Advice Column, Baby, Health, Lifestyle, Pregnancy & Baby

Sleep Safety Guidelines for New Moms 

  • Baby Jakes Mom
  • Category Advice Column, Baby, Health, Lifestyle, Pregnancy & Baby

I am yet to encounter a new mom whose baby sleeps flat on their back. Every time I visit a fellow new mommy friend, they’ve carefully wedged their new baba on their sides, nestled in between those little foam side wedges and sleep positioner’s. Why? Because they’re worried that if their little one is on their back, and spits up in their sleep, they’ll choke to death on their own vomit.

Oh moms. Side sleeping hasn’t been recommended for the last 26 years. Back sleeping is the ONLY safe to sleep position for newborns and infants. 

That said, allow me to state that I am not inherently paranoid. I let Jake sleep on his tummy for many a day nap (OMG?!? Yes, I just admitted that out loud). And yes, you will find many loose toys in Jake’s cot. And a cot bumper. Nor have I ever used the Angelcare Breathing Mat. (This post should be attached with one of those “Do not try this at home” disclaimers). And now that he is older (and out of the high risk stage), he gets himself into the most obscure sleep positions; twisted and curled like a mini contortionist, face down. Accompanied by his many furry friends (Doo Doo, Doo Doo the 2nd, Kitty, Barney & Bunny).

At the end of the day though, I was always fully informed and aware of the risks of SIDS. I’m providing this information for the advancement of your own knowledge. Know the facts. Use common sense and trust your own mommy instincts (because yes, that is a real thing, and yes, you possess it).

Also remember that SIDS (Sudden Infant Death Syndrome) is rare. No need for panic. But it’s about being aware, informed and up to date.

The information listed below is taken directly from official guidelines as provided by various State and Government departments around the world. I’m just sharing the information so you can make informed mommy decisions of your own.


It’s a public education campaign used by governments of first world countries to try and decrease the risk of Sudden Infant Death Syndrome (SIDS) – the current leading cause of death among infants.  The Campaign was first introduced in the early 1990’s. Countries which have implemented public health campaigns to promote the use of the back sleep position for infants have reduced their rates of sudden infant death by as much as 80%. In the USA, SIDS rates have decreased by 50% – while Australia has seen an 83% decline.


  • Babies sleep safest on their backs. Babies who sleep on their backs are much less likely to die of SIDS than are babies who sleep on their stomachs or sides.
  • Every sleep time counts. Babies should sleep on their backs for all sleep times—for naps and at night. Never on tummy or side.
  • Babies who are used to sleeping on their backs but who are then placed on their stomachs to sleep, like for a nap, are at very high risk of SIDS.
  • Sleep surface matters. Babies who sleep on a soft surface, such as an adult bed, or under a soft covering, such as a soft blanket or quilt, are more likely to die of SIDS or suffocation. Babies must therefore never be left alone on an adult bed or put to sleep on a sofa, bean bag, waterbed or sagging mattress
  • Keep soft objects, toys, stuffed animals, crib bumpers, and loose bedding out of your baby’s sleep areato reduce the risk of SIDS and other sleep-related causes of infant death.
  • Do not use pillows, wedges, positioners, nests, blankets, quilts, sheepskins, or crib bumpersanywhere in your baby’s sleep area. Evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries and even death.
  • Use a firm mattress that fits snuggly in the cot with a fitted crib sheet. Avoid using loose blankets.
  • Do not let your baby get too hot during sleep (Remember that a cold baby will wake from discomfort, a hot baby won’t). Around 18 degrees Celsius is the correct room temperature.
  • Don’t let your baby’s head become covered. To prevent your baby wriggling down under the covers, place them in the “feet to foot” position. This means their feet are at the end (foot) of the crib, cot or Moses basket.
  • Smoking remains the most important modifiable risk factor in reducing the risk of SIDS.
  • Make sure that everyone who cares for your baby uses the safe sleeping recommendations to put your baby to sleep.


