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Safe sleep for babies

Babies can sometimes get into dangerous situations while they’re sleeping. They spend a lot of time asleep, so it is important to keep
them as safe as possible. There are plenty of things you can do to reduce their risk.

Top tips for safe sleeping

Some sleeping arrangements are not safe. They can increase the risk of sudden death or
accidents. To keep your baby safe while sleeping:

Place your baby on their back to sleep, not on their tummy or on their side.
Don’t let anyone smoke in the same room as your baby.
Don’t share a bed with your baby, particularly if you’ve been drinking alcohol, if you take drugs
or if you’re a smoker.
Never sleep with your baby on a sofa or armchair.
Don’t let your baby get too hot.
Keep your baby’s head uncovered. Their blanket should be tucked in no higher than their
shoulders.
Place your baby in the ‘feet to foot’ position (with their feet at the end of the cot or pram).
The safest place for your baby to sleep in their own safe space in the same room as an adult caregiver for the first 6 to 12 months.
Breastfeed your baby.

Place your baby on their back to sleep

Place your baby on their back to sleep from the very beginning, for both day and night sleeps. This will reduce the risk of Sudden Unexpected Death in Infancy (SUDI). It’s
not as safe for babies to sleep on their sides as on their backs. When your baby is old enough to roll over by themselves, don’t stop them.

Healthy babies placed on their backs are not more likely to choke.

For more information on safe sleeping, visit Red Nose.

The risks of bed sharing

The safest place for your baby to sleep for the first 6 to 12 months is their own safe space in a room with you. Don’t share a bed with your baby, particularly if you or your
partner:

are smokers (no matter where or when you smoke and even if you never smoke in bed)
have recently drunk alcohol
have taken medicine or drugs that make you sleep more heavily
feel very tired

The risks of bed sharing are also increased if your baby:

was premature (born before 37 weeks), or

weighed less than 2.5kg (5.5lb) when they were born

Never sleep with a baby on a sofa or armchair

It’s lovely to have your baby with you for a cuddle or a feed, but it’s safest to put your baby back in their cot before you go to sleep.

Don’t let anyone smoke in the same room as your baby

Nobody should smoke in the house, including visitors. Anyone who needs to smoke should go outside. Don’t take your baby into smoky places. If you’re a smoker,
sharing a bed with your baby increases the risk of sudden death.

Don’t let your baby get too hot (or too cold)
Babies control their temperature mainly through their face. The best way to stop them overheating is to place them on their back with the head and face uncovered. You
don’t have to monitor the temperature of the room — it should be at a temperature that’s comfortable for you at night — but make sure your baby is dressed
appropriately.

When you check your baby, make sure they’re not too hot. Their chest should feel warm. If your baby is sweating or has a red face, take off some of the bedding.
Don’t worry if your baby’s hands or feet feel cool. This is normal.
It’s easier to adjust for the temperature by using lightweight blankets. Remember, a folded blanket counts as two blankets. A good idea is to use a sleeping bag
with a fitted neck, armholes or sleeves and no hood.
If it’s very warm, your baby may not need any bedclothes other than a sheet.
Even in winter, most babies who are unwell or feverish don’t need extra clothes.
Babies should never sleep with a hot-water bottle or electric blanket, next to a radiator, heater or fire, or in direct sunshine.
Make sure your baby’s head can’t be covered by bedclothes while they’re sleeping.
Remove hats and extra clothing as soon as you come indoors or enter a warm car, bus or train, even if it means waking your baby.

Don’t let your baby’s head become covered

To prevent your baby wriggling down under the covers, place them in the ‘feet to foot’ position. This means that their feet are at the end of the crib, cot or pram.

Make the covers up so that they reach no higher than the shoulders. Tuck the covers in securely so that they can’t slip over the baby’s head. Use one or more
layers of lightweight blankets.
Use a baby mattress that’s firm, flat, well-fitting and clean, and waterproof on the outside. Cover the mattress with a single sheet.
Don’t use doonas, quilts, baby nests, wedges, bedding rolls or pillows.

Wrapping/swaddling your baby

Wrapping or swaddling your baby can be a useful way to help them to settle and stay asleep on their back.

