Safe sleep for babies

Young babies spend a large part of their day and night sleeping. It’s important to keep your baby’s sleep space safe.

The number of cases of Sudden Unexpected Death in Infancy (SUDI) has gone down significantly since the 1990s. This is largely because of recommendations such as placing babies to sleep on their back from birth.

You can remove dangers from your baby’s sleeping area to reduce their risk of SUDI. You can also take steps to avoid accidents and injuries to sleeping babies.

When a baby dies and there is no apparent cause of death, this is called sudden unexpected death in infancy (SUDI). It includes sudden infant death syndrome (SIDS) and ‘fatal sleep accidents’. SIDS also used to be called ‘cot death’. In 2022 there were 117 SUDI deaths in Australia.

Back sleeping is recommended because healthy babies are less likely to choke if they are positioned on their back. When your baby is on their back, their airways are above their oesophagus (food pipe). This helps them swallow any milk they cough up, and keep it out of their lungs.

Sleeping on their back as well as keeping their head uncovered also allows them to stay cool by losing heat through the skin on their face and head.

What about when my baby starts to roll?

If your baby sleeps in a bassinet, move them into a cot when they first show signs of being able to roll.

If you were swaddling your baby, it’s now time to stop. They need to have their arms free while they sleep.

If your baby can only roll one direction on their own, gently roll them onto their back whenever you notice they have rolled onto their front or side.

Once your baby can easily roll in both directions, you can put them down to sleep on their back and let them find their own natural sleeping position. It's not necessary to wake during the night to return your baby to their back.

Some factors that make a sleep space unsafe are having:

• a soft sleep surface
• loose bedding, toys or pillows
• their face covered
• toys and cot bumpers in the cot
• items that prop your baby up or keep them in a position

These things can increase the risk of SUDI.

Soft bedding and loose items can cover your baby’s face and obstruct their breathing. Extra covers could make your baby overheat.

Placing a baby in an inclined or sloped position, like in a bouncinette or sitting up against a pillow or lounge, is not recommended. If your baby falls asleep sitting up, their head can fall forwards, pushing their chin down towards their chest. This can block their airway.

A safe sleeping environment means that the baby’s cot, mattress and bedding are all safe. Any sources of danger have been removed.

Baby items need to meet certain safety standards — the current Australian and New Zealand Standard for cots is AS/NZS 2172:2003.

If you plan to use a second-hand cot, check it meets those standards and is not broken. Don’t use a cot if you are in any doubt about its safety.

Co-sleeping can increase the risk of SUDI. The safest place for your baby to sleep is in their own safe cot. Some breastfeeding mothers find that they and their baby get more rest when they co-sleep.

It’s important not to co-sleep with your baby if:

• you are overly tired or are unwell
• you have been drinking alcohol
• you or your partner smoke
• you or your partner have taken any drugs that make you feel less alert or sleepy
• your baby is premature or small for their gestational age (SGA)

If you choose to co-sleep, you should:

• always place your baby on their back to sleep
• keep your baby’s head and face uncovered and move your bedding away from your baby
• put your baby in a safe sleeping bag
• make sure your mattress is clean, firm and flat
• tie up any long hair and remove any jewellery which could cause strangulation
• move the bed away from the wall so your baby can’t become trapped
• make sure your baby can’t roll off the bed, or place your mattress onto the floor
• create a clear space for your baby to sleep beside one parent and away from the edge

Just like adults do, babies can get hot or cold. It can be difficult for parents to know how to dress their new baby comfortably for the weather. Babies control their temperature mainly through their head and face so keep their head uncovered.

Dress your baby in as many layers as you would wear yourself to be comfortably warm in the room. You can use a baby sleeping bag to keep them from getting too hot or cold. Make sure your baby’s arms are out.

If you use sheets and blankets tuck them in well and only pull them up to your baby’s chest. Place your baby with their feet at the end of the cot.

Hats and beanies

Even when the weather is cold take off any hats or head coverings before your baby goes to sleep, to avoid overheating. Overheating may increase the risk of SUDI.

Sleeping bags

Sleeping bags are a good option if they are the right warmth, weight and size.

Sleeping bags can support safe sleep because they help to:

• reduce the risk of bedclothing covering your baby’s face
• delay rolling onto the tummy during sleep until your baby is past the age when the risk of SUDI is highest
• encourage sleeping on the back
• keep your baby’s temperature steady while they sleep

Many sleeping bags come with a Thermal Overall Grade (TOG) rating which indicates its warmth. Choose a sleeping bag with the right TOG rating for the room where your baby sleeps. Sleeping bags should also have a fitted neck and armholes with no hood. Take care to choose the right size for your baby.

Never let your baby sleep:

• unattended on an adult bed or bunk bed
• on a waterbed, beanbag, couch, pillow or cushion
• with a sleeping adult or child on a couch, sofa or chair
• in a cot that is near anything hanging, including curtains, curtain cords, cords from electrical appliances, or pictures or mirrors
• in a cot with an electric blanket, hot water bottles or wheat bags

Babies who have had their recommended vaccines and those who are breastfed may have a lower chance of SUDI.

Speak with your child health nurse or your GP for more information on safe sleep for babies.

Visit Red Nose (Opens in new tab) or the SleepHeath Foundation for more information on safe sleep.

Languages other than English

Red Nose also has safe sleep resources in languages other than English and for grandparents.

Information for Aboriginal and/or Torres Strait Islander peoples

Product Safety Australia has information and a video called Sleep Bub Safe (Opens in new tab).