Safe sleep: room share, don’t bed share

cropped sleeping babyIn an update to their safe sleep guidelines, the American Academy of Pediatrics (AAP) says that infants should sleep in the same room, but not the same bed, as their parents ideally for the first year of life, but for at least the first 6 months. Evidence suggests that sleeping in the parents’ room but on a separate sleep surface decreases the risk of sudden infant death syndrome (SIDS) by as much as 50%. In addition, this sleeping arrangement is most likely to prevent suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed. The AAP’s safe sleep recommendations include:

Back to sleep for every sleep. Your baby should be put on his back every time, by every caregiver until he is 1 year old. Side sleeping is not safe and is not advised. Premature babies should be placed on their backs to sleep as soon as possible. The AAP states, “Preterm infants are at increased risk of SIDS, and the association between prone [stomach] sleep position and SIDS among low birth weight and preterm infants is equal to, or perhaps even stronger than, the association among those born at term.”

Use a firm sleep surface, such as a crib mattress covered with a tightly fitted sheet. Use only the mattress made for your baby’s crib. The mattress should fit snugly in the crib so there are no spaces between the mattress and the crib frame. The mattress shape should stay firm even when covered with a tightly fitted sheet or mattress cover. Don’t let your baby sleep in his carrier, sling, car seat or stroller. Babies who sleep in these items can suffocate. If your baby falls asleep in one of them, take her out and put her in her crib as soon as you can.

Babies should sleep in the parents’ room but on a separate sleep-surface. Parents should not bed-share. Bed-sharing is the most common cause of death in babies younger than 3 months old. Keep your baby’s crib close to your bed so your baby is nearby during the night. Share your bedroom with your baby but not your bed.

Breastfeeding is recommended. Breastfeeding is associated with a reduced risk of SIDS.

Keep soft objects and loose bedding away from the sleep area. Crib bumpers, pillows, blankets, and toys in the crib put your baby in danger of getting trapped, strangled or of suffocating.

Offer your baby a pacifier at nap time and bedtime. It is not clear why, but studies show that pacifiers protect your baby from SIDS. This is true even if the pacifier falls out of the baby’s mouth. However, don’t hang the pacifier around your baby’s neck or attach the pacifier to your baby’s clothing or a stuffed animal.

Avoid smoke exposure, alcohol, and illicit drugs during pregnancy and after birth. Babies who are around secondhand smoke are more likely than babies who aren’t to die of SIDS. And there is an increased risk of SIDS with maternal use of alcohol or illicit drugs.

Avoid overheating and head coverings. It is difficult to provide specific room temperature guidelines but in general, dress your baby appropriately for the environment. A blanket sleeper can keep your baby warm without covering his head or face.

Avoid the use of sleep positioners, wedges, or other devices that claim to reduce the risk of SIDS. Don’t use home cardiorespiratory monitors as a way to reduce the risk of SIDS. These monitors track a baby’s heart rate and breathing. Some babies need this kind of monitor because of medical problems, but this is rare. There’s no evidence that the monitors help reduce the risk of SIDS in healthy babies.

Give your baby supervised tummy-time while he is awake. Babies need to develop their neck, shoulder and arm muscles and tummy time helps. You can find some tummy time activities here.

It is important that all people who will care for your baby know these guidelines and follow them to keep your baby safe while he sleeps.

Have questions? Text or email us at AskUs@marchofdimes.org.

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One Response to “Safe sleep: room share, don’t bed share”

  1. Mary Green RN, MSN Says:

    I appreciate and feel that the promotional efforts of March of Dimes as well as AAP campaign to promote newborns to sleep in parents rooms is an improvement and realistic goal. For many mothers and parents infants are already sleeping in the same room and often in the same bed with mom and dad. The problem that continues is mom’s not realizing the danger of suffocating a newborn when they are sleeping in the same bed with mom and dad (and possibly other children). For infants to share the same room with mom’s seems like a most natural thing to do because you will be able to hear the baby when they awaken for feedings and it will be easier for mom and baby. the problem is many mothers and fathers or grandparents do not have appropriate newborn beds. We need to assist parents in getting the appropriate resources for their infants. Mary Green RN, MSN