SIDS Guidelines

To help reduce the risk of SIDS for your new baby, it is important to provide a safe sleeping environment for your child. The American Academy of Pediatrics has provided a list of recommendations to help keep your baby as safe as possible.

1. Back to sleep for every sleep!

The risk of SIDS is significantly increased when a child sleeps on his or her belly or side. Sleeping on his or her back at night does NOT increase the risk of choking in infants, even those that have reflux. Infants should be placed on their back to sleep until 1 year of age, but once an infant can roll both ways, they can be allowed to remain in the sleep position that they assume.

2. Use a firm sleep surface

– a firm crib mattress with a fitted sheet is the recommended sleeping surface to reduce the risk of SIDS. Cribs with missing hardware should not be used and the parent should not attempt to fix broken components of a crib. There should be no gaps between the mattress and the side of the crib. Infants should NEVER be placed for sleep on beds because of a risk of suffocation. Car seats, strollers, swings, infant carriers and infant swings are not recommended for routine sleep – infants less than 4 months are particularly at risk for suffocation in those locations.

3. Room-sharing WITHOUT bed sharing is recommended.

Bed co-sleepers are not recommended – the infant’s crib, portable crib or bassinet should be placed in the parents’ bedroom close to the parents’ bed. Infants should not be fed on a couch or armchair when there is a risk that the parent may fall asleep due to an extremely high risk of suffocation in such situations. NO studies have shown that bed sharing protects against SIDS. Certain situations make bed-sharing even more risky including: bed-sharing with infants less than 3 months of age; bed-sharing with parents who are smokers, excessively tired, or who use medications/substances (e.g. antidepressants, pain medications, alcohol or illicit drugs) that decrease their ability to be awoken; bed-sharing with anyone who is not a parent or with multiple people; bed-sharing on a soft surface or a bed with soft-bedding, pillows, blankets, quilts or comforters.

4. Keep soft objects and bedding out of the crib.

Bumper pads do not protect infants against injury and should NOT be used.

5. Avoid smoke exposure, alcohol and illicit drug use during pregnancy and after birth.

6. Any breast-feeding is associated with a decreased risk of SIDS.

7. Consider offering a pacifier at nap time and bedtime.

Pacifiers should not be hung around an infant’s neck or attached to clothing. Stuffed toys should not be attached to pacifiers. The pacifier should not be reinserted once the infant falls asleep.

8. Avoid overheating.

Infants should wear no more than 1 layer than an adult would wear to be comfortable. Overbundling and covering of the head should be avoided.

9. Immunizations have a protective effect against SIDS!

10. Avoid commercial devices to reduce the risk of SIDS

including wedges, positioners, special mattresses and special sleep surfaces.

11. Do not use home cardiorespiratory monitors to reduce the risk of SIDS

– there is no evidence that they work.

12. Promote awake tummy time each day

to reduce the risk of the infant developing a flat head.

Return to Parent Handouts

Is Your Child Sick?®