New Guidelines to Prevent Sudden Infant Death Syndrome (SIDS)

Learn the updated American Academy of Pediatrics (AAP) recommendations on how to protect your baby from SIDS.

Sanaz Majd, MD
5-minute read
Episode #86

1. Back to Sleep: Placing your baby on her back to sleep is not a new recommendation. Placing babies on their stomach or side has shown to decrease oxygenation to the brain, and also contributes to over-heating (another risk factor for SIDS). Doctors recommend that you place you baby on her back, and not on her stomach or side to sleep. 

2. Don’t Pimp the Crib : It may be tempting to adorn the crib with cute plush toys, pretty pillows, loose blankets, cuddly quilts/comforters, or even those colorful bumper pads that almost all venders sell in their crib sets. However, when it comes to the crib, less is more. All those extras are really just for us adults—the baby could care less. Placing any object inside the crib is a risk factor for suffocation or entrapment, and increases the risk of SIDS five-fold. Infants, unlike adults, require a firm sleep surface—so placing soft bedding to make baby more “comfortable” is an adult misperception.  One option is to dress the baby in a wearable blanket, as long as it is appropriately sized. The crib should have nothing else but the following three layers: mattress, mattress pad, and a snug crib sheet. That’s it. The other benefit: no need to spend money on all the other, potentially dangerous frills.

3. Select a Safe Sleep Vessel: Infants should sleep only in the crib, portable crib, play yard, or bassinet. Using a borrowed crib is not recommended since older cribs may not meet safety requirements. The mattress should be firm and must fit snugly into the sleeping vessel. Make sure to not exceed the manufacturer’s maximum weight limits of each product as your baby grows. Routinely putting your baby to sleep in a car seat, stroller, swing, bouncer, sling/carrier, or other sitting devices is not considered safe.

4. Share a Room, Not a Bed: Infants should not be put to sleep in your bed. Sharing a sleep surface with the baby can cause strangulation, overheating, entrapment, or suffocation. Devices that promote bed-sharing as “safe,” such as in-bed co-sleepers, are also not recommended. Sharing a room is highly encouraged, however, but with the baby in his own appropriate sleeping surface close by the parents’ bed. In this way, you can monitor, bond, and comfort the baby, without unnecessary risk.

5. Avoid Overheating and Head Covering: Make sure your baby’s room is well-ventilated and not over-heated. That being said, you don’t want to keep poor junior in a super cold room either. Also, avoid covering your infant’s head or face in any way during sleep. If you swaddle your baby, make sure it’s not too tight or too loose, and that the fabric is a thin, breathable cotton. The swaddle should only cover from the shoulders down.

6. Breastfeed Your Baby: Breastfeeding has shown to have a protective effect against SIDS, and if you can breastfeed your baby for at least the first 6-12 months of life, this is just one more benefit to add to the long list. Just remember to return your princess to her own royal crib if she falls asleep while breastfeeding. It can be too tempting for exhausted mothers to simply leave the baby in their bed after the feeding. But it’s a risk you don’t want to take.

7. Use a Pacifier: Believe it or not, the use of a pacifier at naptime or bedtime may have a protective effect against the incidence of SIDS. However, it should not be introduced until breastfeeding is well-established, typically 4 weeks after birth, so that it does not interfere with the infant’s ability to latch and feed well. Also, never attach a pacifier to the infant in any way, as this is a strangulation hazard. And if it happens to fall out of your baby’s mouth during sleep, no need to reinsert it, as it is still considered to be protective even though it falls out. In order to avoid dental decay and ear infections please discontinue pacifier use at age 1.


Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.

About the Author

Sanaz Majd, MD

Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women's health and patient education.