Why should I place my baby on his or her back to sleep?

Research shows that the back sleep position is the safest for babies. The back sleep position carries the lowest risk of SIDS.

Will my baby choke if placed on his or her back to sleep?

No. Healthy babies naturally swallow or cough up fluids—it’s a reflex all people have to make sure their airway is kept clear. Babies might actually clear such fluids better when on their backs because of the location of the windpipe (trachea) when in the back sleep position. Healthy infants protect their airway when placed on their backs, provided that swallowing and arousal mechanisms are normal. Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach.

Is it okay if my baby sleeps on his or her side?

Side sleeping is not recommended as a safe alternative to sleeping on the back and increases the risk of SIDS. Much (but not all) of the risk associated with the side position is related to the risk of the infant rolling onto their tummy. For this reason, babies should sleep wholly on their backs—the position associated with the lowest SIDS risk.

What if my baby rolls onto his or her stomach during sleep? Do I need to put my baby in the back sleep position again if this happens?

No. Rolling over is an important and natural part of your baby’s growth. Most babies start rolling over on their own around 4 to 6 months of age. And by this stage, baby’s brain is mature enough to alert her to breathing dangers. If your baby rolls over on his or her own during sleep, you do not need to turn the baby over onto his or her back. The important thing is that your baby starts every sleep time on his or her back to reduce the risk of SIDS, and that there is no soft, loose bedding in the baby’s sleep area.

How do I correctly position my baby in the Feet to Foot position?

Position your baby so that their feet touch the bottom of the cot / moses basket etc. This way, if they roll down in their sleep, their heads will not get covered by the blanket.

What about infants with reflux? Must I elevate the mattress?

Research shows that all babies, including babies with gastro-oesophageal reflux, should be placed on their back to sleep. There is no evidence to support the elevation of the head of the cot.

What if my baby’s grandparents or another caregiver wants to place my baby to sleep on his or her stomach for nap time?

Babies who usually sleep on their backs but who are then placed to sleep on their stomachs, such as for a nap, are at very high risk for SIDS. So it is important for everyone who cares for your baby to use the back sleep position for all sleep times—for naps and at night.

Are there times when my baby should be on his or her stomach?

Yes, your baby should have plenty of Tummy Time when he or she is awake and when someone is watching. 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. At first, your newborn may not like being on her belly and will only tolerate tummy time for a few seconds without crying. That’s OK. Over time, she will become more used to being on her belly when awake and will probably even start to like it. Make sure to give her some tummy time every day, and always supervise her during these special times.

Will my baby get flat spots on the back of the head from sleeping on his or her back?

Some parents have heard that the back of a baby’s head may get flat from sleeping on the back. This is actually true. But a flat head is usually avoidable and not serious when it occurs. Nor are flat spots linked to long-term problems with head shape. These flattened head spots do not affect brain growth, and for most babies head shape becomes rounder as the baby develops. Flat spots typically go away on their own once the baby starts sitting up.

The most effective strategy to prevent flattened spots is to ensure baby spends time on their tummy several times a day (awake and supervised).

Other strategies include turning your baby’s head to the side when you put her to sleep. Sometimes turn her head to the left, and other times, turn it to the right. Position the cot to face a different direction or place baby to sleep at either end of the cot (always feet to foot of cot). This can help if she usually looks in the same direction of the room. Avoid prolonged periods in car seats and prams. Carry baby in a sling.

If her head does become a bit flat in the back, it usually is not serious.

Can I use a sleep positioner, nest or wedge?

No. Stop using sleep positioners. Using a positioner to hold an infant on his or her back or side for sleep is dangerous and unnecessary. Never put pillows, infant sleep positioners, comforters, or quilts under a baby or in a crib. Sleep positioners, nests and wedges are now considered suffocation hazards. Only a few years ago these were marketed as SIDS prevention devices, yet now they are known to be dangerous. All aids and devices intended to keep infants in a certain sleep position do not prevent infants from rolling onto their stomachs, are not recommended, and limit the movements of the baby as they get older.

