Infant Safe Sleep

Back to sleep for every sleep

• Supine position (baby on its back) until baby is one year old, even if baby can roll over.
• Baby should be alone in a crib, portable crib, pack-and-play or bassinet.

Use a firm sleep surface

• A firm crib mattress covered by a fitted sheet.

Keep baby's face uncovered for easy breathing

• Use a sleep sack instead of a blanket.

Room-sharing without bed sharing

• Keep baby in a separate, but nearby sleeping area. For example, a bassinet or portable crib in your room.

Keep soft objects and loose bedding out of the crib to reduce the risk of Sudden Infant Death Syndrome (SIDS), suffocation, entrapment and strangulation

• No pillows, bumper pads, blankets, comforters, stuffed animals or other soft objects.

Avoid commercial devices marketing to reduce the risk of SIDS

• These include wedges, sleep positioners, special mattresses and portable recliners.

Don't rely on cardiorespiratory monitors to prevent SIDS

• There isn't any evidence that these decrease SIDS.

Avoid overheating baby

• The infant should be lightly clothed for sleep and the bedroom temperature should be kept comfortable for a lightly clothed adult.
• In general, dress your baby in no more than one extra layer than you would wear.

Avoid exposure to smoke

• Don't allow anyone to smoke around baby.

Consider offering a pacifier at naptime and bedtime

• For breastfeeding infants, offer a pacifier only after nursing is well established.

Breastfeeding is recommended

Immunize following the American Academy of Pediatrics (AAP) and Center for Disease Control (CDC) recommendations

Provide supervised, awake tummy time

• This helps with muscle development and minimizes the risk of plagiocephaly(flat heads).

Tummy Time

Since the American Academy of Pediatrics (AAP) started recommending that babies be put "back to sleep" more than 20 years ago, the occurrences of Sudden Infant Death Syndrome (SIDS) have dropped more than 50 percent. Unfortunately, more infants are developing flat spots on the back of their heads, a condition known as positional plagiocephaly.

In addition, because baby spends so much time on the back, there are fewer chances to work the muscles in the upper body (neck, shoulder, upper trunk and arms) and motor development (grasping, manipulating toys) can be delayed. That can affect how long it takes your baby to master skills like lifting the head and rolling over, but also impact sitting and crawling.

You can start helping your baby today with these following ideas.

• Start early. You can start right away, as early as in the hospital. Aim for two to three times a day, for three to five minutes each time. Place your newborn belly-down on your chest or across your lap for a few minutes so baby gets used to the position. Your baby may not like tummy time at first, so try a slightly different approach if needed.
• Think comfort. As your baby grows stronger, lay baby on a flat, clean surface (e.g., blanket, play mat, etc.). If baby cries or squirms, try some extra padding by rolling up a small receiving blanket and tuck it under the chest.
• Safety first. Babies need time every day to be on their tummies, but always under careful supervision. Also, wait at least 20 minutes after feedings to avoid pressure on a full belly.
• Watch for cues. Choose a time when baby's in the quiet alert state: ready to play and interact.
• Make it fun. Get down on the floor in front of your baby and make eye contact. Next, place and rotate brightly colored toys in front of your baby at different distances to encourage reaching (and later, crawling). Choose toys in a variety of textures, color and shape. A mirror is another good option.
• Get others in on the act. Encourage friends, family and caregivers to get down on the floor for short periods of tummy time.
• Switch it up. On a weekly basis, change how you place baby in the crib. Rotate which end of the crib is considered the head and foot. This encourages baby to turn his/her head to see what's happening.

Sources

• Back to sleep, tummy to play. (2012). Healthy Children.org from the American Academy of Pediatrics.
• Berk, S. (2004, April). Tummy time. Parents Magazine. 171.
• Positional plagiolcephaly. (2007). National Institutes of Health - National Institute of Child Health & Human Development. Retrieved