Is it safe to sleep with my baby?

Sharing a sleep surface with a baby increases the risk of SUDI, SIDS and fatal sleep accidents in some circumstances. SIDS and Kids recommends sleeping a baby in its own safe sleeping environment next to the parents’ bed for the first six to twelve months of life as this has been shown to be protective.

There appears to be no increased risk of SUDI, SIDS or fatal sleep accidents whilst sharing a sleep surface with a baby during feeding, cuddling and playing, providing that the baby is returned to its own safe sleeping surface before the parent goes to sleep.

Babies who are most at risk of SUDI, SIDS or sleep accidents whilst sharing a sleep surface, are babies who are less than four months of age and babies who are born pre-term or small for gestational age. Most studies show that SUDI and SIDS deaths attributable to sharing a sleep surface are predominantly amongst babies whose parents smoke.

However, there is a slightly increased risk of SIDS among babies of non-smoking mothers who bed share with infants less than 11 weeks of age.

Sharing a sleep surface with a baby may also increase the risk of a fatal sleep accident as some sleeping environments contain hazards that can be fatal for babies. These risks include overlaying of the baby by another individual; entrapment or wedging and suffocation from pillows and blankets.

Never fall asleep with baby lying on its tummy on your chest.

Do not share a sleep surface with a baby if:

  • you are a smoker
  • you are under the influence of alcohol or drugs that cause sedation
  • you are excessively tired.
  • other children are sharing the bed with a baby
  • the baby could slip under bedding e.g. pillows and duvets or doonas
  • the bed is a waterbed or if the mattress is too soft
  • the sleep surface is a sofa or chair
  • the baby could become trapped between the bed and the wall or the bed rails
  • the baby may fall off the bed.

Important considerations when choosing to share a sleep surface with a baby

When choosing to share a sleep surface with a baby it is important to consider the sleeping environment. Babies are at the greatest risk if they sleep on their tummies or sides and if their faces become covered. Taking measures to prevent these situations will reduce the risk of SIDS and fatal sleeping accidents.

  • put the baby on the back to sleep (not on the tummy or side)
  • make sure the mattress is firm and falt (not tilted or elevated)
  • sleep the baby in a baby sleeping bag to avoid bedclothes (see Q15)
  • make sure that any bedding cannot cover the baby’s face. Keep pillows, doonas and any other soft bedding well away from the baby
  • do not wrap the baby
  • place the baby at the side of one parent – not in between two parents, as this would increase the likelihood of the baby becoming covered or slipping underneath adult bedding
  • ensure that the baby is not close to the edge of the bed where he/she can fall off. Do not place pillows at the side of the baby to prevent rolling off. A safer alternative is to place the adult mattress on the floor.
  • pushing the bed up against the wall can be hazardous as the baby may become trapped.

Never sleep the baby on a soft mattress, sofa, beanbag, or waterbed with or without a parent as there is a very high risk of a sleep accident.

Does sleeping with a baby on a sofa increase the risk of sudden unexpected death in infancy?

Yes. There is a very high risk of a sleeping accident if an adult falls asleep with an infant on a sofa. This is because baby may become wedged into cushions or the back of the sofa and the sleeping person would not notice. Put baby back into his or her own sleeping place before you doze off on a sofa.

Never fall asleep with baby on your chest whilst lying down as this is the same as sleeping the baby in the tummy position.

How much clothing/bedding does baby need?

Babies control their temperature through the face. Sleeping baby on the back and ensuring that the face and head remains uncovered during sleep is the best way to protect baby from overheating and suffocation.

Sleeping baby in a sleeping bag will prevent bedclothes covering the baby’s face If blankets are being used instead of a sleeping bag, it is best to use layers of lightweight blankets that can be added or removed easily according to the room temperature and which can be tucked underneath the mattress.

When dressing a baby you need to consider where you live, whether you have home heating or cooling and whether it is summer or winter. A useful guide is to dress baby as you would dress yourself – to be comfortably warm, not hot or cold. It is not necessary to leave the heating on all night or to monitor the room temperature with a thermometer, but ensure that baby is dressed appropriately for the room temperature.

A good way to check baby’s temperature is to feel baby’s chest, which should feel warm (don’t worry if baby’s hands and feet feel cool, this is normal). Another way to prevent overheating is to remove hats or bonnets from baby as soon as you come indoors or enter a warm car, bus or train, even if it means waking the baby.

Never use electric blankets, wheat bags or hot water bottles for babies.

Is formula feeding linked with sudden unexpected death in infancy?

There is no consistent evidence that formula feeding increases the risk of SIDS or that breastfeeding reduces the risk of SIDS. However, SIDS and Kids recommends breastfeeding as there is strong evidence to show that breastfed babies have fewer infections and that breastfeeding lowers infant mortality.

Is immunisation linked with sudden unexpected death in infancy?

No. The peak age of SIDS is the same age that babies are most often immunised (two to four months of age), so by chance they can occur at the same time.

However, there is strong evidence to show that immunisation is not associated with SIDS and that immunised babies are actually at a lower risk, so immunise your baby on time.

Can babies be put on the tummy to play?

Yes. Tummy play is safe and very important for babies from birth, but only when they are awake and an adult is present. Tummy play helps muscle development in the arms, neck and back and prepares babies for crawling. Tummy play is also very good to help prevent a misshapen head but remember not to put baby on the tummy to sleep.

Are there specific baby care products that reduce the risk of sudden unexpected death in infancy?

There is no scientific research evidence that has convinced SIDS and Kids that any specific baby care product reduces the risk of SIDS.

Last Reviewed: 01/01/2010

Reproduced with kind permission from SIDSaustralia.