Safe Sleep

For Your Baby

SAFE TO SLEEP

Reduce the Risk of Sudden Infant Death 

Syndrome (SIDS) and Other Sleep-Related 

Causes of Infant Death

Eunice Kennedy Shriver National Institute

of Child Health and Human Development
This is what a safe sleep environment looks like. 

It has no bumpers, pillows, blankets, or toys.
1

What is SIDS?

SIDS is the sudden, unexplained death of a baby 

younger than 1 year of age that doesn’t have 

a known cause even after a complete investigation.

Each year in the United 

States, thousands of 

babies die suddenly and 

unexpectedly. These 

deaths are called SUID 

(pronounced SOO-idd), 

which stands for 

 “Sudden Unexpected 

Infant Death.” 

SUID includes all 

unexpected deaths: those without a clear cause, 

such as SIDS, and those from a known cause, such 

as suffocation. One-half of all SUID cases are SIDS. 

Many unexpected infant deaths are accidents, but

a disease or something done on purpose can also 

cause a baby to die suddenly and unexpectedly. 

Sleep-related causes of infant death are those 

linked to how or where a baby sleeps or slept. They 

are due to accidental causes, such as: suffocation; 

entrapment, when baby gets trapped between 

two objects, such as a mattress and wall, and can’t 

breathe; or strangulation, when something presses 

on or wraps around baby’s neck, blocking baby’s 

airway. These deaths are not SIDS.

Fast facts about SIDS:

 SIDS is the leading

cause of death in 

babies 1 month to 

1 year of age. 

Most SIDS deaths 

happen when babies 

are between 1 month 

and 4 months of age.
2

What should I know 

about SIDS?

We have made great progress in reducing SIDS.

Since awareness campaigns that stressed back 

sleeping for babies started in 1994, the SIDS rate in 

the United States has dropped by 50 percent. This 

decreased rate equals thousands of babies’ lives 

and is a result of parents and caregivers placing 

babies on their backs to sleep. 

• In 1994, 4,073 babies died from SIDS and only 

27 percent of babies slept on their backs. In 2009, 

2,226 babies died from SIDS and 74 percent of 

babies slept on their backs.

• In 1995, 77 American Indian/Alaska Native babies 

died from SIDS. In 2009, 52 American Indian/

Alaska Native babies died from SIDS.

• Despite these decreases, American Indian/

Alaska Native babies are at higher risk for 

SIDS, based on their numbers within the U.S. 

population, than are Hispanic American, Asian

American, or white babies.
3

Babies sleep safest on their backs. Babies who 

sleep on their backs are much less likely to die of 

SIDS than are babies who sleep on their stomachs 

or sides.

Every sleep time counts. Babies should sleep on 

their backs for all sleep times—for naps and at 

night. Babies who are used to sleeping on their 

backs but who are then placed on their stomachs 

to sleep, like for a nap, are at very high risk of SIDS. 

Sleep surface matters. Babies who sleep on a 

soft surface, such as an adult bed, or under a soft 

covering, such as a soft blanket or quilt, are more 

likely to die of SIDS or suffocation. 

Always place your baby on his or her back to 

sleep, for naps and at night.
4

What can I do to lower my 

baby’s risk of SIDS and 

other sleep-related causes 

of infant death?

There is no sure way to prevent SIDS, but parents 

and caregivers can take these steps to reduce the 

risk of SIDS and other sleep-related causes of 

infant death: 

Always place a baby on his or her back to sleep, 

for naps and at night, to reduce the risk of SIDS.

The back sleep position is the safest position for 

all babies, including preterm babies. Keep in mind 

that every sleep time counts.

Room sharing—keeping your baby’s sleep area 

in the same room where you sleep—reduces the 

risk of SIDS and other sleep-related causes of 

infant death.
5

Use a firm sleep 

surface, such as a 

mattress in a safetyapproved* crib, 

covered by a fitted 

sheet, to reduce 

the risk of SIDS and 

other sleep-related causes of infant death. Firm 

sleep surfaces can include safety-approved* cribs, 

bassinets, and portable play areas. Do not use a 

carseat, carrier, swing, or similar product as baby’s 

everyday sleep area. Never place baby to sleep on 

soft surfaces, such as on a couch or sofa, pillows, 

quilts, sheepskins, or blankets. 

* For information on 

crib safety, contact 

the Consumer Product 

Safety Commission 

at 1-800-638-2772 or 

http://www.cpsc.gov.

Your baby should not sleep in an adult bed, on 

a couch, or on a chair alone, with you, or with 

anyone else. Room sharing—keeping baby’s 

sleep area in the same room where you sleep—

reduces the risk of SIDS and other sleep-related 

causes of infant death. If you bring your baby 

into your bed to breastfeed, make sure to put 

him or her back in a separate sleep area in your 

room, such as a safety-approved* crib, bassinet, 

or portable play area, when you are finished.
6

Keep soft objects, toys, crib bumpers, and loose 

bedding out of your baby’s sleep area to reduce 

the risk of SIDS and other sleep-related causes of 

infant death. Don’t use pillows, blankets, quilts, 

sheepskins, or crib bumpers anywhere in your 

baby’s sleep area. Evidence does not support 

using crib bumpers to prevent injury. In fact, crib 

bumpers can cause serious injuries and even 

death. Keeping them out of baby’s sleep area is 

the best way to avoid these dangers.

