Safe sleep for infants means placing a baby alone, on their back, in an empty crib, bassinet, or play yard for every sleep—naps and nighttime—until they are at least 12 months old. These practices, recommended by the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC), and the U.S. Department of Health and Human Services, reduce the risk of sleep-related infant death, including Sudden Infant Death Syndrome (SIDS), choking, and suffocation.
This guide covers the safe sleep guidelines parents, caregivers, and childcare providers can follow, how to write a safe sleep policy for a childcare program, and answers to common questions.
In this guide
- What is safe sleep?
- How should babies sleep?
- Safe sleep at a glance
- Additional safe sleep guidelines for infants
- How to create a safe sleep policy for a childcare program
- Common safe sleep mistakes and how to avoid them
- Which sleep aids are safe for infants?
- Frequently asked questions about safe sleep
What is safe sleep?
Safe sleep is the set of practices for putting an infant to sleep that reduces the risk of sleep-related infant death, including choking, suffocation, and Sudden Infant Death Syndrome (SIDS). For years, experts have researched and outlined recommendations to reduce infant deaths during sleep. Parents, caregivers, and childcare providers can minimize sleeping hazards by taking the necessary precautions and completing training on safe sleep.
How should babies sleep?
The Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services recommend that babies be given their own sleep space free of soft bedding, including blankets, pillows, bumper pads, and toys. This includes no sharing of cribs or bassinets. The American Academy of Pediatrics (AAP) recommends that strollers, swings, infant carriers, car seats, and infant slings not be used for routine sleep, especially for infants younger than four months. The AAP also notes that pacifier use is associated with reduced SIDS risk.
The CDC and AAP also advise that babies be placed on their backs every time they sleep. Many people worry that babies on their backs may choke, but an infant's airway anatomy and gag reflex protect against this. Babies placed on their backs are less likely to experience sudden death than babies who sleep on their sides or stomachs.
Always follow safe sleep guidelines recommended by pediatricians and organizations like the AAP.
Safe sleep at a glance
| Topic | Do | Avoid |
|---|---|---|
| Position | Place baby on their back for every sleep | Side or stomach sleeping |
| Sleep space | Give each baby their own crib, bassinet, portable crib, or play yard that meets CPSC standards | Sharing a crib or bassinet; sleeping on couches or armchairs |
| Surface | Use a firm, flat, level surface with only a fitted sheet | Inclined surfaces (more than 10 degrees) and soft surfaces |
| Bedding and objects | Use a wearable blanket if baby needs extra warmth | Loose blankets, pillows, bumper pads, and toys in the sleep area |
| Location | Room-share, with baby on a separate sleep surface | Bed-sharing |
| Devices | Use swings, car seats, and carriers only while baby is awake and supervised | Routine sleep in strollers, swings, car seats, carriers, or slings |
| Swaddling | Swaddle newborns correctly, with the hips free to move | Swaddling once baby shows signs of rolling over |
| Pacifier | Offer a pacifier at sleep times | Attaching a pacifier to clothing or hanging it around baby's neck |
| Duration | Follow these practices until baby is at least 12 months old | Stopping safe sleep practices early |
Additional safe sleep guidelines for infants
Health and safety training and a clear understanding of safe sleep procedures help reduce sleep-related infant deaths. These safe sleep guidelines from the National Institute of Child Health and Human Development (NICHD) are designed to create a secure environment and minimize risks for infants:
- Use a crib, bassinet, portable crib, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC)
- Use a firm, flat, and level surface covered by only a fitted sheet (surfaces that incline more than 10 degrees aren't safe for a baby to sleep on)
- Remove all objects, toys, blankets, pillows, and other items from the baby's sleep area other than the fitted sheet
- Use a wearable blanket or swaddle instead of putting a blanket in the sleep area
- Place babies on their backs
- Do not allow babies to sleep on couches, armchairs, or infant swings or seats
- Keep the baby's sleeping room at a comfortable temperature
- Maintain a smoke-free environment
- Stop swaddling babies once they are able to roll over
- Feed babies human milk by breastfeeding or pumping from the breast
- Offer a pacifier at sleep times
Safe Sleep Checklist
A free checklist to create a safe sleep environment for infants at your childcare program.
How to create a safe sleep policy for a childcare program
To make sure staff put babies to sleep safely, childcare programs should adopt a written safe sleep policy for infants. Start by explaining the ABCs of safe sleep:
- Alone: Babies should always be on their own sleep surface.
- Back: Babies should only be placed on their backs for every sleep.
- Crib: The crib should be empty and free of pillows, blankets, stuffed animals, toys, wipes, and diapers.
