Many parents have questions about Sudden Infant Death Syndrome (SIDS), Sudden Unexpected Infant Death (SUID), and safe sleep for babies. Talk with your healthcare provider about any questions or challenges related to safe sleep practices for your baby.
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About SIDS and Other Sleep-Related Infant Deaths
Learn more about how SIDS is defined.
SUID stands for Sudden Unexpected Infant Death. SUID is defined as the death of an infant younger than 1 year of age that occurs suddenly and unexpectedly, where the cause of death is not immediately obvious prior to investigation.
SUID includes all unexpected deaths—those from known causes and those from unknown causes. SIDS and suffocation are both types of SUID. About half of all SUID cases are SIDS. Many unexpected infant deaths are accidents, but a disease or something done on purpose can also cause a baby to die suddenly or unexpectedly. For some SUIDs, a cause is never found.
Learn more about other sleep-related deaths, including entrapment, suffocation, and strangulation.
The best way to reduce baby’s risk is to always place them on their back to sleep for all sleep times, in a separate sleep area designed for a baby, with no soft objects, toys, comforters, quilts, pillows, or blankets.
The majority (90%) of SIDS deaths occur before 6 months of age, and the number of SIDS deaths peaks between 1 month and 4 months of age. However, SIDS deaths can occur anytime during a baby’s first year, so parents should still follow safe sleep recommendations to reduce the risk of SIDS until baby’s first birthday.
The term “SIDS” applies only to infants younger than 1 year of age.
Avoid swaddling once baby starts to roll over (usually around 3 months of age), and keep in mind that swaddling does not reduce SIDS risk.
Read AAP’s safe sleep recommendations about safe sleep and SIDS
There is not enough evidence that weighted blankets and swaddles are safe to use for babies. Based on what we know about infant health, SIDS, and sleep-related infant deaths, weighted blankets and swaddles could cause harm.
All parents and caregivers should consider the following:
- A baby’s ribcage is still developing. Adding weight could make it harder for a baby to expand their chest and breathe properly. There are no studies showing that it is safe to put any weight on baby’s chest.
- There are currently no safety standards for weighted swaddles and blankets beyond the general rules for children’s products (such as limiting lead content and reducing the likelihood of catching fire). There are also no studies that examine how using these products may affect the risk of sleep-related death. This is because weighted swaddles and blankets are a new type of product, and more needs to be learned about them.
- If a baby rolls over during sleep, the added weight could make it more difficult for them to roll onto their back again. Sleeping on the stomach carries the highest risk of SIDS. That risk is very high for babies who are used to sleeping on their back but who are placed onto their stomachs for sleep. Risk is also very high for babies who are swaddled and placed on or roll onto their stomachs.
- Because there are no safety regulations for these products, they could be made with heavy/thick materials that can increase the risk of overheating. Overheating from excessive clothing or blankets and high room temperature are associated with increased SIDS risk.
- Claims that these products are safe for infants during sleep are based on a single study of 16 babies in an intensive care unit who had neonatal opioid withdrawal syndrome. Babies in the study were constantly monitored and covered with a weighted blanket for 30 minutes at a time. This tightly controlled situation is very different from using a weighted product on a baby for an hour or more, without constant monitoring, so the safety of using the product in the home cannot be assumed.
- Suggested benefits of weighted blankets and swaddles for babies are unproven. Although there is some evidence suggesting that the products may be beneficial in certain groups of older children or adults, there are no studies that show any benefits specifically in groups of babies.
About Back Sleeping
Research shows that the back sleep position carries the lowest risk of SIDS.
Learn more about back sleeping and SIDS.
Yes. Your baby should have “tummy time” when they are awake and someone is watching them. Supervised tummy time helps strengthen your baby’s neck and shoulder muscles, build motor skills, and prevent flat spots on the back of the head. Learn more about the benefits of tummy time.
About Baby’s Sleep Area
Sharing an adult bed with baby, a practice known as bed sharing, increases the risk of SIDS, suffocation, and other sleep-related infant deaths.
Sharing an adult bed with baby can be risky, especially in some situations.
Very high risk:
- The sleep surface is soft, such as a waterbed, old adult mattress, couch, or armchair.
- The adult is very tired, taking medication that makes them drowsy, or using substances like alcohol, or their ability to respond is affected in some way.
- The adult smokes cigarettes or uses tobacco products (even if they do not smoke in the bed).
- The baby is younger than 4 months of age (regardless of adult smoking or sleep surface).
- The adult is not the baby’s parent but is another caregiver, such as a grandparent or sibling.
- The baby was born preterm (before 37 weeks) or at a low birth weight.
- The sleep area includes unsafe items, such as pillows or blankets.
Instead, healthcare providers recommend sharing your room with baby for at least the first 6 months. Room sharing means baby has their own sleep space (crib, bassinet, or portable play yard) in your room, separate from your bed.
