Sleep

Safe sleep setup

For every nap and nighttime sleep, place baby on their back in their own firm, flat, level space with only a fitted sheet. Keep it in your room but separate from your bed for at least the first 6 months; the back-first, bare setup continues through the first birthday.

Full guide

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The setup for every sleep

These steps lower the risk of sudden infant death syndrome (SIDS), suffocation, and other sleep-related deaths throughout the first year; no setup can promise zero risk. The American Academy of Pediatrics (AAP) safe-sleep guide recommends the same basics for every sleep.

Use the product as instructed, with every part installed and no damage. Check new and secondhand gear against the Consumer Product Safety Commission (CPSC) safe-sleep and recall information.
Keep the surface flat and level. Wedges, inclined sleepers, loungers, nursing pillows, sofas, and adult mattresses are not infant sleep spaces.
If baby falls asleep in a car seat, stroller, swing, carrier, or sling, move them to their regular firm, flat sleep surface on their back as soon as possible after you are out of the vehicle.
Use fitted sleep clothing or a correctly sized wearable blanket for warmth. Keep baby’s head uncovered, skip indoor hats, and avoid overheating; sweating, flushed skin, or a hot chest mean a layer should come off.

Make a plan for sleepy feeds

The AAP does not recommend bed-sharing. Bring baby into an adult bed only for feeding or comfort, then return them to their own space before you sleep. If you may doze, clear pillows, loose sheets, blankets, and other soft items away from baby first; if you wake with baby in bed, move them back immediately.

Do not feed or settle baby on a couch or armchair when you might fall asleep. Bed-sharing risk is higher for babies younger than 4 months and when an adult is very tired, smokes, or has used alcohol, cannabis, other drugs, or drowsiness-causing medicine. The NIH Safe to Sleep risk-reduction guide explains these practical precautions.

What changes as baby grows

At the first signs of trying to roll: stop swaddling. Rolling can begin earlier than expected, so the attempt—not a calendar date—is the signal.
Once baby rolls both ways independently: continue placing them on their back at the start of every sleep. If they roll over on their own, they can remain in the position they choose; keep the sleep space completely clear.
As baby approaches a product limit: check its weight, height, and developmental limits. Move to another compliant space before reaching one.
After at least 6 months: families may reconsider room location, but the back-first, firm, flat, bare setup continues through the first birthday.

A reassuring setup

Safe sleep is a repeatable setup, not a test of whether baby sleeps for a certain length of time. You can check that:

Every caregiver uses the same back-sleeping, separate-space routine for every sleep.
The mattress stays firm, flat, level, snugly fitted, and covered by only its fitted sheet.
Baby’s face and head stay uncovered, and their chest feels comfortably warm rather than hot or sweaty.
The product is intact, correctly assembled, within its limits, and not recalled.

Frequent waking does not mean the setup is failing. Consumer breathing, heart-rate, or oxygen monitors have not been shown to prevent SIDS and should never replace these steps; follow a clinician’s plan if a medical monitor was prescribed.

When to ask or act

Call the pediatrician

Ask during office hours if reflux, congestion, a flat spot, or another concern makes you want to incline or reposition baby, or if you need help making nighttime feeding safer.

Stop and replace unsafe gear

Stop using a sleep product if it is recalled, broken, missing hardware or instructions, tilted, or already outgrown. Use another crib, bassinet, portable crib, play yard, or bedside sleeper that meets applicable CPSC safety standards; contact the manufacturer or CPSC if its status is unclear.

Get urgent help now

If baby is unresponsive, is not breathing, or is only gasping, call 911 immediately and begin infant CPR according to your training or the dispatcher’s instructions. The American Red Cross child and baby first-aid guide explains the response.

Usually not a reason to change the setup

Spit-up or reflux: back sleeping does not increase choking risk for most babies. Do not prop the mattress; ask the pediatrician before following different positioning advice.
Short or noisy sleep: frequent waking does not make a lounger, soft mattress, positioner, or adult bed safer.
Refusing a pacifier: if breastfeeding, wait until feeding is well established before offering one for sleep; otherwise it may be offered sooner. It is okay if baby declines or it falls out. Never attach it to anything during sleep.
Rolling later on: once baby can roll both directions, finding them on their stomach is not a reason to keep turning them back. Always start on the back and keep the space bare.

Useful today

Press the mattress: it should return to shape quickly and stay flat and level.
Remove everything from the sleep space except the fitted sheet.
Confirm the product is assembled correctly, within its limits, and absent from current CPSC recalls.
Place the sleep space near the caregiver’s bed and choose a feeding spot that is not a couch or armchair.
Give every caregiver the same short rule: back for every sleep, in baby’s own bare space.