Advice from Dr. Mom: The ABCs for infant safe sleep

Expectant parents spend months outfitting the perfect nursery for their new baby, while friends and family shower the newborn with blankets and nursery accessories.

Unfortunately, cozy nursery items can be harmful to newborns. Every year we lose babies to sleep-related deaths from suffocation as well as sudden infant death syndrome (SIDS). A recent study in the journal Pediatrics found that nearly 55 percent of infants nationwide are put to bed with blankets or covered by a comforter. These scenarios can increase the risk of infant death in the first year of life.

Follow the ABCs

To ensure a safe sleeping environment, I tell new parents to follow the ABCs:

ALONE: Lay baby to sleep in his or her own crib, bassinet or pack ’n play. Co-sleeping, also called bed sharing, is one of the most significant risk factors in sleep-related deaths. The American Academy of Pediatrics recommends young infants share a room with their parents but have their own dedicated sleep surface.

On their BACK: Placing babies on their back to sleep has proven to decrease the rates of SIDS. This reduces the baby’s risk of suffocation.

In a bare CRIB: Infants should be placed in a crib with a firm mattress and tightly fitted sheet. All other materials should be removed from the sleep space. This includes all blankets, pillows, stuffed animals and bumper pads.

In a SMOKE-FREE home: Exposure to secondhand smoke before birth and during the newborn stage has been linked to a higher risk for SIDS.

Quashing concerns

Parents often express concerns their baby will not be warm enough without blankets. A good rule to follow is to have your baby dressed in one layer more than an adult in the room. The nursery should be kept at a comfortable temperature, and with snug-fitting infant sleep sacks, the use of extra blankets is not necessary. Sleep sacks are a great option for children who are not yet close to rolling over or unwrapping the swaddled blanket.

New families also often fear they will be unable to hear and respond to their child should a problem arise overnight. Sharing a room with your infant during the early months, while having a separate sleep surface for your baby, allows you to attend to your infant’s needs quickly while maintaining a safe sleep routine. A good monitor can allow you to check in on baby even if he or she is sleeping in another room. Pacifier use has also been shown to decrease the rate of SIDS. For breastfed babies, pacifiers should be introduced only after breastfeeding is well-established.

Once parents become comfortable with a safe sleep routine, they should educate other caregivers who play a role in the infant’s first year of life to ensure the baby sleeps safely and soundly when they are not there.

As parents, we need to focus on a new vision of an infant’s safe sleep environment. Even if the image is not as cozy, waking up to a healthy and thriving infant makes the nursery the warmest place in the home.

Visit to read more Advice from Dr. Mom columns.

Erin Frank

Pediatric Hospitalist, UH Rainbow Babies & Children’s Hospital, Assistant Professor, Case Western Reserve University School of Medicine, and mom to a vibrant 2-year-old girl

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