To reduce the risk of SIDS, women should: 

• Get regular health care during pregnancy, and

• Not smoke, drink alcohol, or use illegal drugs 

during pregnancy or after the baby is born.

To reduce the risk of SIDS, do not smoke during 

pregnancy, and do not smoke or allow smoking 

around your baby.

Breastfeed your baby to reduce the risk of SIDS.

Breastfeeding has many health benefits for 

mother and baby.

Dress your baby in light sleep clothing to 

prevent overheating.
7

Give your baby a dry 

pacifier that is not 

attached to a string for 

naps and at night to 

reduce the risk of SIDS.

But don’t force the baby 

to use it. If the pacifier falls 

out of baby’s mouth during 

sleep, there is no need to 

put the pacifier back in. 

Wait until baby is used to 

breastfeeding before trying a pacifier.

If you bring your 

baby into your 

bed to breastfeed, 

make sure to put 

him or her back in 

a separate sleep 

area in your room, 

such as a safetyapproved* crib 

(see page 5), when 

you are finished.

Do not let your baby get too hot during sleep. 

Dress your baby in no more than one layer more 

of clothing than an adult would wear to be 

comfortable. Keep the room at a temperature that 

is comfortable for an adult.
8

Follow health care provider guidance on your 

baby’s vaccines and regular health checkups.

Avoid products that claim to reduce the risk of SIDS 

and other sleep-related causes of infant death.

These wedges, positioners, and other products have 

not been tested for safety or effectiveness.

Do not use home heart or breathing monitors to 

reduce the risk of SIDS. If you have questions about 

using these monitors for other health conditions, 

talk with your baby’s health care provider.

Give your baby plenty of Tummy Time when he 

or she is awake and when someone is watching. 

Supervised Tummy Time helps your baby’s neck, 

shoulder, and arm muscles get stronger. It also 

helps to prevent flat spots on the back of your 

baby’s head. Holding baby upright and limiting 

time in carriers and bouncers can also help 

prevent flat spots on the back of baby’s head.

Place babies on their stomachs when they are awake 

and when someone is watching. Tummy Time helps 

your baby’s head, neck, and shoulder muscles get 

stronger and helps to prevent flat spots on the head.
9

Answers to common 

questions about SIDS

Q What is the best way to reduce my baby’s risk 

for SIDS?

A Placing your baby on his or her back to sleep for 

every sleep time is the best way to reduce the 

risk of SIDS.

Q Will my baby choke if placed on the back 

to sleep?

A No. Healthy babies naturally swallow or cough 

up fluids—it’s a reflex all people have. Babies 

might actually clear such fluids better when on 

their backs.

Q What if my baby rolls onto the stomach on his or 

her own during sleep? Do I need to put my baby 

in the back sleep position again if this happens? 

A No. Rolling over is an important and natural part 

of your baby’s growth. Most babies start rolling 

over on their own around 4 to 6 months of age. 

If your baby rolls over on his or her own during 

sleep, you do not need to turn the baby over 

onto his or her back. The important thing is that 

the baby start off every sleep time on his or her 

back to reduce the risk of SIDS, and that there is 

no soft, loose bedding in the baby’s sleep area.
Spread the word!

Make sure everyone who cares for your baby knows the 

ways to reduce the risk of SIDS and other sleep-related 

causes of infant death. Remember: Babies sleep safest on 

their backs, and every sleep time counts!

Help family members, babysitters, daycare workers—

EVERYONE—reduce your baby’s risk of SIDS and ensure 

a safe sleep area for your baby. Share these safe sleep 

messages with everyone who cares for your baby or for 

any baby younger than 1 year of age.

For more information, contact the Safe to Sleep® campaign:

Mail: 31 Center Drive, 31/2A32, Bethesda, MD 20892-2425

Phone: 1-800-505-CRIB (2742)

Fax: 1-866-760-5947

Website: http://safetosleep.nichd.nih.gov

Safe to Sleep campaign collaborators include:

Eunice Kennedy Shriver National Institute of Child Health 

and Human Development

Health Resources and Services Administration/Maternal 

and Child Health Bureau

Centers for Disease Control and Prevention, Division of 

Reproductive Health

American Academy of Pediatrics

American College of Obstetricians and Gynecologists

First Candle

Association of SIDS and Infant Mortality Programs

HEALTHY

Native Babies

NIH Pub. No. 12-7462

October 2013

Eunice Kennedy Shriver National Institute

of Child Health and Human Development

Safe to Sleep® is a registered trademark of the U.S. Department of Health and Human Services.