Do breathing mat monitors prevent SIDS?

Normal healthy babies do not need a breathing monitor. Some parents find that using a breathing monitor reassures them. However, there is no evidence that monitors prevent SIDS.

What about co-sleeping?

The safest place for your baby to sleep is on their back in a cot in a room with you for the first six months. It’s lovely (and convenient) to have your baby with you for a cuddle or a feed, but it’s safest to put your baby back in the cot before you go to sleep. In some circumstances, sharing a sleep surface with a baby increases the risk of sudden infant death and fatal sleeping accidents. Current evidence has shown that it is not so much bed-sharing, but the circumstances in which bed-sharing occurs that carries the risk. No sleeping environment is risk free.  It is recommended to sleep with a baby in a cot next to the parents’ bed for the first six to twelve months of life as this has been shown to reduce the risk of SIDS.

Should I use a sleeping bag / sack?

Safe infant sleeping bags have several benefits. An infant sleeping bag that is the correct size for baby with a fitted neck, arm holes or sleeves and no hood, is the best way to keep a baby’s head and face uncovered as it makes extra bedding unnecessary. Sleeping bags also delay baby from rolling into the high-risk tummy position during sleep and prevent the baby’s legs from dangling out of cot rails. If additional warmth is needed you can dress baby in layers of clothing within the sleeping bag, but make sure this is appropriate to room temperature (dress baby as you would dress yourself).

What if I don’t have a sleeping bag or sleep sack?

If you do use a blanket (although this is not advised), keep it away from the baby’s mouth and nose. To use a blanket, make sure the baby’s feet are at the bottom of the crib, that the blanket is no higher than the baby’s chest / shoulders, and the blanket is tucked in around the bottom of the crib mattress.

You can also securely swaddle / wrap your baby if you don’t have a sleeping bag / sac. Wrapping / Swaddling is a safe and effective strategy to try if you are having difficulty settling your baby and will help baby to settle and stay in the safe, back sleeping position. If you choose to wrap your baby, make sure baby’s head is not covered, and wrap baby firmly but not too tightly. Wraps should be of lightweight cotton or muslin material, and ensure baby is not overdressed under the wrap. Baby should always be placed on their back to sleep, with their feet to the bottom of the cot. Babies must not be wrapped if they are sharing a sleep surface with another person.

Is my baby at an increased risk if we’re smokers?

Yes. Over 60 studies from many countries have demonstrated a very strong relationship between smoking and sudden infant death syndrome. Smoking during pregnancy increases the risk, while smoking after the baby is born increases the risk further. Babies who are exposed to cigarette smoke from any household member are at an increased risk. The car and home should be smoke free zones. Reducing the number of cigarettes smoked in the household, reduces the risk. Room sharing for sleep is recommended for babies for the first 6-12 months of life, as long as this room is kept smoke free and is well ventilated. Sharing a sleep surface with your baby if you are a smoker is not safe and is not recommended.

How old are babies who die from SIDS?

The majority (90%) of SIDS deaths occur before a baby reaches 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 their baby’s first birthday.


The safest sleep environment for a baby, experts say, is a firm, flat mattress with nothing but a fitted sheet on it. Nothing else should be in the bed: no stuffed animals, blankets, pillows, bumpers, or positioners of any kind. So invest in a sleep sack rather than a blanket. Remove all wedges and loose objects. And put baby to sleep flat on their backs. And if you smoke, quit.

Courtesy: Eunice Kennedy Shriver National Institute of Child Health and Human Development

The guidelines provided here are for information purposes only. Consult your health care provider before making any changes. Remember, SIDS cannot be prevented. But you can take steps to reduce the risk. Use of this information is at your own discretion. This website does not accept any liability to any person for the information or advice (or the use of such information or advice) which is provided on this website or incorporated into it by reference. 

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