Where Should My Newborn Sleep? A Simple Guide to Safe Sleep

As an infant sleep consultant and perinatal therapist, safe sleep is something I am REALLY passionate about. 

The sad truth is that most sleep-related infant deaths are preventable!! Did you know that? 

Most people know about “SIDS” (Sudden Infant Death Syndrome) and many new mommas have a lot of anxiety about it. SIDS is actually just one type of sudden unexpected sleep-related infant death (SUID) and this term is used to describe deaths where no cause can be identified even after a full investigation and autopsy.

Thankfully, cases of true SIDS are extremely rare. Deaths due to or involving an unsafe sleep environment are much more common. Most of these deaths are attributed to ASSB (accidental suffocation or strangulation in bed) from having blankets or plush toys in the sleep space or from adult overlay or entrapment with bed-sharing.

While most SUID cases have a variety of factors at play in addition to an unsafe sleep environment, the fact remains that sleep-related infant deaths occurring in a truly safe sleep environment are estimated to account for only 1% of cases.

Why I’m so passionate about safe sleep

Having worked with so many loss moms – moms who have experienced miscarriage, stillbirth, or losing a premature baby after weeks spent in the NICU – I don’t wish that kind of grief on anyone and so I am committed to helping new parents do everything they can to provide a safe sleep environment for their babies.

I am so dedicated to safe sleep that as a sleep consultant, I require each family I work with to practice safe sleep and I actually won’t work with families who want to continue to bed-share. Generally, as both a therapist and a sleep consultant, I believe wholeheartedly in supporting client autonomy and respecting my clients’ personal values and parenting choices. However, I don’t see safety as a “parenting choice.” I don’t think that pointing out unsafe sleep is “mom shaming.”

I’m strict about safe sleep because I don’t want your baby to die – it’s that simple. Yes, thankfully most babies do survive sleeping in unsafe sleep environments, but why take the risk that your baby will be one of the babies that doesn’t???

Why I want new parents to understand safe sleep practices

It’s quite terrifying to know how many baby products are on the market that aren’t regulated, don’t comply with existing safety standards or recommendations, or don’t even have to prove they meet safety standards! Advertising and social media continue to depict unsafe sleep environments and retail and online stores continue to market products as being for sleep that are actually not safe for sleep at all!

It honestly makes me anxious knowing how many parents are buying unsafe products – or using a product in an unsafe way – because they don’t know any better but are honestly just trying to do their best for their little one. So I want to help parents know and understand safe sleep guidelines so they don’t fall victim to predatory marketing or ignorant social media posts.

So, what are the safe sleep guidelines for infants? If you want to read the entire publication of recommendations on how to practice safe sleep for your baby (including information on feeding human milk, immunizations, avoiding drug and alcohol use among caregivers, etc.) you can find that here. This blog post will focus primarily on the guidelines related to where your newborn should sleep and making that space as safe as possible.

Where should my newborn sleep?

The safest place for newborns to sleep is in either a: 

• Crib (or mini-crib)

• Bassinet

• Playard (more commonly known as a “pack n’ play”) 

that meets federal or international safety standards (which can be found at ecfr.gov or astm.org). NOTHING should be in the sleep space except for a fitted sheet and a pacifier (no bumpers, blankets, pillows, burp cloths, “positioners” such as wedges or anti-rollover blankets, or stuffed animals). 

Beyond generally wanting to know where should newborns sleep, most expectant parents also wonder where should newborns sleep in the first few months, what is the best place for a newborn to sleep at night, and what is the best place for a newborn to sleep during the day. 

Newborns don’t need a special or different sleep space from older babies. Babies can sleep in a regular crib or pack n play from birth – though it will be more convenient if you have it set at the highest level according to the manufacturer’s directions. The AAP does recommend “room-sharing” for the first 6 months in order to reduce the risk of SIDS. Room-sharing means that the parent(s) (or other caregiver) and the baby are sleeping in the same room but on separate surfaces. 

