Safe Sleeping for Newborns – Best Practice for Your Baby

No doubt about it, newborns are far from being just small adults. One area where this can be especially apparent is a newborn’s unique sleeping needs and patterns.

A young baby’s nervous, circulatory and respiratory systems are still maturing, and this can make them more vulnerable to injuries or death during sleep. A newborn also lacks the strength and coordination to reposition their head and body if they should get into a dangerous situation.

As terrifying as that sounds, there are several things you can do to help your baby rest as safely as possible. Thankfully, the number of Sudden Infant Death Syndromes (SIDS) cases has fallen by more than half in the years between 1993 and 2010. This change is due in large part to clear safety guidelines and the “Back to Sleep” parental awareness program initiated in the mid-1990s.

Safe Sleeping for Newborns

Keep the following points in mind as you set up your baby’s sleeping area, and never hesitate to ask your healthcare provider if you have any questions or feel like you need additional guidance.

Always Place Your Baby on Their Back

It used to be common practice to lay infants down on their stomachs to sleep. However, this position could place a young baby at an increased risk of suffocation, and the trend began to change in 1992 when the American Academy of Pediatrics released new guidelines that babies should be laid down on their backs or sides. These guidelines were updated a few years later to recommend that babies be placed exclusively on their backs.

It may seem like back sleeping could put a baby at an increased risk for choking if they spit up while sleeping, but the opposite seems to be true. Protective reflexes help guard against choking by causing your baby to automatically cough, swallow or turn their head so any fluid will run out of their mouth.

As long as you are awake and alert, it is safe to hold your sleeping baby upright in your arms or an appropriate carrier. However, always place your baby on their back whenever you lay them down.

Lay Your Baby on a Flat, Firm Surface

Parents frequently use swings, infant seats, rockers or other reclining devices as beds, mostly due to the fact that their baby seems comfortable and sleeps well in them. However, these products are not designed to be used while your baby is asleep, and using them for this purpose could be dangerous.

Angled surfaces can make it easier for your baby to sink into a position where their chin tucks down against their chest and their airway becomes compromised. Since newborns have such poor muscle strength, they may not be able to move their head or body if they settle into an unsafe position. If your baby falls asleep in a reclining device, move them to a flat surface as soon as you can.

Mattresses that are overly soft or squishy could present a suffocation hazard. While your baby doesn’t have to sleep on a hard surface, it should definitely be a firm one. Fortunately, many crib, bassinet and play yard mattresses are designed to be both comfortable and safe. Look for products that have been approved by the Consumer Product Safety Commission.

Learn to Recognize Normal and Abnormal Newborn Breathing

Maybe you have watched your baby sleep and have felt a little uneasy about the seemingly random episodes of rapid, shallow breathing and several-second pauses followed by a few deep breaths. Not to worry: This is a perfectly normal breathing pattern for a sleeping newborn, and it is the result of an immature respiratory system.

However, seek medical attention right away if you notice your baby doing any of the following:

  • Breathing pauses that last longer than ten seconds.
  • Labored breathing. Your baby is having a hard time breathing when their skin pulls in around their ribs or collarbone (known as retractions), their nostrils widen when they breathe in (known as nasal flaring) or they make a grunting noise at the end of an exhalation.
  • Consistently breathing more than 60 times in a minute.
  • Blue skin around the mouth area.
  • Gasping, wheezing or high-pitched noises when your baby breathes.

Room Share With Your Baby for At Least the First Six Months

Setting up your baby’s sleeping area in your own bedroom can make nighttime breastfeeding and soothing a little easier. The downside to room sharing is that both baby and parents usually sleep less overall.

However, sleeping less seems to have its benefits. Babies who room share for at least the first six months tend to have a lower instance of SIDS. The exact reasons are unclear, but some experts believe that the frequent disruptions and wakings throughout the night actually prevent your baby from falling into a dangerously deep level of sleep.

If your bedroom is large enough, you can set up your baby’s full-size crib. If you have a little less space to work with, look into using a bassinet, play yard with sleeper attachment or a bedside co-sleeper. We have covered the differences between the crib, cradle and bassinet in a separate article.

Swaddle Your Baby Safely

Swaddling is the process of snugly wrapping your baby in an attempt to mimic the cozy feel of the womb. Both swaddling blankets or sleepsuits can help you achieve this comforting sensation.