Staff should be familiar with these preventive measures. To make sure procedures are followed, place posters around the childcare facility as a reminder. Also include safe sleep information in new hire training and employee handbooks, and hold annual health and safety training so everyone stays current on safe sleep policies.
As a childcare provider, be sure to:
- Enforce no-smoking laws and regulations
- Create a safe sleep policy and educate staff
- Provide a space for parents to nurse their infants
- Educate families
- Provide supervised "tummy time" when infants are awake
- Monitor the immunization status of infants
- Practice crib safety
- Follow swaddling recommendations
A well-documented safe sleep policy helps ensure compliance with regulations and reassures families about their child's safety. When families enroll, give them a handout describing the safe sleep policies your program uses. This safe infant sleep infographic from the National Institute for Children's Health Quality (NICHQ) works well as a handout for families and a training reminder for staff.
Brightwheel is childcare software that brings daily reports and family communication into one platform, so programs can document and share their safe sleep practices more easily. Brightwheel saves each admin and staff member 20 hours per month of administrative work.
Common safe sleep mistakes and how to avoid them
Even with the best intentions, caregivers can make mistakes that increase the risk of unsafe sleep for infants. The most common mistakes, and how to avoid them:
- Placing baby on their side or stomach: Babies should always be placed on their backs to sleep—for naps and bedtime—to reduce the risk of SIDS.
- Using soft bedding or loose blankets: Pillows, comforters, bumper pads, and stuffed animals can pose suffocation hazards. Use a firm mattress with a tightly fitted sheet and consider a wearable blanket for warmth.
- Co-sleeping in adult beds: Sharing a bed with a baby significantly increases risk. Keep your baby in the same room, but on a separate, safe sleep surface like a crib or bassinet.
- Overheating the sleep environment: Overbundling or keeping the room too warm can be dangerous. Dress your baby in breathable layers and keep the room at a comfortable temperature.
- Skipping regular crib checks: Make sure the crib or bassinet stays free of clutter and hazards and meets current safety standards. Do regular visual checks to maintain a safe sleep setup.
Which sleep aids are safe for infants?
Sleep aids are objects (including a child's own body parts) that help a child fall asleep without help from a parent, caregiver, or childcare provider. Because no objects belong in an infant's crib, safe sleep aids are limited to a few options:
- Wearable blankets and correctly applied swaddles (until baby shows signs of rolling over)
- Pacifiers
- Skin-to-skin contact while baby is awake and being held
Used correctly, these aids support better rest without adding suffocation hazards to the sleep space.
Frequently asked questions about safe sleep
What is safe sleep for infants?
Safe sleep refers to recommended practices that reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related hazards. These include placing babies on their backs to sleep, using a firm sleep surface, and keeping the crib free from loose bedding or soft objects.
How should babies sleep?
Babies should sleep alone, on their backs, on a firm, flat surface in a crib, bassinet, or play yard with only a fitted sheet, for every nap and every night.
At what age can babies stop following safe sleep guidelines?
Safe sleep practices should be followed until a baby is at least 12 months old. Once your baby can roll over independently both ways, they can be allowed to find their own sleep position—but you should still place them on their back to start.
Can babies sleep in a swing, bouncer, or car seat?
No, these are not safe sleep environments. Babies should sleep on a flat, firm mattress in a crib, bassinet, or play yard. Items like swings and car seats are for supervised use only and should not replace a safe sleep surface.
Are sleep sacks or swaddles safe?
Sleep sacks (wearable blankets) are a safe alternative to loose blankets. Swaddling can be safe for newborns when done correctly, but it should be stopped as soon as a baby shows signs of rolling over.
Why is room-sharing recommended but bed-sharing discouraged?
The American Academy of Pediatrics recommends room-sharing—keeping baby’s crib or bassinet in your bedroom—for at least the first 6 months. This reduces the risk of SIDS. However, bed-sharing increases the risk of suffocation or entrapment and is not considered safe sleep.
How can I create a safe sleep environment in childcare settings?
Ensure every infant has their own approved crib or bassinet with a firm mattress, no soft toys or loose bedding, and is always placed on their back to sleep. Follow licensing guidelines and log sleep checks as required.
What should a childcare safe sleep policy include?
A childcare safe sleep policy should explain the ABCs of safe sleep (alone, back, crib), require safe sleep training for all staff, describe how sleeping infants are monitored, and be shared with families at enrollment. Check your state licensing rules for additional requirements.
Safe sleep best practices for every program and home
By creating a safe sleep environment and educating staff, childcare programs can give every child the best possible care at nap time. With proper training on safe sleep guidelines and clear resources for families, you can build a culture of safety both at home and at your program.
