From the Guidelines
Infants should sleep on their backs on a firm, flat surface with no loose bedding or soft objects in the crib to reduce the risk of Sudden Infant Death Syndrome (SIDS). According to the American Academy of Pediatrics (AAP) recommendations 1, a firm sleep surface is essential for infant safety. The AAP also recommends room-sharing with the infant on a separate sleep surface, as this can reduce the risk of SIDS by allowing for close monitoring of the infant while minimizing the risks associated with bed-sharing 1.
Some key recommendations for infant sleep include:
- Back to sleep for every sleep
- Use a firm sleep surface
- Breastfeeding is recommended
- Room-sharing with the infant on a separate sleep surface is recommended
- Keep soft objects and loose bedding away from the infant’s sleep area
- Consider offering a pacifier at naptime and bedtime
- Avoid smoke exposure during pregnancy and after birth
- Avoid alcohol and illicit drug use during pregnancy and after birth
- Avoid overheating
- Pregnant women should seek and obtain regular prenatal care
- Infants should be immunized in accordance with AAP and CDC recommendations
It is also important to note that bed-sharing is not recommended, especially in certain high-risk situations, such as when one or both parents are smokers, or when the infant is younger than 4 months of age 1. Additionally, soft objects and loose bedding can obstruct an infant’s airway and increase the risk of SIDS, suffocation, and rebreathing 1.
Establishing a consistent bedtime routine, including activities like bathing, reading, or gentle rocking, can help signal sleep time and promote healthy sleep associations 1. For sleep difficulties, trying swaddling young infants, using white noise, maintaining a cool room temperature (68-72°F), and ensuring the room is dark can be helpful 1. Avoiding sleep training methods involving crying before 4-6 months of age, when infants develop more mature sleep patterns, is also recommended 1.
Overall, prioritizing a safe sleep environment and following the AAP recommendations can help reduce the risk of SIDS and promote healthy sleep habits for infants.
From the Research
Recommendations for Infant Sleep
The American Academy of Pediatrics (AAP) provides guidelines for infant sleep to promote health and prevent sleep problems 2. Some key recommendations include:
- Establishing a consistent bedtime routine, such as a massage-based routine, to improve infant sleep and maternal mood 3, 4
- Creating a sleep-promoting environment, including a firm, noninclined sleep surface, and avoiding soft bedding and overheating 5
- Practicing supine positioning, room sharing without bed sharing, and avoiding exposure to nicotine, alcohol, and other substances 5
Sleep Environment
A safe sleep environment is crucial to reduce the risk of sleep-related infant deaths 5. This includes:
- Using a firm, noninclined sleep surface
- Avoiding soft bedding, such as blankets and pillows
- Keeping the sleep environment at a comfortable temperature to prevent overheating
- Avoiding bed sharing, especially with adults who smoke or use substances
Bedtime Routine
Establishing a consistent bedtime routine can improve infant sleep and maternal mood 3, 4. This can include:
- A massage-based routine to promote relaxation and improve sleep quality
- A calming and predictable bedtime routine, such as reading or singing
- Avoiding screens and stimulating activities before bedtime
Sleep Duration and Patterns
Understanding normal sleep physiology and developmental changes in sleep is essential for promoting healthy sleep habits in infants 6. This includes:
- Recognizing the different stages of sleep, including REM and NREM sleep
- Understanding the importance of sleep cycles and sleep continuity
- Promoting optimal sleep duration and patterns, such as establishing a consistent sleep schedule and creating a sleep-conducive environment