According to the Centers for Disease Control and Prevention, each year there are about 3,400 sudden unexplained infant deaths (SUID) — the unexpected death of an infant under 1 year of age due to unknown causes. These deaths include accidental suffocation or strangulation in the sleeping area when babies are not able to breathe normally.

A safe sleeping area — along with how you lay your baby down to sleep — can prevent SUID.

Reducing the Risk for Sleep-Related Infant Deaths

The American Academy of Pediatrics recommends the following for reducing the risk for sleep-related deaths from birth to 1 year old:

• Know the ABCs of safe baby sleep:
  • A is for alone. Put baby to sleep alone in their crib. Keep soft items like toys, crib bumpers and blankets out of the crib.
  • B is for back. Place your baby on their back to sleep. Do this during naps and at night. Studies show this is the best way to reduce the risk for SUID or other sleep-related causes of infant death. Don’t put a baby on their side or stomach to sleep.
  • C is for crib. Use a safe sleep surface. Babies should sleep on a firm, flat surface. Don’t use one that is at an angle or inclined. Safe examples are a crib, bassinet, portable crib, or play yard that follows the safety standards of the Consumer Product Safety Commission. Check their website at cpsc.gov to make sure the product is not recalled. This is especially important for used cribs. Don’t use broken cribs or cribs with missing instructions or missing parts. Many babies have died in cribs that were broken or had missing parts. The space between crib bars must be no more than 2-3/8 inches apart. This way, the baby can’t get their head stuck between the bars.
• Don’t smoke or use nicotine around your baby. Keep smoke of any kind away from your baby. No cigarettes, marijuana or vaping in your home. Babies exposed to smoke have more colds and other illnesses. Smoke of any kind increases a baby’s risk of dying while sleeping, especially babies who are sick.
• Don’t share a bed with your baby. This is extra important if your baby is very young or small or was born prematurely. This is also very important if you have been drinking alcohol, used marijuana, or have taken any medicines or illegal drugs. Don’t put your baby to sleep in a bed with other children or adults. You can bring your baby to your bed for feedings and comforting, but return your baby to the crib or bassinet for sleep. Don’t fall asleep with your baby. Bed-sharing is also not advised for twins or other multiples.
• Share your room instead of your bed with your baby. The American Academy of Pediatrics recommends that babies sleep in the same room as their parents, close to their parents’ bed. But, babies should be in a separate bed or crib appropriate for babies. This sleeping arrangement is recommended for at least the first six months.
• Use correct bedding. Your baby should sleep on a firm, flat mattress or firm surface with no slant. The mattress should fit tightly and be designed just for the crib. Cover the mattress with a fitted sheet. Don’t use fluffy blankets or comforters. Don’t let your baby sleep on an adult bed, waterbed, air mattress, sofa, sheepskin, pillow or other soft material. Don’t put soft toys, pillows or bumper pads in the crib. Don’t use weighted blankets, sleepers, swaddles or other weighted items. Make sure nothing is covering your baby’s head. These increase a baby’s risk of suffocating.
• Put your baby in other positions while they are awake. This helps your baby grow stronger. It also helps prevent your baby from having a misshaped head. When your baby is awake, hold your baby. Give your baby time on their tummy while awake and supervised for short periods of time, beginning soon after coming home from the hospital. Slowly increase tummy time to at least 15 to 30 minutes each day by 7 weeks old. Try not to let your baby sit in a seat or swing for long periods of time.
• Don’t use sitting devices for routine sleep. Infant seats, car seats, strollers, infant carriers and infant swings are not advised for routine sleep. These may lead to blockage of a baby’s airway or suffocation. If your baby is in a sitting device, remove them from the device and put them in the crib or other appropriate surface as soon as is safe and practical.
• Make sure your baby doesn’t get overheated when sleeping. Keep the room at a temperature that is comfortable for you and your baby. Dress your baby lightly. Instead of using blankets, keep your baby warm by dressing them in a sleep sack, or a wearable blanket. Don’t use a hat on your baby indoors.
• Use caution when swaddling your baby. Swaddling doesn’t reduce the risk for SUID. If you choose to swaddle your baby, make sure they are on their back and the swaddle is not too tight. Stop swaddling your baby when they look like they’re trying to roll over. Some babies start working on rolling as early as 2 months. The risk of suffocation is higher if your baby rolls to their stomach while they are swaddled.
• Offer a pacifier (not attached to a string or a clip) to your baby at naptime and bedtime. This helps reduce the risk for SUID. If you are breastfeeding, don’t give the baby a pacifier until he or she is breastfeeding well.
• Don’t use wedges, positioners, special mattresses or special sleep surfaces. These devices have not been shown to prevent infant death, and in rare cases, have resulted in infant death. Cardiorespiratory monitors sold for home use are also not helpful in preventing death.
• Always place cribs, bassinets and play yards in hazard-free areas. Make sure there are no dangling cords, wires or window coverings. This is to reduce the risk for strangulation. Place the crib away from windows.

Other Ways to Lower Risk of SUID

• Breastfeed your baby. Give your baby only human milk for at least six months, unless your child’s doctor tells you otherwise. Experts advise giving babies human milk for one year or longer. This depends on if both you and your baby want to do this. Using human milk for a year or longer reduces the risk for SUID and many other health problems.
• Take your baby for checkups and vaccines. If your baby seems sick, call your baby’s pediatrician. Take your baby in for regular well-baby checkups and routine shots.
• Don’t use alcohol, marijuana, opioids or illegal drugs. There is an increased risk for SUID with exposure to substance use. Using these substances affects your ability to care for your baby.

Safe Sleep When Your Baby is Sick

Babies with a recent or current illness, such as a respiratory infection, are at a higher risk for SUID. Following safe sleep guidelines is even more important when your baby is sick. Do this even if they have symptoms like congestion, runny nose, coughing or poor appetite.

If you are concerned about your baby’s health, contact your baby’s pediatrician right away.