AAP Safe Sleep Guidelines for Babies 2025

The ABCs of Safe Sleep

Alone - Baby sleeps alone in their own space Back - Always on their back Crib - In a safety-approved crib or bassinet

Safe Sleep Recommendations

Sleep Position

• Always place baby on back for every sleep (naps and nighttime)
• Once baby can roll both ways, they can find their own sleep position
• Never place baby on side or stomach to sleep

Sleep Surface

• Use firm, flat surface (safety-approved crib, bassinet, or play yard)
• Covered with fitted sheet only
• No inclined surfaces (car seats, swings, bouncer seats are not for sleep)
• Avoid soft surfaces (couches, armchairs, adult beds)

Sleep Location

• Room-sharing recommended: Baby sleeps in parents' room for at least 6 months, ideally 12 months
• No bed-sharing: Baby should have their own sleep surface
• Keep crib close to parents' bed

Sleep Environment

• Keep crib bare: No pillows, blankets, bumpers, or stuffed animals
• Use sleep sack or wearable blanket: Instead of loose blankets
• Room temperature: Keep comfortable (68-72°F / 20-22°C)
• No overheating: Dress baby in light sleep clothing

What to Avoid

❌ Dangerous Sleep Practices

• Bed-sharing (especially with smoking, alcohol, or drug use)
• Sleeping on couches or armchairs with baby
• Soft bedding in crib
• Crib bumpers (even mesh ones)
• Sleep positioners
• Inclined sleepers

❌ Products Not Recommended

• Wedges and positioners
• In-bed co-sleepers attached to adult bed
• Car seats, swings, bouncers for routine sleep
• Weighted swaddles or sleep sacks

Reduce SIDS Risk

Protective Factors

1. Breastfeeding: Reduces SIDS risk
2. Pacifier: Offer at naptime and bedtime (after breastfeeding established)
3. Immunizations: Up-to-date vaccines reduce SIDS risk
4. Prenatal care: Regular checkups during pregnancy
5. Smoke-free environment: No smoking during pregnancy or around baby

Risk Factors to Avoid

• Smoking, alcohol, or drug use
• Overheating
• Soft bedding
• Bed-sharing
• Prematurity (extra precautions needed)

Swaddling Guidelines

If you choose to swaddle:

• Stop when baby shows signs of rolling (usually 2-4 months)
• Always place swaddled baby on back
• Use thin blanket or swaddle designed for infants
• Don't swaddle too tightly
• Monitor for overheating

Tummy Time

While back-sleeping is safest, tummy time is important:

• Start from birth
• Always supervised
• When baby is awake and alert
• Helps develop neck and shoulder muscles
• Prevents flat spots on head

Common Questions

Q: What if baby rolls during sleep?

A: Once baby can roll both ways independently, it's okay if they roll to stomach during sleep. Always place on back initially.

Q: Is a dock or lounger safe for sleep?

A: No. These products are not safe for infant sleep. Use only safety-approved cribs, bassinets, or play yards.

Q: Can siblings share a room?

A: Yes, but baby should have their own separate sleep surface.

Q: What about co-sleepers?

A: Only use bassinet-style co-sleepers that meet safety standards. Avoid in-bed co-sleepers.

Red Flags - Call Healthcare Provider

• Baby has trouble breathing during sleep
• Excessive snoring
• Long pauses in breathing
• Blue or pale color
• Extreme fussiness or changes in sleep patterns

Key Takeaways

✅ Back to sleep, every sleep ✅ Firm, flat surface with fitted sheet only ✅ Room-sharing without bed-sharing ✅ No soft objects in sleep area ✅ Smoke-free environment ✅ Breastfeed if possible ✅ Offer pacifier ✅ Keep baby from overheating

Additional Resources

• AAP Safe Sleep Recommendations: healthychildren.org/sleep
• Consumer Product Safety Commission: cpsc.gov
• Safe to Sleep Campaign: safetosleep.nichd.nih.gov

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Source: American Academy of Pediatrics (AAP) Last Reviewed: January 2025 Evidence Level: A (Strong recommendation based on high-quality evidence)