The AAP’s safe sleep guidelines come down to this: your baby sleeps alone, on their back, on a firm, flat surface in an empty crib or bassinet, in your room but not your bed. These recommendations apply to babies up to 1 year old, for every sleep, naps included. Below is the full checklist, based on the American Academy of Pediatrics’ 2022 policy, with UK guidance from the NHS and The Lullaby Trust where it adds detail.
This checklist is part of our sleep science and safety section. It covers the essentials only. Your pediatrician, midwife or health visitor is the right person for questions about your own baby.
What are the ABCs of safe sleep?
Alone, on the Back, in a Crib. It’s a memory aid that hospitals and health departments use to summarize the AAP’s core advice:
- Alone: your baby has their own sleep space. No adults, siblings, pets, pillows or toys.
- Back: on their back for every sleep, naps and nights, until their first birthday.
- Crib: a crib, bassinet or play yard that meets safety standards, with a firm, flat mattress.
The safe sleep checklist
Sources: AAP 2022 policy, HealthyChildren.org, CDC.
Room-sharing guidelines: why in your room, but not your bed?
The AAP recommends room-sharing without bed-sharing, ideally for at least the first 6 months. Your baby sleeps in their own crib or bassinet close to your bed, so you can respond to them easily. The AAP recommends that parents avoid bed-sharing under any circumstances, and HealthyChildren.org notes that the risk of sleep-related infant death is up to 67 times higher when babies sleep with someone on a couch, soft armchair or cushion.
The NHS gives the same 6-month advice: a separate cot or Moses basket in the same room as you for every sleep. It also advises never sharing a bed if you or your partner smoke, have drunk alcohol, have taken drugs, or are taking medication that makes you drowsy.
Crib safety: what goes in the crib (and what doesn’t)
| In the crib | Out of the crib |
|---|---|
| Firm, flat mattress that fits snugly | Pillows, quilts, comforters, mattress toppers |
| Fitted sheet | Bumper pads, positioners, wedges |
| Your baby in a sleep sack or appropriate layers | Loose blankets, stuffed toys |
| Weighted blankets, sleepers or swaddles | |
| Phones, speakers, sound machines and cords |
The Lullaby Trust in the UK adds pods, nests and positioning products such as wedges to the list of things to avoid, and recommends a firm, flat, waterproof mattress.
Avoiding overheating
Babies don’t need to be bundled for sleep. HealthyChildren.org suggests dressing your baby in about one more layer than you’d wear in the same room, and no hat indoors once you’re home from the hospital. The NHS suggests keeping the room at about 16 to 20°C (roughly 61 to 68°F) and checking with a room thermometer. Signs your baby may be too hot include sweating or a hot chest.
When can baby sleep with a blanket?
Not in the first year. The AAP’s guidance on keeping soft bedding out of the sleep area applies to babies up to 1 year old. Use a wearable blanket or sleep sack instead. After 12 months, talk to your pediatrician before adding a light blanket.
Swaddling, pacifiers and breastfeeding
- Swaddling: fine for young babies who are always placed on their back, but stop as soon as your baby shows signs of trying to roll, often around 3 to 4 months. HealthyChildren.org notes that swaddling doesn’t reduce the risk of SIDS.
- Pacifiers: the AAP recommends offering one at sleep times. If you’re breastfeeding, wait until feeding is established. Don’t force it, and if it falls out after your baby is asleep, there’s no need to put it back.
- Breastfeeding: the AAP notes that human milk feeding is associated with a lower risk of SIDS, and the longer the better. If you formula-feed, following the rest of the checklist still matters just as much.
Phones, sound machines and baby monitors
Safe sleep guidance doesn’t ban sound, but devices belong outside the sleep space:
- Out of the crib: never place a phone, speaker or sound machine in the crib, bassinet or on the rail.
- About 2 m (7 ft) away, with cords and chargers out of reach.
- Low volume: around 50 dB or lower at your baby’s ear. A 2014 Pediatrics study found that infant sleep machines at maximum volume can be loud enough to be a hearing concern (Hugh et al., 2014). See how loud white noise should be for a baby.
- Monitors aren’t a safety net: the AAP advises against using home cardiorespiratory monitors to reduce the risk of SIDS. Follow the checklist instead.
Safe sleep for newborns
The first weeks bring the most night wakings and the most temptation to bend the rules when you’re exhausted. Plan ahead: keep the bassinet within arm’s reach of your bed, and if you feed in bed, put your baby back in their own space before you might fall asleep. Our newborn sleep guide has more on nights in the first weeks.
Sources
- American Academy of Pediatrics. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 2022.
- HealthyChildren.org (AAP). How to Keep Your Sleeping Baby Safe: AAP Policy Explained.
- Centers for Disease Control and Prevention. Providing Care for Babies to Sleep Safely.
- NHS. Sudden infant death syndrome (SIDS).
- The Lullaby Trust. Safer sleep overview.
- Hugh SC, Wolter NE, Propst EJ, et al. Infant sleep machines and hazardous sound pressure levels. Pediatrics, 2014.
