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Safe Sleep for Infants

Safe Sleep for Infants

Safe Sleep at UVM Health

Safe Sleep refers to a set of recommendations by the American Academy of Pediatrics (AAP) based on research on how to reduce the risk of sleep-related infant deaths, such as sudden infant death syndrome (SIDS) or accidental suffocation or strangulation.

The AAP Safe Sleep Guidelines key recommendations are:

  • Babies are safest sleeping alone on their back on a flat surface.
  • Use a crib, bassinet, portable crib or play yard that is approved by the Consumer Product Safety Commission.
  • Remove unsafe products from your baby’s sleep area, such as pillows, blankets, stuffed animals, loungers and pacifier cords/attachments.
A newborn infant sleeps in a crib.

Finding Support

While frequent waking is normal and healthy for a baby, it can be very difficult for parents. Lack of sleep can make it feel hard to follow safe sleep practices. If you are struggling, there are places you can reach out to for support:

  • Talk to your pediatrician about strategies specific to your child’s needs.
  • Ask family members, friends or someone you trust to watch your baby while you nap.
  • Contact the Prevent Child Abuse Vermont Parent Helpline at 1-800-CHILDREN (244-5373).

Frequently Asked Questions

Our Safe Sleep experts answer common questions from new parents and caregivers.

What is room sharing versus surface sharing?

Room sharing means keeping your baby's crib, play yard or bassinet in your bedroom and close to your bed for at least the first six months. This makes it easier to comfort or feed your baby and then place them in their own sleep space when you're ready to go to sleep. Room sharing is highly recommended by the AAP.

Surface sharing, commonly referred to as co-sleeping or bed-sharing, is when a caregiver and baby share the same sleeping surface, such as a couch, chair or bed. The AAP strongly discourages surface sharing. Surface sharing increases the risk of injury and death for infants in the United States.

If there is any possibility that you might fall asleep while your baby is in your bed, make sure there are no pillows, sheets, blankets or any other items that could cover your baby's face, head and neck or overheat them. As soon as you wake up, be sure to move your baby to their own bed.

Avoid falling asleep with your baby in other locations, too. The risk of sleep-related infant death is higher when infants sleep with someone on a couch, soft armchair or cushion.

It's extra important not to bed share with your baby if you have been drinking alcohol or have used cannabis, illicit drugs or any medications that cause drowsiness or impact sleep.

Why isn’t my baby sleeping?

Babies do not have regular sleep cycles until about six months of age. While newborns will sleep 16 to 17 hours each day, they typically sleep for only one to two hours at a time. Frequent waking is developmentally appropriate for babies.

Sleeping in a safe sleep space can be a hard adjustment for baby from the warmth of the womb and it may take them time to adapt. And babies who normally sleep well may suddenly start struggling to settle for sleep or waking up more frequently at night. This change in behavior is known as a sleep regression. While sleep regressions are difficult, they are normal and expected.

Sleep regressions can be caused by a number of things, including:

  • Teething
  • Growth spurts
  • Developmental milestones
  • New environments
  • Illness

While there is nothing that can prevent sleep regressions, sticking to your baby’s normal bedtime routine can help them pass.

How can I make bedtime easier?
  • Create a consistent, calming bedtime routine. A routine can be as simple as feed, change and then off to sleep.
  • Create an environment that encourages sleep, such as darkening the room with window covers or playing white noise.
  • Pay attention to signs of being sleepy or overtired. If your baby is four months or older, put them to bed when they are drowsy.  This helps babies learn to fall asleep on their own, in their own bed.
  • Help your baby fall asleep with a soothing sensation, such as rocking or sucking a thumb, hand or pacifier.
  • Stay calm and quiet when you feed or change your baby.
  • If your baby is four months or older, do not rush in to soothe them. They may go back to sleep by themselves after a few minutes.
  • If your baby needs help resettling, consider the following tips:
    • Look at and talk or sing to them.
    • Put a hand on their belly or chest.
    • Hold and rock or rub their back.
    • Swaddle your baby if they are not yet showing signs of rolling.
    • Place a pacifier in their mouth (or help them get their hand or thumb to their mouth to suck).
    • Offer milk or formula, but do not leave the bottle in the crib.
    • Avoid putting your baby in an unsafe sleep space, such as in a swing or in your bed during the night.
How do I keep my baby warm during winter if I can’t use a blanket?

You can keep your baby cozy and warm using a one-piece sleeper or a sleep sack. Sleep sacks come in different fabrics or materials, so you can match the TOG (Thermal Overall Grade, a warmth rating) to the temperature of your baby’s sleep area.

Can my baby have a pacifier while napping or sleeping?

Yes! Pacifiers may have a protective effect against SIDS. Make sure the pacifier does not have any cords or attachments on it.

What do I do if my baby falls asleep in their car seat or swing?

If your baby falls asleep in a car seat, stroller, swing, infant carrier or sling, move them to a firm sleep surface on their back as soon as possible.

When should I stop swaddling my baby?

You should stop swaddling your baby when they start showing signs of being able to roll over, which is usually around three months of age. Swaddling does not reduce the risk of SIDS and may not help your infant sleep.

Are crib bumpers illegal?

As of the Safe Sleep for Babies Act, crib bumper pads and inclined sleep products are prohibited from being manufactured or sold. Crib bumpers are considered a banned hazardous product.

What do I do if my baby won’t sleep or can’t be soothed?

Sometimes babies can’t be soothed and that’s okay. It does not harm a child’s development. If you are stressed or overwhelmed, take care of yourself first and let your baby stay in the safety of their crib. Crying is not harmful to the baby if you need to take a break.

Safe Sleep Committee

The following organizations are committed to safe sleep education and advocacy.

  • Safe Kids Vermont: Safe Kids Vermont is a coalition of individuals and organizations across the state of Vermont dedicated to keeping children and teens healthy and safe by preventing injury.
  • Vermont Department of Health: With a focus on prevention, the Vermont Department of Health offers many programs and initiatives to help Vermonters live fuller, healthier lives from birth through old age.
  • The American Academy of Pediatrics Vermont Chapter (AAPVT): AAPVT is dedicated to improving the physical, mental and social health and well-being of the state’s infants, children, adolescents and young adults.
  • Vermont Department for Children and Families (DCF): DCF's mission is to foster the healthy development, safety, well-being and self-sufficiency of Vermonters.
  • Prevent Child Abuse Vermont (PCAVT): PCAVT is the Vermont chapter of Prevent Child Abuse America and the national Circle of Parents. Their mission is to promote and support healthy relationships within families, schools and communities to eliminate child abuse.
  • Safe Infant Sleep: Safe Infant Sleep is a nonprofit organization dedicated to providing peer-to-peer caregiver support and education. In addition, they provide safe sleep items such as portable cribs and sleep sacks to those who otherwise don’t have access.
  • Vermont Child Health Improvement Program (VCHIP): VCHIP is the population-based maternal and child health services research and quality improvement program of the University of Vermont.
  • Golisano Children’s Hospital: Golisano Children’s Hospital at University of Vermont Health provides high-quality, child-friendly care with a patient- and family-centered approach that improves the health of children throughout Vermont and northern New York.
  • Vermont Center For Children, Youth, And Families (VCCYF): VCCYF provides care from a family-based framework to support the emotional and behavioral health of children and their families.
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