This page summarises published guidance — it is not medical advice and it is not a substitute for your pediatrician. It reflects the American Academy of Pediatrics 2022 policy statement on sleep-related infant deaths. Recommendations differ slightly between countries; follow the guidance issued by your own national health authority, and speak to your healthcare provider about your specific situation.
Sleep-related infant death is rare, and the great majority of the risk is modifiable. The recommendations below apply from birth through the first year, and the first four are the ones that carry the most weight.
The core recommendations
1. On the back, every sleep
Place your baby fully on their back for every sleep, including naps and including sleep outside the home. Side-lying is not safe — it is unstable and babies roll to their front from it. Once a baby can roll both ways independently, usually around 4–6 months, you do not need to reposition them if they roll during the night; keep starting every sleep on the back.
2. A firm, flat, level sleep surface
Use a crib, bassinet, portable crib or play yard that meets current safety standards, with a firm mattress and a tight-fitting sheet. The surface should be flat and level — not inclined. Car seats, strollers, swings, slings, and infant carriers are not for routine sleep; if a baby falls asleep in one, move them to a flat surface as soon as it is practical.
3. Nothing else in the sleep space
No pillows, no loose blankets, no quilts, no bumper pads, no positioners or wedges, no soft toys. A fitted sheet and the baby. For warmth, use a wearable blanket or sleep sack rather than loose bedding.
4. Room-share, but do not bed-share
Sleep in the same room as your baby — on a separate surface, close to your bed — ideally for at least the first six months. Bed-sharing is not recommended. Risk is substantially higher if the baby is under four months, was born preterm or low birth weight, or if the surface is a sofa or armchair, or if anyone in the bed smokes, has drunk alcohol, or has taken medication or substances that affect arousal. Sofas and armchairs are the highest-risk surfaces of all — if you feel you might fall asleep while feeding, the bed is safer than the sofa.
The rest of the guidance
- Avoid overheating. Dress your baby in no more than one layer more than an adult would find comfortable. Watch for sweating or a hot chest. Do not cover the head.
- No smoke exposure, during pregnancy or after birth. This includes vaping.
- Avoid alcohol and drug use during pregnancy and after birth.
- Breastfeeding is protective against SIDS, with the effect increasing the longer it continues.
- Consider a pacifier at nap and bedtime once feeding is established. If it falls out after the baby is asleep, there is no need to reinsert it.
- Keep up routine immunisations. There is no evidence vaccines increase SIDS risk, and some evidence of a protective effect.
- Supervised tummy time while awake, from the first days, helps development and reduces flat spots.
- Avoid home cardiorespiratory monitors as a strategy to reduce SIDS risk — there is no evidence that consumer monitors reduce it.
- Avoid commercial devices inconsistent with safe sleep guidance, including inclined sleepers, positioners and weighted blankets or weighted sleep sacks.
- Swaddling: if you swaddle, keep the baby on their back, keep the hips loose, and stop swaddling as soon as your baby shows any sign of trying to roll, usually around 3–4 months. A swaddled baby who rolls to their front is at serious risk.
Safe sleep and sleep training
Every one of the methods in our sleep training guide assumes a sleep space that follows this guidance. If you are changing anything about where or how your baby sleeps, sort the safety of the space first — a clear crib, a firm flat mattress, on the back, in your room.
Room temperature is worth checking too: somewhere around 16–20°C / 61–68°F is commonly recommended, with the baby dressed accordingly.
Sources
- American Academy of Pediatrics, Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, Pediatrics (2022).
- NHS, Reduce the risk of sudden infant death syndrome (SIDS).
- The Lullaby Trust, Safer sleep advice.
Guidance is updated periodically. Check the current recommendations from your own national health authority.
Common questions
When can my baby sleep on their stomach?
Continue placing your baby on their back for every sleep through the first year. Once a baby can roll both ways independently on their own, usually around 4 to 6 months, there is no need to turn them back if they roll during sleep. Always start each sleep on the back.
When should I stop swaddling?
Stop as soon as your baby shows any sign of trying to roll, which is typically around 3 to 4 months. A swaddled baby who rolls onto their front cannot free their arms to lift their head, which is a serious risk.
Is room-sharing the same as bed-sharing?
No. Room-sharing means your baby sleeps in your room on their own separate flat surface, such as a bassinet or crib next to your bed, and is recommended for at least the first six months. Bed-sharing means the baby sleeps on the same surface as an adult, and is not recommended.
Can my baby sleep in a car seat or swing?
Not for routine sleep. Car seats, swings, strollers and carriers are not flat and can allow a young baby’s head to fall forward and restrict their airway. If your baby falls asleep in one, move them to a firm flat surface as soon as it is practical.
Do baby monitors reduce the risk of SIDS?
There is no evidence that consumer home cardiorespiratory or wearable monitors reduce the risk of SIDS, and the AAP advises against using them for that purpose. Following the core recommendations on position, surface and sleep space is what makes the difference.