The Ultimate Guide to Newborn Safe Sleep: Evidence-Based Practices

The "ABCs" of safe sleep are universally endorsed by pediatric organizations worldwide.

Always Sleep Baby on the Back (The "A")

Every time your baby is put to sleep—for naps and at night—they must be placed flat on their back. [cite: American Academy of Pediatrics]

• Rationale: The American Academy of Pediatrics (AAP) recommends the back position because it keeps the airway open and significantly reduces the risk of SIDS. [cite: American Academy of Pediatrics]
• Actionable Tip: If your baby rolls from back to tummy on their own, the AAP states you do not need to reposition them, but they must always be placed to sleep on their back initially. [cite: American Academy of Pediatrics]

Alone, on a Firm, Flat Surface (The "B" and "C")

The sleep environment must be firm, flat, and completely bare.

• Use an Approved Sleep Surface: The U.S. Consumer Product Safety Commission (CPSC) advises using a crib, bassinet, or play yard that meets current federal safety standards. [cite: CPSC] The sleep surface must be firm, covered only by a fitted sheet. [cite: American Academy of Pediatrics]
• Keep the Crib Bare: To prevent accidental suffocation and entrapment, never place blankets, pillows, bumper pads, stuffed animals, or any soft objects in the baby’s sleep space. [cite: American Academy of Pediatrics]
• Avoid All Soft Surfaces: Infants should not sleep on adult beds, couches, armchairs, or soft bedding, as these dramatically increase the risk of suffocation. [cite: American Academy of Pediatrics]

Swaddling can comfort a newborn, but it must be done correctly and stopped promptly when a developmental milestone is reached.

Proper Swaddling Technique

The American Academy of Pediatrics (AAP) recommends that swaddling should only be used while the baby is placed on their back. [cite: American Academy of Pediatrics]

• Hip Health: The swaddle must be wrapped loosely around the hips and knees to allow for freedom of movement. Wrapping the legs tightly straight down can increase the risk of hip dysplasia. [cite: American Academy of Pediatrics]
• Safety Precaution: Ensure the swaddle does not restrict the baby's chest and that the baby is not overheating.

The Mandatory Transition Timing

It is critical to stop swaddling immediately when your baby shows any signs of attempting to roll.

• The AAP and the Centers for Disease Control and Prevention (CDC) agree that once a baby shows signs of rolling, swaddling becomes a major safety risk, as the baby may roll onto their stomach but lack the arm mobility to roll back, increasing the risk of suffocation. [cite: American Academy of Pediatrics, CDC]
• Actionable Tip: This transition often occurs around 2 months of age, but all parents should cease swaddling as soon as they observe any rolling attempts.

Certain products should never be used for infant sleep.

Warnings Against Inclined Sleepers and Positioners

Never use inclined sleepers, wedges, pillows, or positioners for sleep.

• Following multiple infant deaths, the U.S. Consumer Product Safety Commission (CPSC) has issued firm warnings and recalls for many popular inclined sleeper products. The CPSC now requires that all products intended for infant sleep must have a sleep surface angle of 10 degrees or less. [cite: CPSC]
• The U.S. Food and Drug Administration (FDA) also advises against the use of wedges and positioners, as they are not safe and can cause a baby to roll into an unsafe position, leading to suffocation. [cite: FDA]
• Empathetic Note: While these products may seem helpful for reflux or comfort, the safety risk is absolute. Prioritize the firm, flat sleep surface above all else.

Practical logistics are key to implementing safe sleep practices seamlessly.

Room-Sharing Logistics (Without Bed-Sharing)

The American Academy of Pediatrics (AAP) strongly recommends room-sharing (having the baby’s sleep space in the parents’ room) for at least the first six months, and ideally for the first year, as it is associated with a reduced SIDS risk. [cite: American Academy of Pediatrics]

• Positioning: Place the bassinet or crib immediately adjacent to the parents’ bed for easy access, especially for night feeds, but ensure the baby is always returned to their own sleep surface when finished feeding.
• White Noise: If using a white noise machine, the AAP recommends placing it at least 7 feet away from the crib and keeping the volume below a permanent, maximum limit (around 50 A-weighted decibels) to protect the baby’s hearing. [cite: American Academy of Pediatrics]

Overheating Prevention

Overheating is a known risk factor for SIDS. Keep the baby comfortable without being too hot.

• Temperature Range: The optimal room temperature for a baby's sleep environment is generally considered to be between 68°F and 72°F (20°C and 22.2°C). [cite: CDC, American Academy of Pediatrics]
• Checking for Overheating: Do not rely on touching the baby’s hands or feet. Check the baby’s chest or the back of their neck; if they are hot or sweaty, they are too warm. [cite: CDC]
• Dressing: Dress your baby in no more than one layer more than an adult would wear to be comfortable in the same environment. Use a wearable blanket (sleep sack) instead of loose blankets. [cite: American Academy of Pediatrics]

The use of a pacifier at naptime and bedtime is associated with a reduced risk of SIDS. [cite: American Academy of Pediatrics]

• Breastfeeding Caution: If you are breastfeeding, the American Academy of Pediatrics (AAP) suggests waiting until breastfeeding is well-established, typically around 3–4 weeks of age, before introducing a pacifier. [cite: American Academy of Pediatrics]
• Safety Rule: Do not attach the pacifier to the baby with a cord, clip, or string that could pose a strangulation hazard. [cite: American Academy of Pediatrics]

This guide is built upon the evidence-based recommendations from the following authoritative organizations: