Articles

Key takeaways

• Always place your baby on their back to sleep.
• Keep their cot clear of all loose items.
• Room-share with your baby for the first 6 months.
• A consistent bedtime routine can help your baby sleep.

The ABCs of safe sleep

Sudden infant death syndrome (SIDS) is when a baby dies suddenly during sleep and no cause is found. It is rare. In England and Wales, it affects about 1 in 3,495 live births.

Doctors do not yet know what causes SIDS. It is most common in babies under 6 months old.

Babies born prematurely (before 37 weeks) or with a low birthweight (under 2.5kg) have a higher risk. It is even more important to follow safer sleep advice for these babies.

While this can feel worrying, there are simple steps you can take to lower the risk and help your baby sleep more safely.

The Lullaby Trust promotes the ABCs of safer sleep. ALWAYS place your baby on their BACK in a CLEAR cot or sleep space.

Back to sleep

Since the "Back to Sleep" campaign began in 1991, SIDS rates have dropped by 80%.

This campaign recommends placing your baby on their back to sleep. If your baby rolls onto their front, gently roll them back onto their back. Once your baby can roll from back to front and back again by themselves, you can let them find their own sleeping position.

A clear, separate space

The safest place for your baby to sleep is in a separate cot or Moses basket. For the first 6 months, this should be in the same room as you. This applies to both night and daytime naps.

Creating a safe sleep environment

Place your baby in the feet-to-foot position. This means their feet are at the bottom of the cot. This helps prevent them from wriggling down under bedding.

The mattress and cot

Your baby's mattress should be firm, flat, and waterproof. If you are using a second-hand cot, buy a new mattress if possible. Ensure the mattress fits snugly in the cot without leaving gaps. Your baby's head should not sink into the mattress by more than a few millimetres.

Keep the cot clear

Do not place anything in the cot that could cover your baby’s face or head.

The following items should not be used in your baby’s cot, as they may increase the risk of overheating or interfere with breathing:

• Pillows
• Duvets
• Cot bumpers
• Loose blankets
• Soft toys
• Sleep pods
• Nests

Bedding and clothing

You will need sheets to cover the mattress.

If you use blankets:

• Tuck them firmly across your baby’s chest and under the arms.
• Use lightweight cellular cotton blankets.
• Avoid thick, fleecy, padded, or quilted blankets.
• Place your baby feet-to-foot at the bottom of the cot.

Baby sleeping bags are another safe option. They are available in different tog ratings for different room temperatures. For example, a 2.5 tog is suitable for rooms between 16°C and 20°C.

If your baby feels cold while using a sleeping bag, add an extra layer of clothing instead of extra blankets.

Keeping your baby at a safe temperature

Aim to keep room temperature between 16 to 20°C.This prevents your baby overheating or getting too cold. A room thermometer can help you monitor the temperature.

Babies can overheat if they are dressed in too many layers or have too much bedding. Check your baby's temperature by feeling their chest or the back of their neck. If your baby feels hot or they are sweating, remove a layer of clothing or bedding. Remove hats and extra clothing when you come indoors.

Your baby should never sleep with a hot water bottle or electric blanket. Do not place their cot near radiators, heaters, or in direct sunlight.

Bed-sharing

The safest place for your baby to sleep is in their own cot, crib or Moses basket.

If you choose to bed-share with your baby, follow these steps to reduce risk:

• Place your baby on their back on a firm, flat mattress.
• Keep pillows, sheets, and blankets away from your baby.
• Do not swaddle your baby. A well-fitted baby sleeping bag is a safer option.
• Do not have other babies, children, or pets in the bed.
• Never leave your baby alone in an adult bed.
• Make sure your baby cannot fall out of the bed.
• Make sure your baby cannot become trapped between the mattress and any nearby furniture.
• If you breastfeed lying down, return your baby to their back after feeding.
• Do not use sleep pods, positioners, or nests. These are not safe sleep spaces and may cause overheating and increase the risk of SIDS.
• Keep the sleep space free from toys, blankets, pillows and other loose items.

When to avoid bed-sharing

It is never safe to share a bed with your baby if any of the following apply:

• Your baby was born prematurely (before 37 weeks) or had a low birthweight (less than 2.5kg or 5.5lb).
• You or your partner smoke.
• You or your partner have consumed alcohol (two or more units) or have taken recreational drugs.
• You or your partner have taken medicine that may make you drowsy.
• You are extremely tired.
• Your baby has a fever or is unwell.
• You are sleeping on a sofa or in an armchair, as this greatly increases the risk of SIDS.

Helping your baby sleep

Bedtime routines

A simple bedtime routine can help your baby settle and sleep. It is also a good time for one-on-one time and bonding.

Your routine could include:

• A bath, fresh nappy, and changing into night clothes.
• Reading a bedtime story and dimming the lights
• A goodnight kiss and cuddle.
• Singing a lullaby or a wind-up musical mobile.

Try to keep the time before bed calm and quiet. Avoid exciting or stimulating activities. You may find it helpful to rock or gently sway your baby until they are drowsy. Place them in their cot before they fall asleep. This can help them learn to settle themselves to sleep.

Soothing techniques

Swaddling your baby can keep them cosy, snug, and secure. Always follow safer sleep guidelines if you choose to swaddle.

Some babies respond well to white noise. Newborns are used to sounds from the womb, such as a heartbeat, and may find gentle background noise soothing. This could include soft music, a fan, or a white noise recording. If you use white noise, use it for short periods only. Keep the device well away from your baby and never place it inside the cot. Keep the volume low.

Some babies prefer very little noise or a quiet room.

If your baby uses a dummy, you can offer it for each sleep time, as this may help reduce the risk of SIDS. If you are breastfeeding, wait until feeding is established before introducing a dummy. This is usually around four weeks.

Night-time environment

A calm night-time environment can help your baby settle and sleep. Tips to creating this include:

• Keeping the room dark or dimly lit.
• Not talking much and keeping your voice soft and quiet.
• Putting your baby down as soon as they have been fed and changed.
• Avoid changing your baby unless they need it.
• Avoid playing with your baby at night. This helps them learn that night-time is for sleeping.

Navigating sleep difficulties

It is normal for newborn babies to wake frequently during the night for the first few months of life. This can be very tiring for parents, but does not usually indicate a problem. Every baby is different, and will develop their own sleep and waking pattern over time.

As your baby grows, their sleep patterns will change. Several common factors can affect sleep, including:

• Growth spurts.
• Teething.
• Minor Illness.

Coping and reassurance

Broken sleep can feel both physically and emotionally draining. It may help to:

• Sleep or rest whenever your baby sleeps, even for short periods.
• Accept help from friends and family where possible.
• Share night-time care if you have support available.

Your health visitor can offer advice and reassurance if you are concerned about your baby’s sleep. Over time, most babies will usually settle into a more predictable sleep pattern.