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Safe Sleep Tips

X - DO NOT USEProtective Factors against Sudden Unexplained Infant Death (SUID):

  • Room sharing is a protective factor that has been shown to decrease risk of SIDS by 50% [Leach, C., Blair, P.S., Fleming, P.J., Smith, I.J. Platt, M. W., Berry, P. J. (1999) Epidemiology of SIDS and Explained Sudden Infant Deaths Pediatrics, 104 (4)].  It is recommended that infants sleep in the parents' room, close to the parents' bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.  Infants who are brought into the bed for feeding or comforting should be returned to their own crib or bassinet when the parent is ready to return to sleep.
  • Circumstances that substantially increase the risk of SIDS or unintentional injury or death while bed-sharing:
  • Bed-sharing with an infant younger than 4 months
  • Bed-sharing with a current smoker (event if he or she does not smoke in bed)
  • Bed-sharing with someone who is impaired in alertness because of fatigue, sedating medications or alcohol
  • Bed-sharing with anyone who is not the infant's parent, including non-parental caregivers and other children (even twins or higher-order multiples)
  • Bed-sharing on a soft surface, such as a waterbed, old mattress, sofa, couch, or armchair
  • Bed-sharing with a soft mattress, bedding accessories, such as pillows and blankets  (Reference: AAP)
  • Infants should also not sleep with other babies, children, or pets
  •  Consider offering a pacifier at nap time and bedtime. Studies have reported a protective effect of pacifiers on the incidence of SIDS. The protective effect of the pacifier is observed even if the pacifier falls out of the infant's mouth. For breastfed infants, pacifier introduction should be delayed until breastfeeding is firmly established.  The pacifier should be used when placing the infant for sleep. It does not need to be reinserted once the infant falls asleep. If the infant refuses the pacifier, he or she should not be forced to take it. In those cases, parents and caregivers can try to offer the pacifier again when the infant is a little older.  Because of the risk of strangulation, pacifiers should not be hung around the infant's neck or attached to infant clothing when used with sleeping infants. Pacifiers should be cleaned often and replaced regularly.
  • Breastfeeding till 12 months when possible can further reduce the risk of SIDS by 50% [Vennemann, M. M., Bajanowski, T., Brinkmann, B., Jorch, G., Yücesan, K., Sauerland, C., Mitchell, E. A. (2009) Does Breastfeeding Reduce the Risk of Sudden Infant Death Syndrome? Pediatrics, 123 (3)]
  • Regular tummy time when baby is awake
  •  Skin-to-skin contact for newborns
  • Set “smoke-free” rules around you and your baby before and after birth to keep tobacco smoke away from you and your baby’s environment to prevent risks of tobacco use.  Babies whose mothers smoke during pregnancy are at 2-3 times higher risk for SIDS. A baby exposed to second hand smoke after birth is also at increased risk for SIDS and other respiratory illness.  If you are pregnant, may become pregnant or have a baby, quitting smoking and not allowing your baby to be near cigarette smoke are the best gifts you can give yourself and your child. Eliminate cigarette smoke from your baby’s life today.  Free help to quit smoking is available in Oklahoma! Call 1-800-QUIT-NOW (800-784-8669)

For more information, go to for the National Institute of Child Health and Human Development website of interactive resources, brochures, and other educational materials.

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