Safe Sleep 101

Why does back sleeping help lower the risk of SIDS?

When babies sleep on their backs, it helps to keep their mouths and noses unblocked so they breathe in clean, fresh air and do not overheat.

Will my baby choke if placed on his or her back to sleep?

No. Healthy babies naturally swallow or cough up fluids—it’s a reflex all people have to make sure their airway is kept clear. Babies might actually clear such fluids better when on their backs because of the location of the windpipe (trachea) when in the back sleep position. When the baby is in the back sleep position, the windpipe lies on top of the esophagus, which leads to the stomach. Anything regurgitated or refluxed from the stomach through the esophagus has to work against gravity to enter the trachea and cause choking. When the baby is sleeping on its stomach, such fluids will exit the esophagus and pool at the opening for the trachea, making choking much more likely.

What if my baby can't get used to sleeping on his or her back?

The baby’s comfort is important, but safety is more important. Parents and caregivers should place babies on their backs to sleep even if they seem less comfortable or sleep more lightly than when on their stomachs.

Some babies don’t like sleeping on their backs at first, but most get used to it quickly. The earlier you start placing your baby on his or her back to sleep, the more quickly your baby will adjust to the position.

What can I do to help baby fall asleep?

Keep bedtime and naptime routines the same every day, as much as possible. Establish a nightly routine, such as bathing, cuddling, feeding and rocking baby before bed. Gently rubbing baby’s arms and legs, soft lighting, and keeping things quiet for one hour before bedtime helps. Try reading a story, or playing soft music or white noise prior to sleep.

Consider using a pacifier when you place baby on her back for sleep for the first year. Pacifier use has been shown in studies to decrease the risk of SIDS. If baby spits out the pacifier after falling asleep, you do not need to put it back in her mouth.

What if baby rolls over from his back to his tummy or side while sleeping?

Always place babies on their backs when you put them down for sleep. Continue to place babies on backs at bedtime and nap time, even after learning how to roll. Once babies start rolling and choosing own sleep position, you don’t need to keep turning them over onto backs. When babies can roll over, it is even more important that there is nothing else (blankets, soft toys, bumper pads, pillows) in the sleep area to get near their face.

What is Sudden Infant Death Syndrome (SIDS)?

Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant younger than one year of age that remains unexplained. SIDS is the leading cause of death among babies between one month and one year of age. Most SIDS deaths occur in babies between one month and four months of age, and the majority (90%) of SIDS death occur before a baby reaches six months of age. However, SIDS deaths can occur at any time during a baby’s first year. There is no certain way to prevent SIDS, but there are ways to reduce the risk of SIDS and other sleep-related infant death.

What can I do to lower my baby's risk of SIDS?

Safe Sleep Top 10

  1. Always place your baby on his or her back to sleep, for naps and at night. The back sleep position is the safest, and every sleep time counts.
  2. Place your baby on a firm sleep surface, such as on a safety-approved* crib mattress, covered by a fitted sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces.
  3. Keep soft objects, toys, and loose bedding out of your baby’s sleep area. Don’t use pillows, blankets, quilts, sheepskins, and pillow-like crib bumpers in your baby’s sleep area, and keep any other items away from your baby’s face.
  4. Do not allow smoking around your baby. Don’t smoke before or after the birth of your baby, and don’t let others smoke around your baby.
  5. Keep your baby’s sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in a bed or on a couch or armchair with adults or other children, but he or she can sleep in the same room as you. If you bring the baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside co-sleeper (infant bed that attaches to an adult bed) when finished.
  6. Think about using a clean, dry pacifier when placing the infant down to sleep, but don’t force the baby to take it. (If you are breastfeeding your baby, wait until your child is 1 month old or is used to breastfeeding before using a pacifier.)
  7. Do not let your baby overheat during sleep. Dress your baby in light sleep clothing, and keep the room at a temperature that is comfortable for an adult.
  8. Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.
  9. Do not use home monitors to reduce the risk of SIDS. If you have questions about using monitors for other conditions talk to your health care provider.
  10. Reduce the chance that flat spots will develop on your baby’s head: provide “Tummy Time” when your baby is awake and someone is watching; change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncers.
  11. Breastfeed your baby to reduce the risk of SIDS. Babies who are breastfed with breast milk for the first six months of life are at a lower risk of SIDS.
  12. Follow health care providers’ guidance on your baby’s vaccines and regular health checkups. Following the recommended schedule for your baby’s vaccines has a protective effect against SIDS. Research shows that immunizations reduce the risk of SIDS by 50%.
Where can I find more information on crib safety guidelines?

For information on crib safety guidelines, contact the Consumer Product Safety Commission at 1-800-638-2772 or