In the early weeks of life, babies sleep for about 16 hours a day. Planning where your baby can sleep safely is important.

Creating a safe sleeping environment for your baby will reduce the risk of injuries and sleep related infant death, including sudden infant death syndrome (SIDS). For more information on sleep related infant death, see HealthLinkBC File #46 Sleep related infant death.

Share this information with anyone who may take care of your baby; it is important for all parents, babysitters and caregivers to be informed about safe sleeping practices for babies. For a safe sleeping resource for parents and caregivers see Safer Sleep For My Baby.

What can I do to keep my baby safe during sleep?

Put your baby to sleep on his or her back every time (at night and for naps)

Babies should always be placed on their backs to sleep. Healthy babies and newborns do not choke or have any problems from sleeping on their backs.

When your baby can roll over on his or her own from back to stomach, there is no need to return your baby to his or her back if your baby turns over in sleep.

Do not use items that prop the baby in one position during sleep. If your baby has a health condition that requires a different position for sleep, discuss safe options to meet your baby’s needs with your health care provider.

When a baby is awake, some supervised ‘tummy time’ (lying on his or her stomach) is needed for healthy development. This also prevents temporary flat spots that may develop on the back of a baby’s head.

Place your baby on a firm surface that is free of hazards

Use a crib, cradle, or bassinet that has a firm mattress, a tight-fitting sheet and no bumper pads, pillows, heavy blankets or toys. Ensure the crib, cradle or bassinet meets Canadian safety regulations.

For more information about Canadian safety regulations and to check for product recalls, visit Health Canada: Product safety – Consumer products and cosmetics at www.canada.ca/en/health-canada/services/consumer-product-safety.html.

Put the crib together using the manufacturer’s instructions, and do not change the crib in any way.

Never sleep with or let a baby sleep alone on a soft mattress, couch, chair, air mattress, pillow, sheepskin, duvet or quilt, or waterbed.

To prevent a baby from being trapped, smothered, or strangled check and be sure:

• The crib mattress fits the frame and is no thicker than 15 cm. There should be no gaps bigger than 3 cm between the mattress and frame when the mattress pushes into the corners of the crib
• The crib bars are less than 6 cm apart
• There are no knobs or items on a crib that could catch a baby's clothing. If a baby tries to climb out of a crib and catches his or her clothing, the baby could strangle
• There are no straps, cords or window blinds near the baby’s crib

Some babies fall asleep while travelling in a car seat. Keep an eye on a baby sleeping in the car and take your baby out of the car seat once you have reached your destination. Babies should not be left to sleep in a car seat, a stroller, baby swing, or bouncer seat because their airway may become restricted.

Do not smoke around your baby

Smoking or exposure to second-hand smoke increases the risk of SIDS.

Carefully consider the risks of bedsharing

The safest place for your baby to sleep is on his or her back, in a safety approved crib beside your bed. However, bedsharing is a common practice for many families due to cultural traditions or personal preference. Some families will end up bedsharing even if they did not plan to.

There are some circumstances in which bedsharing is especially risky and should be avoided. Babies who were born prematurely or with a low birthweight are at higher risk of death while bedsharing. The risk also goes up if there is any smoking in the home, if smoking occurred during the pregnancy or if the adults in the bed are less alert due to the effects of alcohol, medications or other drugs.

For families choosing to bedshare, the risk can be reduced:

• Ensure that the baby is placed on their back on a mattress that is clean and firm
• The baby should be unswaddled and placed on the outside of the mattress (not between parents), far away from pillows, blankets and duvets
• The mattress should be placed on the floor and away from walls or other furniture to reduce the risk of falls or the baby becoming trapped
• Older children and pets should not be in the bed
• If the adults sharing the bed have long hair, they should tie it back
• Any adult in the bed must know that the infant is in the bed

Share a room with your baby

You can help protect your baby from sleep related infant death by sharing a room and sleeping close to your baby. For example, your baby’s crib can be placed beside your bed. This means that they are within arm’s reach, but you are not sharing the same bed or sleeping surface.

Breastfeed your baby

Breastfeed your baby, as this protects against SIDS and has many other benefits. Breastfeeding is easier when you share a room with your baby. This means your baby sleeps near you on a separate surface, allowing you to be close to your baby.

For more information about breastfeeding, see HealthLinkBC File #70 Breastfeeding or chestfeeding.

Keep your baby warm but not hot

The temperature of the room should be comfortable for an adult. A sleep sack, blanket-weight sleeper, or light blanket should be all that is needed to keep your baby warm. Do not swaddle your baby during sleep and do not use hats or toques indoors.

Stop or reduce any substance use

The use of certain drugs or substances during and after pregnancy can increase the risk of sleep related infant death. This includes alcohol, cannabis (marijuana), crack, cocaine, heroin, nicotine and others.

If you or your partner need support to stop or reduce substance use, call your local public health unit to find out about services in your area. You can also call the Alcohol and Drug Information and Referral Service: in Greater Vancouver call 604-660-9382, and in other areas of B.C. call toll-free 1-800-663-1441.

Speak with your health care provider or pharmacist if you or your partner need help to quit smoking. You can sign up for the BC Smoking Cessation program at your local pharmacy. You can also call the QuitNow helpline toll-free in B.C. by dialing 604-731-5864 (LUNG) or 1-877-455-2233 or visit https://quitnow.ca.