In the early weeks of life, babies sleep for about 16 hours a day. Planning where your baby can safely sleep is important as some sleep practices are safer than others.
Creating a safe sleeping environment for your baby will reduce the risk of injuries and sleep related infant death, including sudden infant death syndrome (SIDS). The cause of SIDS is not fully understood but there are sleep practices that are known to reduce a baby’s risk of SIDS and to promote safer sleep for babies.
Share this information with anyone who may take care of your baby; it is important for all parents and caregivers to be informed about safe sleeping practices for babies. For a safe sleeping resource for parents and caregivers, read HealthLinkBC Safer sleep for my baby.
What can I do to keep my baby safe during sleep?
Place baby to sleep on their back
Always place babies on their backs to sleep. Healthy babies and newborns can breathe well on their back and will not choke on their spit-up or saliva.
When your baby can roll over on their own from back to stomach, there is no need to return your baby to their back if your baby turns over in sleep.
Do not use items that put the baby in one position during sleep. If your baby has a health condition that requires a different position for sleep, discuss safe options with your health care provider.
When a baby is awake, they need some supervised tummy time (lying on their stomach) for healthy development. This also prevents temporary flat spots that may develop on the back of a baby’s head. Baby carriers can also be used to help babies get tummy time during the day. For more information about baby carrier safety, visit: www.canada.ca/en/health-canada/services/infant-care/baby-slings-carriers.html
Use a firm mattress free of hazards
Use a crib, cradle, or bassinet that meets Canada safety regulations. It should have a firm mattress, a tight sheet and no bumper pads, pillows, blankets or toys. Plan ahead when travelling, and make sure there is a safe sleep space for your baby.
For more information about Canadian safety regulations and to check for product recalls, visit Health Canada: Product safety – Consumer products and cosmetics at www.canada.ca/en/health-canada/services/consumer-product-safety.html.
Put the crib together using the manufacturer’s instructions, and do not alter the crib in any way.
For the safest sleeping environment in a crib, ensure:
- The crib mattress fits the frame and is no thicker than 15 cm. There should be no gap bigger than 3 cm between the mattress and frame
- The crib bars are less than 6 cm apart
- There are no knobs or items on a crib that could catch a baby’s clothing
- There are no straps, cords or window blinds near the baby’s crib and no items that could fall into the sleep surface
It is never safe for your baby to sleep on a soft mattress, couch, chair, air mattress, pillow, sheepskin, duvet or quilt, or waterbed- either alone or with a caregiver. Your baby can fall to the floor or slip between your body and the cushions, leaving them unable to breathe. Have a bassinet or crib ready or ask someone else to take the baby when you need rest.
Some babies fall asleep while travelling in a car seat. Keep an eye on a baby sleeping in the car and take your baby out of the car seat and place them on a safe sleep surface once you have reached your destination. Babies should not be left to sleep in a car seat, stroller, or mechanical swing. To learn more about safer sleep on the go, visit www.canada.ca/en/public-health/services/safe-sleep/on-the-go.html
Consider carefully the risks of bedsharing
The safest place for your baby to sleep is on their back in a Health Canada-approved crib beside your bed. However, bedsharing is a common practice for many families due to cultural traditions or personal preference. Some families will end up bedsharing even if they did not plan to.
Bedsharing is especially risky for babies who were born prematurely or with a low birthweight. They are at higher risk of sleep-related death while bedsharing. The risk also goes up if there is smoking in the home, if smoking occurred during the pregnancy, or if the adults in the bed are less alert due to alcohol, medications or other drugs.
For families choosing to bedshare, reduce the risk by:
- Placing the baby on their back on a mattress that is clean and firm
- Placing the baby on the outside of the mattress (not between parents), far away from pillows, blankets and duvets. Both adults need to be aware that baby is in the bed and be comfortable with this decision
- Placing the mattress on the floor and away from walls or other furniture to reduce the risk of falling or the baby becoming trapped
- Baby is able to move freely and is not swaddled
- Older children and pets should not be in the bed
- If adults sharing the bed have long hair, they should tie it back
- Ensure that baby is not left alone in an adult bed
Share a room with your baby
The safest place for many babies to sleep for the first 6 months is on their own safe sleep surface in your room. For example, place your baby’s crib beside your bed within arm’s reach.
Breastfeed or chestfeed your baby
Breastfeed or chestfeed your baby if you are able to. Human milk will help boost your baby’s immune system, protect against SIDS, and has many other benefits. Feeding is easier when you share a room with your baby. This means your baby sleeps near you on a separate surface, allowing you to be close to your baby. For more information visit HealthLinkBC File #70 Breastfeeding or chestfeeding.
Keep your baby warm but not hot
Use a thin, light-weight sleep sack, or cotton baby blanket to keep your baby warm. Extra bedding or hats indoors are not needed. If the temperature is comfortable for you, then it is comfortable for your baby.
What about swaddling?
Swaddling is not needed and can be unsafe. Tight swaddling can make it hard for your baby to breathe and can lead to pneumonia. Swaddling can also cause your baby to overheat and increase the risk of sleep-related infant death. It can also cause hip problems. In addition, swaddled babies can get stuck on their stomachs and be unable to move into a safer position if they roll over. If you choose to swaddle, please visit HealthLinkBC Safer sleep for my baby for ways to make swaddling as safe as possible for your baby.
Do not smoke around your baby
Smoking or exposure to second-hand smoke increases the risk of sleep-related death. Avoid exposing your baby to commercial tobacco, cannabis, vaping and e-cigarettes during pregnancy and after birth. Speak with your health care provider or pharmacist if you or your partner need help to quit smoking. You can sign up for the BC Smoking Cessation program at your local pharmacy. You can also call the QuitNow helpline toll-free in B.C. by dialing 604-731-5864 (LUNG) or 1-877-455-2233 or visit https://quitnow.ca.
Stop or reduce any substance use
Drinking alcohol, using drugs or taking some medicines can make you drowsy and cause you to sleep more heavily. Heavy sleep increases the risk that you will roll over onto your baby if you are bedsharing. Have another adult on hand to help with your baby if you have consumed anything that makes you less alert.
If you would like support for any kind of substance use, call your local public health unit to find out about services in your area. You can also call the free and confidential Alcohol and Drug Information and Referral Service: in Greater Vancouver call
604-660-9382, and in other areas of B.C. call toll-free 1-800-663-1441.
What can you do when your baby won’t stop crying when attempting to put them to sleep?
There is no all-purpose solution to stop every baby from crying. Here are some suggestions that may help comfort your baby:
- Snuggle your baby close to your chest; your heartbeat may comfort your baby, skin-to-skin contact is preferable
- Follow your baby’s cues for hunger such as bringing their hands to their mouth, rooting or moving their head, opening their mouth, licking their lips and sucking their hands
- Check your baby’s diaper. Keep your baby clean and dry
Remember, never shake a baby. Put your baby in a safe place and take a break when you need to. For more tips and resources online, visit www.dontshake.ca
For more information on safe sleeping, visit Safer sleep for my baby at: www.HealthLinkBC.ca/living-well/parenting/parenting-babies-0-12-months/baby-safety/safer-sleep-my-baby.
