What Parents Should Know About Safe Sleep for Infants

On average, newborns sleep for 16 to 17 hours daily, or approximately 70% of the day.

The length of time an infant sleeps decreases with age but remains high, with 6-month-old infants resting for 13 to 14 hours daily. While needed for normal growth and development, it can also be dangerous. Approximately 3500 infants die each year from sleep-related deaths in the US, and many are preventable. Parents have so many responsibilities that begin the day they take their newborn home from the hospital. An important task is creating a safe sleep environment.

Phrases such as “back to sleep” and “back is best” emphasize that the safest sleeping position for infants is on their backs on a firm, flat surface. Examples of safe sleep spaces include cribs, bassinets, and play yards without any pillows, blankets, loose sheets, crib bumpers, or toys. Baby swings, in-bed sleepers, and car seats can be used when infants are awake but are not safe for sleeping. Swaddling, the wrapping and tucking of an infant in a blanket to soothe them, is safe until about 3 to 4 months of age, or until the infant begins to show signs of wanting to roll over. At that point, swaddling during sleep should be stopped to decrease the risk of suffocation in a loosened swaddle blanket.

Surface sharing or co-sleeping is a dangerous practice with severe consequences. When a parent, sibling, or other individual sleeps on the same surface as the infant in a bed, chair, or on the couch, this increases the risk of suffocation more than 60 times. An infant who is suffocated can have permanent brain damage or die. When a caregiver begins to feel drowsy, the infant should be placed in a separate safe sleep space as described above. Some infants have trouble falling asleep without being held, and this can lead to co-sleeping. Tips that may help the infant fall asleep in the crib, bassinet, or play yard include wearing a warm snug outfit or listening to white noise on a sound machine. For close monitoring and bonding, the crib, bassinet, or play yard should remain in the parent’s room for at least the first 6 months of life. Infants who stay in the parent’s room during sleep have a lower risk of sudden infant death syndrome (SIDS).

There are other practices parents can do to reduce the risk of sleep-related infant deaths, such as breastfeeding (especially in the first months of life), offering a pacifier, and ensuring a nonsmoking and drug-free environment. Parents can play an active role in helping their infant thrive.

Infants spend more time asleep than awake, and sleep is crucial for an infant’s growth and brain development. Even as infants grow, toddlers, children, and adolescents need safe and consistent sleep practices. For infants, sleep is one of the most important activities they do but can also be one of the most dangerous. Sleep is just as important as feeding or play time, and a parent is the most important person in ensuring safe sleep for infants.

The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be downloaded or photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email reprints@jamanetwork.com.

JAMA Pediatrics

Back to Archive