Safer sleep advice has saved many babies’ lives. It is all backed by research that has shown how to reduce the chance of babies dying suddenly with no explanation (known as sudden infant death syndrome, SIDS, or cot death). To reduce the chance of SIDS, families should follow key safer sleep advice for baby sleep.

The most important thing to remember is to always place your baby on their back for sleep

  • Put your baby down on their back, not their front or side, for every sleep
  • No special equipment or products are needed to keep them on their back
  • Once they start to roll from front to back by themselves, you can leave them to find their own position for sleep
  • Tummy time while awake can help to strengthen the muscles they need for rolling

The reason for this is many more babies have died suddenly when placed to sleep on their front or side, than on their back. Since the Back to Sleep campaign in 1991 the rate of SIDS has dropped by 80%.

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Give your baby a clear, safe sleep space, in the same room as you

For most babies, a clear sleep space will mean a cot or a Moses basket, but for some babies sharing an adult bed may be an alternative.

Whatever space you choose, it needs to be:

  • A firm flat mattress with no raised or cushioned areas
  • No pillows, quilts or duvets, bumpers, loose bedding or soft toys in the bed
  • No pods, nests or sleep positioners
  • Make sure your baby’s head is kept uncovered so they don’t get too hot

Babies should always be in the same room as you for the first six months for sleep, day and night. This doesn’t mean you can’t leave the room to make a cup of tea or go to the toilet, but for most of the time when they are sleeping they are safest if you are close by.

The reason a clear cot is advised is that soft or raised surfaces, pillows or quilts can increase the chance of SIDS by making it difficult for babies to breathe or cool down. The chance of SIDS is lower when babies sleep in a room with an adult than when they sleep alone.

Keep your baby smoke free before and after birth

  • Smoking in pregnancy greatly increases the chance of SIDS – all pregnant women should make every effort to take up the help to stop smoking provided locally
  • You should also avoid being exposed to others’ smoke when you are pregnant – if your partner smokes they can get help to quit too
  • Keep your baby away from smoke in your home, car and out and about

This is because babies who are exposed to tobacco smoke before or after birth have a much greater chance of SIDS than babies who are kept smoke-free.

Breastfeeding

  • Breastmilk and breastfeeding provides all the nutrition your baby needs for the first 6 months

and protects them against infections and diseases

  • Breastfeeding lowers the chance of SIDS

The risk of SIDS is halved in babies who are breastfed for at least 2 months.

If you share a bed with your baby

Whether you choose to bed-share, or it is unplanned there are some key risks you should avoid.

It is dangerous to share a bed with your baby if:

  • you or anyone in the bed has recently drunk any alcohol
  • you or anyone in the bed smokes
  • you or anyone in the bed has taken any drugs that make you feel sleepy
  • your baby was born prematurely (before 37 weeks of pregnancy) or weighed under 2.5kg or 5½ lbs when they were born.

In these scenarios, it is always best to put baby in their own safe sleep space such as a cot or a Moses basket. Keeping the cot or Moses basket next to the bed might make it easier to do this.

The reason for this is studies have found that bed-sharing with your baby after drinking alcohol or using drugs has a very high risk of SIDS. Sleeping close to a smoker also greatly increases the chance of SIDS. Premature and very small babies have a greater chance of SIDS when they share a bed with an adult.

Safer sleep tips for reducing the risk when bed-sharing

Follow the tips if you think you might fall asleep with your baby in the bed even if you don’t intend to co-sleep:

  • Make sure baby won’t fall out of bed or get trapped between the mattress and the wall
  • Keep pets away from the bed and do not have other children sharing the bed
  • Keep pillows and adult bedding away from baby
  • Never sleep with your baby on a sofa or armchair

Any time you think you might fall asleep with your baby make sure they are on their back in a clear safe space. If you are breastfeeding whilst lying down, make sure your baby cannot roll

on their front. Try and keep your baby on their back, or move them onto their back once they have been fed.

Never fall asleep with your baby on a sofa or armchair

Sofas and armchairs are dangerous places to fall asleep with your baby- move somewhere safer if you might fall asleep.

The risk of SIDS is 50 times higher for babies when they sleep on a sofa or armchair with an adult. They are also at risk of accidental death as they can easily slip into a position where they are trapped and can’t breathe.

Keeping your baby at the right temperature

Temperature is key to safer sleep. We advise that babies’ sleeping environment should be between 16 and 20 degrees, which can feel quite cool for us as adults, however, the key is ensuring babies don’t get too hot.  It is important to make sure that your baby is a comfortable temperature – not too hot or too cold. The chance of SIDS is higher in babies who get too hot.

A room temperature of 16-20°C – with light bedding or a lightweight, well-fitting baby sleep bag– is comfortable and safe for sleeping babies.

It can be difficult to judge the temperature in the room, so use a room thermometer in the rooms where your baby sleeps. In the winter months It is rarely necessary to keep your heating on all night, and adding an extra layer will usually help. Remember not to add a hat to your baby when they are indoors, as their head is important for maintaining their body temperature by releasing heat. If you do feel your home is too cold and you want to leave the heating on all night, make sure it is set at a low temperature, and certainly no higher than 20?C.

All babies are different so we recommend checking baby’s chest and/or back of their neck to make sure their skin doesn’t feel clammy or sweaty to the touch, (their hands and feet will always feel cold to touch.) Warm is fine but if it feels sweaty or clammy it means they are too hot so remove a layer of what they are wearing.

When babies feel unwell, with a cold or fever, they may be warmer than usual. It is important that you put fewer layers on an unwell baby so they have the opportunity to lower their body temperature – don’t feel tempted to wrap an unwell baby up more than usual.

Choosing the right bedding for your baby

When it comes to safer sleep advice and bedding, there are a few things you should remember.

Baby sleeping bags are a good option as they prevent your baby’s head from being covered by wriggling under bedding. You can choose different togs for different seasons to help keep your baby at the right temperature. You can also select different sizes depending on the age of your baby. It is important that the sleeping bag fits well around the shoulders so that your baby’s head does not slip down into the bag. Extra bedding should not be needed.

Blankets are fine as an alternative as long as they aren’t too thick or doubled over, so there is no chance of overheating. If using blankets, make sure they are firmly tucked in and come up no higher than the shoulders. Sleep your baby in the ‘feet-to-foot’ position (baby’s feet against the foot of the cot) to avoid their face becoming covered by loose bedding.

We do not advise on a set tog rating for bedding, sleep bags or what babies need to wear, as individual differences in baby’s temperature are too great and it will also be dependent on the time of year and room temperature. Generally, we advise parents to use a lower tog rating and if you feel the baby is too cool then you can add an extra layer of clothing or bedding. We know research shows babies are better to be cooler rather than overheated so do bear that in mind.

If you follow safer sleep advice for every sleep, the chance of SIDS is very low. Do not worry alone – if you have a question ask your midwife or health visitor or contact The Lullaby Trust or Basis.

Remember: if you think your baby is showing any signs of being unwell, always seek medical advice

The Lullaby Trust is working in partnership with HALO®, the trusted leader for safe sleep-focused baby products, to champion the charity’s safer sleep advice and help all families give their babies the best possible start in life. HALO’s® first products to arrive in the UK were the SleepSack® Swaddle & Sleeping Bags in October followed by the BassiNest® in November, the only bassinet on the market to swivel 360 degrees for safe, close sleep.

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