AAP Safe Sleep Guidelines for Babies 2025

# AAP Safe Sleep Guidelines for Babies 2025 ## The ABCs of Safe Sleep **A**lone - Baby sleeps alone in their own space **B**ack - Always on their back **C**rib - 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 --- **Source**: American Academy of Pediatrics (AAP) **Last Reviewed**: January 2025 **Evidence Level**: A (Strong recommendation based on high-quality evidence)