Guidelines for Safe Sleeping (and Co-Sleeping)

By Cate Coulacos Prato


The American Academy of Pediatrics (AAP) has revised its guidelines and recommendations for the prevention of sudden infant death syndrome (SIDS).

The AAP's new policy does not recommend that infants sleep in the same bed as a parent. Read more

The U.S. Consumer Product Safety Commission and the American Academy of Pediatrics have these recommendations on sleep safety for infants:


Always place a healthy baby to sleep on his or her back to reduce the risk of sudden infant death syndrome (SIDS). 

Wherever your baby sleeps should be as safe as possible. 

Reduce Risk of Suffocation


Babies placed on adult beds risk suffocation from several hidden hazards, including:

• Entrapment between the bed and wall or involving the bed frame, headboard or footboard;


• Falls from adult beds onto piles of clothing, plastic bags or other soft materials resulting in suffocation; and


• Suffocation in soft bedding (such as pillows, thick quilts and comforters).

• To reduce the risk of suffocation, remove all soft bedding – pillows, thick quilts, comforters, sheepskins and other pillow-like soft products – before placing your baby to sleep.


• When using a crib, make sure it meets current safety standards and has a firm, tight-fitting mattress and tight-fitting bottom sheet.


• When using a portable crib or play yard, be sure to use only the mattress or pad provided by the manufacturer.

Safe Co-Sleeping

Pediatrician and “attachment parenting” advocate Dr. William Sears offers similar guidelines, as well as the following co-sleeping advice in his books and on his Web site,


• Take precautions to prevent your baby from rolling out of bed. Place baby between mother and a guardrail or push the mattress flush against the wall and position baby between mother and the wall.


• Place the baby adjacent to the mother, rather than between mother and father.


• Use a large bed, preferably a queen-size or king-size bed,

Unsafe Co-Sleeping


Sears recommends avoiding co-sleeping with a baby in a family bed if the parent is:


• Under the influence of any drug (such as alcohol or tranquilizing medications) that could diminish sensitivity to the baby’s presence;


• Extremely obese


• Exhausted from sleep deprivation


• Breastfeeding a baby on a cushiony surface, such as a waterbed or couch. An exhausted mother could fall asleep breastfeeding and roll over on the baby.

Sears discourages co-sleeping if the adult is the child’s babysitter and not the parent. A babysitter’s awareness and ability to be aroused from sleep is unlikely to be as acute as a mother’s.


Sears also recommends against:


• Allowing older siblings to sleep with a baby under 9 months of age;


• Falling asleep with a baby on a couch;


• Overheating or overbundling a baby. Be particularly aware of overbundling if the baby is sleeping with a parent. Other warm bodies are an added heat source.


• Wearing lingerie with string ties longer than eight inches. Ditto for dangling jewelry. The baby may get caught in these entrapments.


Return to:
The Family Bed: The Risks and Rewards of Co-Sleeping with Your Child