Room sharing is safer than sharing your bed with baby. It is also safer than putting baby in their own room. Room sharing also lowers baby’s risk for injury and death from situations like an adult accidentally rolling over them. Keeping baby’s sleep space close to your bed makes it easy to check on, feed, and comfort baby without having to get all the way out of bed.
Learn about room sharing as part of a safe sleep environment for your baby.
If you fall asleep while feeding or comforting baby in your bed, put them back in a separate sleep area as soon as you wake up. Research shows that the longer an adult shares a bed with baby, the higher baby’s risk for suffocation and other sleep-related death.
Before you bring baby into your bed for feeding or comforting, remove or clear away all soft items and bedding from your side of the bed. This practice may help prevent suffocation in case you fall asleep. When finished, put baby back in their own sleep space close to your bed.
Currently, the AAP Task Force on SIDS does not have enough evidence to recommend for or against using a cardboard box, a wahakura (a woven bassinet-like structure intended as a safe sleeping space for an infant), or a Pepi-Pod® (a plastic version of a wahakura).
The use of any sleep area that is not safety-approved for infant sleep or that does not adhere to Consumer Product Safety Commission (CPSC) mandatory safety standards for infant sleep products is not recommended.
The AAP Task Force recommends that parents and caregivers use a sleep surface for baby that is firm (returns to its original shape quickly if pressed on), flat (like a table, not a hammock), level (not at an angle or incline), and covered with only a fitted sheet.
Crib bumpers, bumper pads, and similar products that attach to crib sides, railings, or slats are often used with the intent of protecting babies from injury. However, evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can increase your baby’s risk of suffocation and wedging and can cause serious injuries or death. Keeping bumpers out of your baby’s sleep area is the best way to avoid these dangers.
Before crib safety was regulated, the spacing between the slats of the crib sides could be any width, which posed a danger to infants if the spaces were too wide. Parents and caregivers used padded crib bumpers to protect infants. Now that cribs must meet safety standards, the spaces between slats don’t pose the same dangers. As a result, bumpers are no longer needed.
In 2021, President Biden signed the Safe Sleep for Babies Act (PDF, 185 KB), which prohibits the manufacture and sale of crib bumpers and certain inclined sleepers.
Contact your state health department if you need help finding a safe sleep environment for your baby. Your state health department has resources and can connect you with local initiatives and groups that may be able to help you and your baby.
About Products Advertised to Prevent SIDS
There are currently no products that can prevent SIDS, because there is no known way to prevent SIDS.
Many wedges, positioners, or other products that claim to keep babies in one position or to reduce the risk of SIDS, suffocation, or reflux do not meet federal guidelines for sleep safety. These products, such as inclined sleepers, are linked to injury and death, especially when used in baby’s sleep area. You can help prevent injuries and deaths by not using these products and devices.
The U.S. Food and Drug Administration, CPSC, AAP, and other organizations warn against using these products because they are dangerous for babies.
Home heart, breathing, motion, or other monitors are not recommended as a primary way to detect SIDS. If you choose to use devices that measure baby’s heart rate and breathing for reasons other than detecting SIDS, make sure to follow safe sleep recommendations to reduce baby’s risk of sleep-related death.
The NICHD-led Collaborative Home Infant Monitoring Evaluation study looked at babies who were at high risk for SIDS. The monitors were not effective at identifying situations that might lead to SIDS. Based on this and other research findings, AAP recommends that caregivers not use these monitors to prevent SIDS or identify babies at risk for SIDS.
Healthcare providers might prescribe these products to manage certain medical conditions. If you have questions about using these devices for health problems or concerns other than SIDS, talk with your baby’s healthcare provider.
Keep in mind that breathing, heart, motion, and other home monitors are different from baby monitors that allow caregivers to hear and/or see the infant from another room.
CPSC and the Juvenile Products Manufacturers Association advise parents and caregivers to check all baby monitors and other products with electrical cords to make sure they are out of baby’s reach. Monitors should be placed at least 3 feet away from any crib, bassinet, play yard, or other safe sleep environment.
Experts recommend immediate skin-to-skin contact for all parents and newborns for at least 1 hour after birth, once a healthcare provider says the parent is OK and able to respond to their baby. When the parent needs to sleep or handle other things, baby should be placed on their back in their own separate sleep area, such as a safety-approved crib* or bassinet.
One of the most important things to remember when a baby dies from SIDS is that the family is not to blame. The causes of SIDS remain unknown. Even though there are ways to help reduce the risk, there is no definitive way to keep SIDS from occurring.
A variety of resources are available to help families who have lost an infant to SIDS. Talking to other parents or caregivers who have lost an infant to SIDS may be helpful. A healthcare provider may also be able to recommend local resources and groups.
Parents can also find support at the community and state levels through the National SUID/SIDS Resource Center and other organizations, such as First Candle and Cribs for Kids®.
* The Consumer Product Safety Commission has more information on crib safety at https://www.cpsc.gov/SafeSleep.