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Safe Sleep

Each year, there are about 3,400 sudden unexpected infant deaths (SUID) in the United States. According to the Michigan Department of Health and Human Services, a baby dies every three days in Michigan. Many of these deaths are preventable by using safe sleep practices.

Click this button to see Dr. Denise Wynee-Baker, a board-certified pediatrician at Einsten Healthcare Network, discusses the new safe sleep guidelines released by the American Academy of Pediatrics.

Updated Recommendations from AAP 

What is SUID?
SUID stands for "Sudden Unexpected Infant Death." SUID are defined as deaths in infants less than 1 year of age that occur suddenly and unexpectedly, and whose cause of death is not immediately known. About 40% of all SUID cases are SIDS related, but many unexpected infant deaths are accidents. Additionally, a known disease or something done on purpose can also cause a baby to die suddenly or unexpectedly. For some, a cause is never found.

Why should my baby sleep alone?
Babies are safest when they sleep alone in a crib, bassinet, or pack 'n play. When a baby sleeps with another adult or child, that person could accidentally roll over and suffocate the baby, or the baby may get wedged between two objects, such as a bed and wall or a furniture cushion.

Your baby should sleep where you can see and hear them. Experts have found that babies who sleep in a crib, bassinet, or pack 'n play in their parents' room have a reduced risk of sleep-related infant death. You can share your room, but you should not share your bed. This can be difficult when new parents are tired and babies have difficulty sleeping. If you need help or feel overwhelmed, reach out to your pediatrician, family members, or one of our Breast Feeding Peer Counselors.

Why shouldn’t I use bumpers pads, pillows, blankets, or stuffed animals in my baby’s sleep area?
Babies can suffocate on pillows, blankets, stuffed animals and other objects placed in the sleep area. Before crib safety was regulated, the spacing between the slats of the crib sides could be any width. Parents and caregivers used padded crib bumpers to protect infants from getting trapped. Now that cribs must meet safety standards, the bumpers are no longer needed.

Why should I place my baby on his or her back to sleep?
Back sleeping protects a baby's airway and ensures access to fresh air. Babies sleeping on their stomach can sleep too deeply and may not wake up to take a breath. Young babies can have poor head and neck control, when placed on their stomachs they may not be able to phyiscally move to take a breath if needed.

Will my baby get flat spots on the back of their head?
Flat spots can occur if babies are left in the same position too often or for too long a time. Making sure your baby gets enough tummy time, and changing positions during feedings can help prevent these flat spots. Flat spots are usually not dangerous and typically go away on their own once the baby starts sitting up. Flat spots also are not linked to long-term problems with head shape. Contact your pediatrician or primary care provider if you have questions or concerns.

What if my baby can’t get used to sleeping on his or her back?
Parents and caregivers should place babies on their backs to sleep even if they seem less comfortable or sleep more lightly than when on their stomachs. Some babies don't like sleeping on their backs at first, but most get used to it quickly. The earlier you start placing your baby on his or her back to sleep, the more quickly your baby will adjust to the position.

Is it okay if my baby sleeps on his or her side?
Babies placed to sleep on their sides are at increased risk for SIDS. For this reason, babies should sleep wholly on their backs—the position associated with the lowest SIDS risk.

My baby sleeps well in their car seat, bouncy seat or swing, why is that wrong?
A baby's airway is only about the size of a drinking straw. Babies can suffocate while sleeping in a swing or any seat that puts them on an incline. The incline could cause the baby's head to slump and their airway could be pinched.

Car seats, swings and other sitting devices are not recommended for routine sleep. If your baby falls asleep in a swing, bouncy seat, car seat, or other sitting devices, he or she should be moved to a crib, bassinet, or pack ‘n play as soon as it is possible.

What if my baby rolls onto his or her stomach during sleep? Do I need to put my baby in the back sleep position again if this happens?
No. Rolling over is an important and natural part of your baby's growth. Most babies start rolling over on their own around 4 to 6 months of age. If your baby rolls over on his or her own during sleep, you do not need to turn the baby over onto his or her back. The important thing is that your baby starts every sleep time on his or her back to reduce the risk of SIDS, and that there is no soft, loose bedding in the baby's sleep area.

Are there times when my baby should be on his or her stomach?
Yes, your baby should have plenty of tummy time when he or she is awake and when someone is watching. Supervised tummy time helps strengthen your baby's neck and shoulder muscles, build motor skills, and prevent flat spots on the back of the head.

Should I swaddle the baby or use a hat to keep them warm?

Avoid overheating your baby when using a hat or swaddle. Hats and swaddles can become a suffocation hazard if they fall off into the sleeping space.  Additionally, swaddling a baby too tightly can make it hard for baby to breathe. Swaddling with the baby's legs straight and tight together can cause developmental problems with a baby's hip joints. Baby's hips and legs should be able to move when swaddled. Swaddling should be stopped by 6 to 8 weeks of age, or if baby shows signs of trying to roll over.

Are there other things I can do to decrease the risk of sudden infant death?

Breastfedding is recommended because it provides the best nutrition for babies. Breastfeeding builds the immune system and promotes bonding. It has been shown to reduce the risk of sleep-related infant death. If you have questions about breastfeeding, contact Your Local Health Department to speak to one of our Peer Counselors, or your baby's provider.

Consider offering a pacifier at naptime and bedtime. While not completely understood, sucking a pacifier may support the baby's airway, or it may allow additional airflow around baby's nose. Pacifier use should be discontinued by age 1 to protect developing teeth. If breastfeeding, pacifiers should not be used until breastfeeding is firmly established.

Don't allow anyone to smoke around your baby. Smoking during pregnancy and exposure to second hand smoke can increase a baby's risk of SIDS and sleep-related death.

What if my baby’s grandparents or another caregiver wants to place my baby to sleep on his or her stomach for naptime?
Babies who usually sleep on their backs but who are then placed to sleep on their stomachs, such as for a nap, are at very high risk for SIDS. So it is important for everyone who cares for your baby to use the back sleep position for all sleep times—for naps and at night.

For additional questions contact:

Coldwater 517-279-9561 ext. 116

Hillsdale 517-437-7395 ext. 324

Three Rivers 269-273-2161 ext. 245

Additional Parent/Caregiver Resources

What is normal?

Safe Sleep for Baby

How to Keep your Sleeping Baby Safe

Smoking and Safe Sleep

Professional Resources

Safe Sleep Communication Toolkit - MDHHS