SAFE

SLEEP FOR YOUR

Reduce the 

Risk of 

Sudden 

Infant Death 

Syndrome 

(SIDS) BABY

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

Eunice Kennedy Shriver National Institute of 

Child Health and Human Development

Spread the Word! 

Make sure everyone who cares for your baby 

knows the Safe Sleep Top 11! Tell grandparents, 

babysitters, childcare providers, and other 

caregivers to always place your baby on his or 

her back to sleep to reduce the risk of SIDS. 

Babies who usually sleep on their backs but 

who are then placed on their stomachs, even for 

a nap, are at very high risk for SIDS—so every 

sleep time counts!

Enjoy Your Baby!

Fast Facts About SIDS

n SIDS is the leading cause of death in infants 

between 1 month and 1 year of age. All 

babies younger than 1 year of age are at 

risk for SIDS.

n Most SIDS deaths happen when babies are 

between 2 months and 4 months of age.

n American Indian/Alaska Native babies are 

nearly 3 times as likely to die of SIDS as 

white babies.

n You can reduce the risk for SIDS in your family.

If you use a blanket, place the baby with feet at the end 

of the crib. The blanket should reach no higher than the 

baby’s chest. Tuck the ends of the blanket under the crib 

mattress to ensure safety.

Babies Sleep Safest on Their Backs.

One of the easiest ways to lower your baby’s 

risk of SIDS is to always put him or her on the 

back to sleep, for naps and at night. Health care 

providers used to think that babies should sleep 

on their stomachs, but research now shows that 

babies are less likely to die of SIDS when they 

sleep on their backs. Placing your baby on his 

or her back to sleep is the number one way to 

reduce the risk for SIDS.

Q. But won’t my baby choke if he or she 

sleeps on his or her back?

A. No. Healthy babies automatically swallow or 

cough up fluids. There has been no increase in 

choking or other problems for babies who sleep 

on their backs.

HEALTHY

Native Babies

For more information on sleep position for babies, 

reducing the risk of SIDS, or the Healthy Native Babies 

Project contact the Back to Sleep campaign at:

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

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

Fax: (301) 496-7101

Web site: http://www.nichd.nih.gov/SIDS

Back to Sleep campaign sponsors include:

Eunice Kennedy Shriver National Institute of 

Child Health and Human Development

Maternal and Child Health Bureau/HRSA

American Academy of Pediatrics • First Candle/SIDS Alliance

Association of SIDS and Infant Mortality Programs

NIH Pub. No. 09-7462 

August 2009
What is SIDS?

SIDS stands for sudden infant death syndrome. 

This term describes the sudden, unexplained 

death of an infant younger than 1 year of age.

There is no 100-percent effective way to prevent 

SIDS, but there are ways to reduce the risk.

What Should I Know 

About SIDS?

Health care providers don’t know exactly what 

causes SIDS, but they do know:

Babies sleep safer on their 

backs. Babies who sleep on their 

stomachs are much more likely to die 

of SIDS than babies who sleep on their 

backs.

Sleep surface matters. Babies 

who sleep on or under soft bedding 

are more likely to die of SIDS.

Every sleep time counts. Babies 

who usually sleep on their backs 

but who are then placed on their 

stomachs, like for a nap, are at very 

high risk for SIDS. So it’s important for 

everyone who cares for your baby to 

use the back sleep position for naps 

and at night.

Communities across the nation, 

including Native communities, 

have made great progress in 

reducing SIDS! Since the Back to 

Sleep campaign began in 1994, the 

SIDS rate in the United States has 

declined by more than 50 percent.

* For information on crib safety guidelines, contact 

the Consumer Product Safety Commission at 

1-800-638-2772 or http://www.cpsc.gov. 

Always place your baby on his or her back to sleep.

What Can I Do to Lower My 

Baby’s Risk of SIDS?

Here are 11 ways that you and others who care 

for your baby can reduce the risk of SIDS.

Safe Sleep Top 11

1 Always place your baby on 

his or her back to sleep, for 

naps and at night. The back 

sleep position is the safest, and every 

sleep time counts.

2 Place your baby on a firm 

sleep surface, such as on a 

safety-approved* crib mattress, 

covered by a fitted sheet. Never 

place your baby to sleep on pillows, 

quilts, sheepskins, or other soft 

surfaces. It is very dangerous to place 

your baby to sleep on water beds, 

sofas, couches, or armchairs.

3 Keep soft objects, toys, and 

loose bedding out of your 

baby’s sleep area. Don’t use 

pillows, blankets, quilts, sheepskins, or 

pillow-like crib bumpers in your baby’s 

sleep area, and keep all items away 

from your baby’s face. 

4 Do not allow smoking around 

your baby. Don’t use commercial 

tobacco before or after the birth of 

your baby. Don’t let others smoke 

around your baby anywhere in the 

house or in the car.

5 Do not drink alcohol while you 

are pregnant or breastfeeding.

Drinking alcohol while you are 

pregnant increases your baby’s risk 

for SIDS. There is no known safe 

level of alcohol consumption during 

pregnancy or breastfeeding. 

6 Keep your baby’s sleep area 

close to, but separate from, 

where you and others sleep.

Your baby should not sleep on a 

couch or armchair with adults or 

other children, but he or she can 

sleep in the same room as you. If you 

bring your baby into bed with you 

to breastfeed, put him or her back 

in a separate sleep area, such as a 

bassinet, crib, cradle, or a bedside 

co-sleeper (infant bed that attaches 

to an adult bed) when finished. 

7 Think about using a clean, dry 

pacifier when placing your 

infant down to sleep, but don’t 

force the baby to take it. If you are 

breastfeeding your baby, wait until 

your child is 1 month old or is used to 

breastfeeding before using a pacifier.

8 Do not let your baby overheat 

during sleep. Dress baby in light 

sleep clothing, and keep the room at a 

temperature comfortable for an adult. 

Baby may be too warm if he or she 

is sweating or breathing rapidly or 

has damp hair, flushed cheeks, or 

heat rash. 

9 Avoid products that claim to 

reduce the risk of SIDS, and 

do not use home monitors to 

reduce the risk of SIDS. Most 

products have not been tested for 

effectiveness or safety. If you have 

questions about using home monitors 

for other conditions talk to your health 

care provider.

10 Reduce the chance that flat 

spots will develop on your 

baby’s head: provide “Tummy Time” 

when your baby is awake and someone 

is watching; change the direction that 

your baby lies in the crib from one week 

to the next; and avoid too much time in 

car seats, carriers, and bouncers.

11 Invite a Public Health Nurse 

(PHN) into your home. Visits from 

a PHN are known to reduce SIDS risk.

For more information about 

SIDS risk reduction, visit 

http://www.nichd.nih.gov/SIDS.

Your baby needs Tummy Time! Place babies on their 

stomachs when they are awake and 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.