Only Online: How to create a Safe Sleep Setting for Your Infant

Jonathan Midgett (Col ’92, Educ ’94) is an engineering psychologist with the Office of Hazard Identification and Reduction of the US Consumer Product Safety Commission, where he uses his knowledge of child development to help regulate children’s products.

alt textCaring for a newborn is not rocket science: very little equipment is absolutely essential. Just the same, when new parents start shopping for baby gear, they can be quickly overloaded with the volume of choices. Learn how to minimize risks in your baby’s sleep setting, no matter what sleep product you choose for your baby.

Place infant(s) to sleep on their backs
This simple rule is associated with a dramatic decreased risk of sudden infant death syndrome.

Use a firm, tight-fitting mattress
If you can fit more than two fingers between the edge of the mattress and crib side, the mattress is too small. An infant can suffocate if its head or body becomes wedged between the mattress and the crib sides.

Never use extra padding, blankets or pillows under your baby
You may think that the crib or bassinet mattress that came with your baby gear seems too hard. You wouldn’t want to sleep on it. But the truth is that infants cannot maintain open airways on the soft, pillowy surfaces that adults prefer to sleep on. Resist the urge to place extra padding under your infant—your old bones may need extra padding to sleep well, but infants don’t need it.

Remove pillows or thick comforters
Decorative pillows and comforters look nice in a nursery, but they can be obstacles in a crib or bassinet, actually pinning a child in a bad position or becoming a suffocation hazard if the child squirms about during the night.

Positioning devices are not necessary
No research supports using sleep positioners, and if children slip off them or flip out of them they can become trapped between the positioner and the side of their crib or bassinet.

Regularly check gear
Any broken parts on your child’s sleeping gear can be deadly. Check the fit and tightness of fasteners and any adjustable parts of your crib or bassinet to ensure that no gaps may open up when a child wriggles while sleeping.

Do not try to fix a broken crib or bassinet
Many fatal incidents are associated with repaired cribs or bassinets. Throw them away or get exact replacement parts from the manufacturer.

Place cribs or bassinets away from windows
Children can quietly explore their environment during the night, reaching through the crib slats to pull cords and curtains into their crib.

No strings or cords
Never use strings to hang any object, such as a mobile, on or near the crib where a child could become caught in it. If you have toys with cords or elastic for hanging, cut the strings or cords off. Never tie pacifiers around your child’s neck. Remove bibs and necklaces whenever you put your baby to sleep.

Avoid cribs more than 20 years old
Many older, unsafe cribs do not meet safety standards and may lead to entrapment or strangulation. Destroy all cribs with:

  • Slat spacing greater than 60 mm (2 3/8 inches). Infants might pass through gaps generated between wide slat openings and becomes entrapped at the neck.
  • Headboard designs that have decorative cutouts that may allow an infant’s head to become caught in the openings.
  • Corner posts that extend more than 1.5mm (1/16 inch) above the top of the end panel. Children have died when items or clothing around their necks caught on corner posts.

Avoid makeshift and adult bedding
Never place your infant to sleep on an inflatable mattress. Also, never place your infant to sleep in an adult bed, waterbed or bunk bed.

A warning about bedsharing:
Many parents choose to sleep with their infants to facilitate breastfeeding and bonding. Be aware of the many risks associated with bedsharing and, if you choose to accept those risks for your family, strictly follow the rules outlined by expert proponents of bedsharing. Overlay deaths are real and more common than you think.

When to stop using a crib:
When your child reaches 35 inches (890 mm) in height, or can climb out of the crib, he/she has outgrown the crib and should no longer sleep in it. Placing the crib mattress on the floor is a common and safe solution until the child gets a bed.

Avoid hazardous toys and sheets
Crib gyms and other toys that stretch across the crib with strings, cords or ribbons can be a hazard for older or more active babies.

Sheets also can be hazardous, so make sure they fit snugly and overlap the mattress at least 2 inches. Never use an adult sheet on a crib mattress; it can become loose and entangle an infant.