New parents hear plenty of advice about how to care for a baby, from how often to feed them to how much they should be held and cuddled. But when it comes to sleep, the safest choice is also the simplest: A baby’s sleep space should be clear of blankets, toys, and crib bumpers and separate from an adult bed. Most importantly, safe-sleep practices should be followed every time a baby sleeps.
October is Safe Sleep Awareness Month and Sudden Infant Death Syndrome (SIDS) Awareness Month, a time to remind parents and caregivers that small choices around sleep can make a significant difference in an infant’s safety.
Emily Nicoletti, nurse manager of pediatrics at The University of Texas Medical Branch (UTMB Health) in Galveston, and Kim Hillman, neonatal program manager at UTMB Health Clear Lake Hospital, are helping educate parents about creating a safe sleep environment and reducing the risks associated with sleep-related infant deaths.
Close by, but not in the same bed
“Families are often surprised when we strongly advise them not to sleep in the same bed with their baby,” Nicoletti said. “A baby’s crib or bassinet should be in the same room as the parent for the first six months, but bed-sharing is never recommended.”
Hillman added that placing a baby on their stomach to sleep also increases the risk of sleep-related death. Infants should be placed on their backs for every sleep.
The reason for the recommendations is simple: Newborns are not yet able to reliably move their heads or bodies away from something blocking their airway. A blanket, toy, or other soft object near a baby’s face can cover the nose and mouth, restricting airflow and creating a risk of suffocation.
The Centers for Disease Control and Prevention (CDC) reported about 3,700 sleep-related deaths among U.S. infants in 2022, including SIDS, accidental suffocation, and other sudden unexpected infant deaths, Nicoletti said.
“That’s a staggering statistic, and we want to do everything we can to prevent that from happening,” she said.
Hillman said infant mortality remains a concern in Harris County, where there are six infant deaths per 1,000 live births.
“It’s not talked about enough,” she said. “We want every baby to have a safe sleep environment so they can grow up.”
When babies fall asleep in unexpected places
Exhaustion and sleep deprivation can be overwhelming for new parents, who may be willing to try almost anything that helps a fussy baby settle down. But Nicoletti cautions parents to be careful about products and devices marketed to help babies sleep.
“I always tell new parents that many of the devices that are marketed to help babies sleep are not safe,” she said. “Car seats and swings aren’t safe places for babies to sleep. Babies should always sleep on a flat surface with no accessories, just a fitted sheet.”
The couch is not a safe place for a baby to sleep, either. And when babies fall asleep in the car, as they often do, parents should move them to a safe, flat sleep surface once they reach their destination.
Devices designed to position babies on their sides also should not be used for sleep.
“Side sleeping doesn’t help with spit-up,” Hillman said. “Because of the anatomy of the baby’s airway, the safest position for them to sleep is on their back.”
Decorate the room, not the crib
Part of the joy of anticipating a baby’s arrival is preparing the nursery. Nicoletti understands that parents want to create a beautiful, welcoming space, but she encourages them to keep the crib itself simple.
“Buying those cute bedding sets is what we all want to do, but we encourage parents to decorate the room, not the sleep space,” she said. “The crib needs to be as basic as possible.”
The CDC recommends keeping blankets, pillows, bumper pads, and soft toys out of an infant’s sleep area.
Getting safe sleep advice
For exhausted parents, the temptation to bring a sleeping baby into the adult bed or continue holding a baby who has finally settled can be strong. Well-meaning family members and friends may also offer advice based on their own experiences or information they have seen online.
“People have been heavily impacted by social media, and the information isn’t always accurate,” Nicoletti said. “While it can be tempting to keep a baby in your arms if they seem calmer or sleep longer that way, the safest place for an infant to sleep is on their back in their crib. Falling asleep while holding a baby can create serious safety risks that far outweigh any benefit in that situation.”
Nicoletti said educating parents also means helping them feel confident in making safe choices, even when those choices differ from advice they hear from others.
“It’s tough for new parents,” she said. “There are a lot of influences on their decisions, and not all of them are safe.”
UTMB Health Clear Lake Hospital has earned Bronze Level Safe Sleep Certification from Cribs for Kids, a national nonprofit dedicated to preventing sleep-related infant deaths through education and advocacy. The recognition reflects the hospital's strong commitment to equipping families with the knowledge and resources they need to create safe sleep environments for their babies.
For Nicoletti and Hillman, the message to parents is straightforward: Safe sleep does not have to be complicated. In fact, the safest sleep space is often the simplest.
“Safe sleep applies to every baby, every nap, every sleep, every time,” Nicoletti said.