Swaddling blankets are usually a little larger in size and are ideal for wrapping and tucking around your baby. They are made from light, open-weave materials that allow for airflow and decrease the risk of suffocation.

Proper wrapping techniques are crucial for safe swaddling. There are helpful video tutorials available online, or you can also ask your child’s healthcare provider if they or a nurse could give you a lesson in person.

Sleepsuits are an easy-to-use garment designed to mimic the feel of a traditional swaddle without all the layers and tucking required with a swaddling blanket. These products wrap around your baby and secure with zippers, snaps or Velcro.

Dress Your Baby in Appropriate Clothing

Overheating is a risk factor for SIDS, so you need to be careful to avoid over-dressing your baby.

Since your baby can’t tell you if they are too hot or cold, it can be a challenge for you to know if your baby is at a comfortable and safe temperature. A good general rule is to dress your baby in clothing you would feel comfortable in plus one additional layer. For example, if you would be comfortable in knit pants and a long sleeve top, dress your baby in similar clothing with a onesie underneath or with a light layer over their top.

Even though your baby probably wore a hat at the hospital, don’t use one during sleep after your baby is more than a few days old. Babies lose a great deal of body heat through their scalp and covering their heads while sleeping could lead to overheating.

Be observant for signs that your baby is too hot:

  • Feeling warm to the touch, especially the ears and neck area. Do not base your assessment of your baby’s body temperature on the feel of their hands and feet. Newborns still have immature circulatory systems, so cool hands and feet are perfectly normal.
  • Unusually rapid breathing.
  • Difficulty sleeping, crying and general fussiness.
  • Red cheeks or forehead.
  • Sweating on the head or underarms.

Keep Your Baby’s Crib Free of Toys or Excess Bedding

Even though baby stores or magazines may display elaborate crib set-ups with coordinating sheet sets, comforters, pillows and bumper pads, these items are not only unnecessary but could also be unsafe.

Always use a minimum amount of bedding. Lay a waterproof pad directly on the mattress, then cover it with an elasticized sheet. Make sure your crib sheet fits well with no puckering. Instead of loose blankets, use your baby’s clothing and a swaddle or sleepsuit to keep your baby warm.

Don’t place any pillows, toys or stuffed animals in bed with your newborn. These could cause a choking or suffocation hazard.

Even though your baby’s bare bed may not look like what you had pictured, remember that safety is most important. Luckily, your baby is too young at this point to notice or care what their bed looks like, and there will be plenty of chances for you to set up that adorable bed when your baby gets a little older.

What About Bed-sharing?

While there are families who bed-share at least part of the time, experts strongly recommend against having your baby sleep in bed with you. The typical adult bed is not designed for an infant to sleep in safely, and there have been numerous reports of babies getting injured or worse while bed-sharing.

A bedside co-sleeper or a bassinet next to your bed could be an ideal alternative. These products provide your baby with a safe place of their own to sleep while also keeping them easily within your reach.

If you have any interest in bringing your baby in bed with you, it’s best to have a plan already in place rather than just laying down together in the middle of the night out of desperation and exhaustion. The family bed should meet as many of the same safety requirements of a traditional baby bed as possible.

  • Make sure your base sheet fits tightly, and don’t use any pillows, extra blankets or other bedding.
  • A firm mattress. Never let your baby sleep on sofa, armchair or waterbed.
  • Since your baby will be near enough to absorb some of your body heat, dress your baby in fewer layers and be especially vigilant for signs of overheating.
  • Move your bed to eliminate any spaces between the mattress and the wall or bed frame.

Additionally, many infant accidents have occurred when the parents were under the influence of various substances, and you should never attempt to bed share when either you or your partner has had any alcohol or drugs, including some prescription medications. These substances could greatly alter your spatial perception or cause you to sleep more deeply than you normally would. If you have any questions about how a medication may affect you, talk to your health care provider.

No parent wants to think about their baby having an accident of any kind while sleeping or otherwise. Although it can be easy to focus on the negative and let worry take over, do your best to stay positive. Remember to be thankful for with the advances in baby equipment, safety guidelines and knowledge about how a newborn’s body works.

By investing the time to learn about a newborn’s sleep needs and taking steps to make their bed as safe as possible, you can help both yourself and your baby rest a little easier.