Evidence‑Based Safe Sleep Practices for Infants
Room‑Sharing Recommendations
Sleep Surface and Environment
Contraindicated Sleep Locations
High‑Risk Bed‑Sharing Situations to Avoid Completely
Feeding and Comfort Practices
Special Populations
Equipment and Devices
Safe Sleep Practices for Infants
Sleep Position
- The American Academy of Pediatrics recommends that infants be placed supine (on their back) for every sleep until 1 year of age, as this position confers the lowest risk of SIDS compared to side or prone positioning 6, 7
- Side sleeping is not safe and should not be used, as it carries significantly higher risk than supine positioning 6, 7
- The supine position does not increase choking or aspiration risk, even in infants with gastroesophageal reflux, because infants have protective airway mechanisms 6, 7
Sleep Location
- Room-sharing without bed-sharing is the recommended arrangement, as it decreases SIDS risk by up to 50% 8, 9
- The infant's crib, portable crib, play yard, or bassinet should be placed in the parents' bedroom close to the parents' bed 8, 9, 10
Sleep Environment Safety
- Remove all soft objects and loose bedding from the sleep area, including pillows, quilts, comforters, sheepskins, and pillow-like toys 8, 11
- Keep the sleep area free of hazards such as dangling cords, electric wires, and window-covering cords that present strangulation risk 8, 6, 9
- Avoid elevating the head of the crib, as this is ineffective for reflux and may cause the infant to slide into a compromised position 6, 7
High-Risk Bed-Sharing Situations to Absolutely Avoid
- Parents must avoid bed-sharing when the infant is younger than 3 months, with a current smoker, or with someone who is excessively tired, using medications or substances that impair alertness, or with anyone who is not a parent 8, 9, 11