To wrap your baby safely:

the wrap needs to be firm but not too tight

make sure your baby’s chest and hips have room to expand
make sure the wrap is below the neck and doesn’t cover the face
use a lightweight wrap made of cotton or muslin (bunny rugs and blankets are not safe as they may cause your baby to overheat)
make sure your baby is not over dressed under the wrap. They just need a nappy and singlet in warmer weather and a lightweight grow suit in cooler weather

As your baby gets older you can change the way you wrap them. For example, you can leave their arms free from around 3 months. Stop wrapping them as soon as they
can roll. After about 6 months they will probably resist being wrapped. An alternative to wrapping is to use a safe infant sleeping bag.

Sharing a bed with a baby is particularly dangerous if the baby is wrapped.

Safe infant sleeping bag

Infant sleeping bags can help reduce the risk of sudden death and also prevent arms and legs from getting trapped in the cot rails.

A safe infant sleeping bag is made in such a way that the baby cannot slip inside the bag and become completely covered. The sleeping bag should be the correct size
for the baby, with a fitted neck, armholes (or sleeves) and no hood.

When using a sleeping bag, make sure the baby is dressed according to the room temperature and do not use sleeping bags with quilts or doonas. If additional warmth
is needed, a light blanket is usually all that is necessary, but take care to tuck the blanket in firmly so it cannot ride up and cover baby’s head during sleep. Another way to
provide additional warmth is to dress your baby in layers of clothing inside the sleeping bag to keep baby warm.

Household cots
It is very important to make sure your baby’s cot is safe and meets the current Australian Standard AS/NZS 2172.

Make sure you remove toys, extra pillows and bumpers from the cot so your baby can’t suffocate or use them as a foothold to climb out.

If you are using a second-hand cot, make sure all its parts are in good working order and you have the full instructions to put it up correctly.

Folding cots
Folding cots or travel cots are only for temporary use. It’s very important to make sure the mattress fits properly and that the cot is sturdy and won’t collapse.

To minimise these risks, make sure the cot meets the mandatory Australian Standard AS/NZS 2195 for Portable Cots.
Mattresses
Only use the mattress specifically designed for the cot. An ill-fitting mattress can create dangerous gaps that can trap a sleeping child and cause suffocation. The
mattress should be firm, clean and in good condition, and should be placed flat (not tilted or elevated).

Make sure the mattress complies with the AS/NZS Voluntary Standard (AS/NZS 8811.1:2013). You can also test the firmness of the mattress yourself. This video will
show you how.

Never place an extra mattress in the cot. While the mattress that comes with the cot may look thin and uncomfortable to you, it has been designed for the comfort and
safety of babies and infants.

Pillows and extra bedding

Pillows are not necessary for babies — they increase the risk of sudden death because they can cover the baby’s face or cause overheating. Older babies can climb on
them and get out of the cot.

As a general rule, don’t introduce a pillow until your child starts to sleep in a bed.

Don’t leave toys or stuffed animals in the cot with a sleeping child.

Cot position
Set the cot up out of reach of blind and curtain cords so your baby can’t be strangled. Make sure decorative mobiles are out of reach.

Keep heaters or any electrical appliances away from the cot to avoid the risk of overheating, burns and electrocution.

Changing the mattress base position

If the cot has an upper and lower mattress level, move it to the lower level as soon as the child can stand up — otherwise the child may be able to climb out and fall from
the cot.

Repairs
If parts of your cot break or stop working properly, always take it back to the supplier to organise repairs. Never modify a new or old cot yourself, as this can destroy
inbuilt safety features. Infants have died in cots where do-it-yourself repairs have created hazards. If a reputable cot supplier cannot fix your cot, you should immediately
stop using it and dispose of it.

Related information
You can find out more about Sudden Infant Death Syndrome (SIDS).

Visit Red Nose for more information on safe sleeping for babies.

Visit Product Safety Australia for information and guides on baby safety.

Sources: Product Safety Australia (Household cots), Product Safety Australia (Folding cots), Product Safety Australia (Safe sleeping for infants), Red Nose (Safe sleeping)

Last reviewed: October 2018

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical
condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical
problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means
without the prior written permission of Healthdirect Australia.

https://www.pregnancybirthbaby.org.au/safe-sleep-for-babies