Newborns can sleep in the same place during the day as they sleep during the night. You can certainly have them sleep on the main floor/in your living area during the day if that is more convenient or comfortable for you, but I recommend using a monitor and having them in the same space they are in overnight.

You may have heard it recommended to keep baby sleeping in a bright or loud environment during the day to help them separate day and night or to make sure they’ll sleep in the car or when you’re running errands – I disagree with this. We want to create consistent, positive sleep associations and create a sleep environment conducive to restful sleep – intentionally disrupting baby’s sleep environment at home to try to train them to sleep well when you aren’t at home doesn’t make sense to me.

Focus first on getting baby to sleep really well at home as often as possible, and then you do your best on the occasions when they can’t have their ideal environment. Well-rested babies with good sleep habits usually adapt much better on these occasions anyways, and are able to bounce back more quickly when they do have a shorter or more disrupted nap here and there. 

What is the best sleeping arrangement for newborn babies?

As long as the baby is in their own separate, safe sleep space, then the “best” sleeping arrangement is going to depend on each family’s space and preferences and whatever works best to maximize sleep and support everyone’s mental and emotional well-being. 

Common sleeping arrangements:

• If there is enough room, some families put the whole crib in the parents’ bedroom at first rather than buy a separate bassinet

• If space is a concern, then a bassinet, mini-crib, or pack n’ play in the parents’ bedroom

• If parents’ sleep or mental health is negatively impacted by room-sharing, then the baby can safely* sleep in the nursery from birth.   

*Room-sharing is considered a “protective factor” – this means that doing it does reduce the risk of SIDS; however, not doing it does not increase the risk (whereas bedsharing or tummy sleeping for example do increase risk). If you are practicing all other safe sleep guidelines, the risk of SIDS is still extremely low. So while room-sharing the first 6 months is considered ideal, moving baby to their own room anytime before that is not an unsafe choice. 

One arrangement that many families I work with hadn’t heard of but I think can work very well is this: the baby sleeps in their crib in the nursery, and parents take turns sleeping in the nursery with the baby. Depending how much space they have, families will put a full or at least a twin bed in the room along with all the other typical baby furniture. If space or budget makes that difficult, an air mattress or even those foldable memory foam mattresses that go on the floor are actually quite comfortable! Here is why some families end up loving this sleeping arrangement:

• Because the baby starts sleeping in the crib from night one, there is no need to worry about making that transition later and you can start developing positive sleep associations with the crib and the nursery from the beginning

• Parents take turns sleeping in the nursery (some parents do this in shifts, each taking part of the night in the nursery and part of the night in the master bedroom…while others prefer to alternate nights). This allows whichever parent that is not sleeping in the nursery to get better quality rest because their sleep isn’t being disrupted by the baby (newborns are LOUD sleepers). 

• Parents don’t have to worry about keeping it dark and whispering in their own room in the evenings – babies have very early bedtimes and so parents can proceed with their evening/bedtime routine as usual rather than having to stay out of their own room or being afraid they will wake the baby if they are going in and out.

3 extra tips for safe sleeping for newborns

There are a handful of common ways I see new parents unknowingly practicing unsafe sleep with their newborns – even for those committed to safe sleep, these are a few more nuanced guidelines that can be easy to overlook!

1. Don’t let baby sleep in a swing, bouncer, or lounger 

Bouncy seats, swings, and loungers (sometimes called “nests”) are NOT safe for sleep. Regardless of how they are marketed, they are to be used for soothing or during supervised awake time only.

Some parents may know not to do this for overnight sleep but think it’s okay for naps as long as they are supervising. Unfortunately, supervision doesn’t make unsafe sleep safe – SIDS deaths and accidental suffocation (asphyxia) can happen completely suddenly and silently This happens primarily due to positional asphyxiation, meaning the baby’s neck is angled in such a way that it blocks their airway. There are no warning signs that this is occurring, which is why it is so important that if your baby falls asleep in one of these, you move them immediately to a safe sleep space.

