body do not get trapped in between. Make sure the mattress is the same size as the crib so that there are no gaps that can cause the arms or legs to be trapped. Ensure that the crib mattress is low so the child cannot fall out by leaning against the side or pulling themselves over it.
  • Place your baby on a firm surface without any soft or loose bedding such as blankets or nonfitted sheets, stuffed animals, crib bumpers, or pillows. Although it is tempting to decorate your baby’s crib, stuffed animals and pillows increase the risk of suffocation. Crib bumpers are also dangerous because not only can babies suffocate, as they grow older, they can stand on the crib bumper and climb out, increasing their risk of fall.
  • Also avoid other extra products to put in the crib with your baby such as inclined sleepers and positioners advertised as baby nests, docks, pods, nappers, and rockers. These products are not regulated and do not meet any safety standards. They are often soft and can make it difficult for a baby to breathe if they roll on their stomach.
  • Breastfeed your baby exclusively for the first 6 months, and continue up to one year or longer, if you are able and have not been advised against it by your doctor. Feeding of human milk is linked to reduced risk of sudden infant death.
  • Have your baby sleep in your room in their own bassinette or crib for the first year. This gives you easier access to the baby, allowing you to reach them faster if they are in need.
  • Do not have your baby sleep in your bed. Although sleeping with your baby may be seen as bonding time or seem easier at night when they need to be fed often, bed sharing can be extremely dangerous, as the risk of suffocation increases tremendously.
  • Do not let your child fall asleep on nursing pillows. Your baby might roll over onto their stomachs and place their heads into the soft fabric that could block their airway.
  • Avoid smoking in the house. Second-hand smoking has been shown to increase the risk of sudden infant deaths.
  • Avoid alcohol, marijuana, opioids, and illicit drug use during pregnancy and after birth. Consumption of these substances, especially in combination with bed sharing, increases the risk of suffocation and sudden infant death.
  • Give your child a pacifier at naptime and bedtime. If you are breastfeeding your child, allow the baby to learn the proper breastfeeding techniques first and then introduce the pacifier.
  • Do not swaddle baby in weighted swaddle clothing. When your baby starts to show signs that they can roll (usually around 3-4 months), stop swaddling the baby. This is because a swaddled baby on their stomach is more likely to suffocate.
All of this information can summarized by the ABC of safe sleep Alone, On their Back and in an empty Crib !
Being a parent is a great gift that comes with tremendous responsibility. Practicing these recommendations will allow you to sleep more soundly, knowing that your child is sleeping safely. For more information about safe sleeping for infants, visit or contact the Injury Free Coalition for Kids, a program of the Children’s Trust, at 305-243-9080  or online at


  1. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment:
  2. How to Keep Your Sleeping Baby Safe: AAP Policy Explained.
  3. Inclined Sleepers, Crib Bumpers & Other Baby Registry Items to Avoid.
  4. About SUID and SIDS.

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