Please note: The information provided on this page was initially collected, compiled into a document, and first published in May 2007 by the U.S. Department of Health and Human Services (www.hhs.gov), Health Resources and Services Administration (www.hrsa.gov), Maternal and Child Health Bureau (www.mchb.hrsa.gov) under a contract with the National Sudden Infant Death Syndrome (SIDS)/Infant Death Resource Center operated by Circle Solutions, Inc., Contract No. NIHIDIQ-263-01-D-0208.
The 2009 update was produced by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center, Georgetown University, under a cooperative agreement (U48MC08717) with HRSA’s Maternal and Child Health Bureau.
- Helping Baby "Back to Sleep"
- Why does back sleeping help?
- Will babies choke?
- Are babies uncomfortable?
- What helps baby fall asleep?
- What if baby rolls over?
- What if baby wakes up fussy?
- Don’t forget “tummy time!”
- More ways to keep baby safe...
- Printable Document
The American Academy of Pediatrics (AAP) and the Back to Sleep Campaign recommend that babies under 1 year of age be placed on their backs to sleep inorder to lower the risk of Sudden Infant Death Syndrome (SIDS).
Since the start of the Back to Sleep Campaign in 1994, the number of babies dying of SIDS has decreased by more than 50 percent. But many babies still sleep on their tummies or sides, and babies are still dying of SIDS.
When babies sleep on their backs, it helps to keep their mouths and noses unblocked so they breathe in clean, fresh air and do not overheat. This may be why the risk is lowered.
❚ Remember that babies must be placed on their backs for EVERY sleep—at nighttime and naptime.
❚ Placing babies to sleep on their sides is not as safe as their backs because they are more likely to roll onto their tummies.
IMPORTANT: The risk of SIDS is much higher when babies who are used to sleeping only on their backs are put to sleep on their tummies for the first time, such as in child care or with a new caregiver.
Sometimes babies “spit up” when sleeping. Studies have shown that babies are NOT at risk of choking if they spit up when sleeping on their backs.
❚ Babies do sleep longer and more soundly on their tummies -- but that is the problem. They sleep so deeply that they can’t wake up easily when they might be in danger Sleeping not as deeply may help to protect babies.
❚ Some babies seem happier on their tummies. However, babies will adjust to sleeping on their backs if you start placing them on their backs for EVERY sleep.
❚ Keep bedtime and naptime routines the same every day, as much as possible.
❚ Most babies sleep well after a feeding and/or a bath. Hold baby to feed—do not give baby a bottle or sippy cup in the crib.
❚ Gently rub baby’s arms and legs.
❚ Try to keep baby’s crib away from loud noise. Keep things quiet for 1 hour before bedtime. Soft lighting helps baby get sleepy.
❚ Babies like to hear a quiet story or song before bedtime.
❚ Cuddle and rock baby gently before bedtime.
❚ Consider using a pacifier when you place baby on her back for sleep. If baby is breastfed, wait until she is one month old or is used to breastfeeding before using a pacifier.
❚ If baby spits out the pacifier after falling asleep, you do not need to put it back in her mouth.
❚ Always place babies on their backs when you put them down for sleep.
❚ Continue to place babies on their backs at bedtime and nap time, even after they have learned how to roll over.
❚ Once babies start rolling and choosing their own sleep position, you do not need to keep turning them over onto their backs.
❚ When babies roll over, it is even more important that there is nothing else (blankets, soft toys) in the sleep area to get near their face.
❚ If baby is only fussing (and not crying), wait a moment to make sure the baby is actually awake. Some babies fuss a bit during an “active phase” of sleep, and then fall back asleep.
❚ If baby wakes up and cries, go to him as quickly as possible—that helps calm baby so he can fall asleep again.
❚ Hold and feed baby if she is hungry, and comfort her before placing her on her back to sleep in her own crib or bassinet.
❚ In the early weeks and months of life, babies need to be fed often. The time between night feedings should increase as babies grow bigger and begin to sleep for longer periods of time at night.
❚ Try not to play with baby during the night when she wakes up.
❚ Healthy babies need some tummy time when awake to help develop strong muscles. Place baby on tummy on a firm, safe surface, and play together or stay nearby to keep baby safe.
❚ Tummy time for a few minutes 2-3 times a day can also help to prevent a flat area from forming on the back of baby’s head.
❚ After feeding and burping, place baby on her back in a safety-approved crib or bassinet near your bed, but not in your bed. The crib or bassinet is the safest place for baby to sleep.
❚ Enjoy cuddling baby when awake, but don’t fall asleep together while holding baby close.
❚ Baby should NEVER sleep on sofas; chairs; recliners; waterbeds; soft surfaces such as pillows, cushions, sheepskins, or quilts; or any bed with another adult or child.
❚ Use a firm crib mattress with a tight-fitting crib sheet.
❚ Keep pillows, quilts, comforters, sheepskins, stuffed toys, bumper pads, and other soft objects out of baby’s crib or bassinet.
❚ Avoid sleep positioners, apnea monitors, and other items that promise to reduce the risk of SIDS. These have not been proven safe or effective.
❚ Make sure that baby is not too warm. Keep the room at a temperature that feels comfortable for a lightly clothed adult.
❚ Use light sleep clothing like a one-piece sleeper instead of loose blankets. Be sure the sleeper is the right fit (not too large) for baby.
❚ Keep baby’s head uncovered during sleep.
❚ Don’t allow anyone to smoke around your baby, or in your home or car.
❚ Talk to grandparents, relatives, friends, babysitters, and child care providers about safe sleep and what works best to help baby fall asleep on her back EVERY TIME. Tell everyone who takes care of your baby to follow these important safe sleep practices.