2)   Don’t let baby sleep in the car seat outside of the car 

Car seats, strollers, and infant slings and carriers are considered “sitting devices” (meaning they are not a flat, firm surface) and therefore are not recommended for sleep – hundreds of sleep-related deaths occur each year due to improperly using sitting devices for sleep.

Sometimes, it’s impossible to avoid the baby falling asleep while driving. But in a moving vehicle, a car seat is required for safety in the event of an accident. So while you are driving, you should use the car seat even though they risk falling asleep. BUT as soon as you arrive at your destination, you should either wake your baby or remove them from the seat and transfer them to a safe sleep space. For long car or plane rides, it is recommended to take baby out of the seat at least every 2 hours. 

Despite being marketed for their convenience because you don’t have to take the baby out when transitioning from car to stroller, “travel systems” where a car seat attaches to a stroller are not safe to sleep in. When going on walks or errands, your safest choice is a stroller with a bassinet attachment that passes the safety standards for a bassinet (like the one pictured below).

Note: Infant slings and carriers are also NOT recommended for routine sleep. However, when you are away from home and are unable to put baby down in a safe sleep space, baby-wearing when done correctly is a safer alternative than the car seat or non-bassinet stroller. Use the TICKS acronym to remember how to baby-wear safely.

3)   Don’t put any items in the sleep space besides a pacifier 

Most parents know not to use loose blankets or let babies sleep with a regular pillow or stuffed animals. However, I see many parents putting other items in the sleep space that they think are okay, since they don’t sound like they fall under the category of “soft bedding.”

The most common ones I see are:

• laying a burp cloth under the baby’s head while baby is asleep or leaving one draped on the side of the crib or bassinet

• letting baby sleep with a pacifier that has a soothie (small stuffed animal) attached to it

• using wedges to incline the baby while sleeping to help with reflux (which has been proven ineffective)

• using “plagio pillows” while sleeping to try to prevent baby from getting a flat head

 

How to start safe sleep practices with your baby

If you are realizing you haven’t been fully practicing safe sleep with your baby, it’s not too late to start! Commit right now to 100% following safe sleep.

I’ll be honest that it may be a difficult adjustment the first few days or nights if your baby is used to sleeping in a swing or Dockatot or sleeping in bed with you. Babies don’t like change, and they will cry to let you know that, but you are doing what’s best for them! Remember, a crying baby is a breathing baby.

If you’re struggling to follow safe sleep with your baby, or if you feel like continuing unsafe sleep practices is the only way you or your baby is ever going to get any sleep, I would love to support you in helping your entire family get more sleep, safely.

I’m not going to judge you – I know you’re doing your best! Those early weeks and months can feel like a day-by-day struggle to just get through, sometimes to the point where you’re so desperate for a stretch of sleep longer than an hour that you’ll do anything, even trying unsafe things because you feel you have no other options. But I promise there are other options (that don’t require “crying it out”).

Book a consult with me and we’ll come up with a plan so you don’t have to make unsafe choices out of desperation ever again! 

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Are you exhausted and overwhelmed thinking about how to improve your baby’s sleep or how to get your baby to actually sleep while practicing safe sleep?

Click here to learn more about Sleeping Baby, Sane Momma – my newborn coaching program for motivated mommas who want to set themselves and their baby up for success from the very start. You can feel confident in caring for your newborn and be successful in teaching your baby to sleep independently and to be able to sleep 11-12 hours uninterrupted by approximately 12 weeks of age – allowing you to get the rest you need to preserve your sanity and actually enjoy the newborn phase!

Or click here to learn more about my infant program (3-12 months), which is for motivated mommas who are ready to let go of their fears and guilt over sleep training and learn the tools they need to be successful in teaching their baby to sleep safely and independently.

Or click below to schedule a free 15-minute discovery call if you’d like to talk more about how my infant or newborn sleep consulting services can help you start getting the rest you need to be the best momma you can be for your little one!