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List of safe sleep recommendations for infants gets an update

baby sleeping
Photo: fizkes/iStockphoto

Infants should sleep on their backs on flat surfaces without soft bedding, the American Academy of Pediatrics says.

The recommendation is part of a recently published policy statement on reducing infant deaths in the sleep environment.

The AAP also discourages families from sharing a bed with a child up to a year old. The statement represents the academy’s first update to safe infant sleep recommendations since 2016.


About 3,500 infants die each year in the United States from various sleep-related causes, such as sudden infant death syndrome, the AAP says. The risks of sleep-related infant deaths are up to 67 times greater when sleeping on a couch or soft armchair or cushion, and 10 times higher when sleeping with someone who is impaired because of fatigue, medications, alcohol or drugs, or is a smoker.

Other recommendations from the AAP:

  • For at least the first six months, babies should sleep in the parents’ room close to their bed but on a separate surface designed for infants.
  • Offer infants a pacifier at naptime and bedtime to reduce the risk of SIDS.
  • Keep soft objects (examples: pillows, toys, quilts, comforters and loose bedding) away from an infant’s sleep area to reduce the risk of SIDS, suffocation, strangulation and entrapment/wedging.
  • Have supervised tummy time while the infant is awake to assist in development and minimize the potential for positional plagiocephaly, a condition in which an infant’s head develops an abnormally flattened shape or appearance.

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