Safe sleep — reducing the risk of SIDS
Sudden infant death is rare, and it has become much rarer since the advice changed. Most of what reduces the risk is simple, free, and takes about a minute to set up.
In short
- On their back, every sleep — naps included, by everyone who looks after them.
- Feet to the foot of the cot, so they cannot wriggle under the covers.
- In your room for at least the first six months, in their own cot or Moses basket.
- Firm, flat mattress. Nothing else in the cot. No pillows, duvets, bumpers, pods, nests or toys.
- Room at 16–20°C, and never too hot.
- Nobody smokes, anywhere near them, ever.
- Don’t let them sleep in a car seat once you have arrived.
This summarises NHS guidance — it is not medical advice about your baby.
If your baby was premature, has a low birth weight, reflux, or any health condition, speak to your midwife, health visitor or GP — some advice may be adjusted for them. If you are ever worried your baby is unwell, call 111, or 999 in an emergency. Never delay getting help because of something you read online.
The basics, in order of impact
Three things do most of the work.
-
Always on their back
For every sleep, day and night, from birth. Not on the side, not on the front. This single change is the reason SIDS rates fell so dramatically after the “back to sleep” campaigns.
Once your baby can roll both ways by themselves, you do not need to keep turning them back — but always place them on their back to begin with.
-
Feet to foot
Put your baby with their feet at the bottom end of the cot, so they cannot slide down under the blanket and cover their face.
-
In your room for six months
In their own cot or Moses basket, in the room where you sleep, for at least the first six months — naps included where you can. Same room, separate sleep surface.
Alongside those: nobody smokes around the baby or during pregnancy, breastfeed if you can and want to, and keep vaccinations up to date. All three are associated with lower risk.
What goes in the cot — and what doesn’t
A safe cot is an almost empty one. It looks stark. That is correct.
In
- A firm, flat mattress that fits the cot with no gaps, protected by a waterproof cover.
- A well-fitting sheet.
- Either lightweight blankets tucked in no higher than their shoulders, or a baby sleeping bag of the right size and tog.
Out
- Pillows and duvets
- Cot bumpers
- Soft toys
- Loose or heavy blankets
- Sleep pods, nests and cushioned positioners
- Anything that could cover their face or head
A lot of these are sold in beautiful matching sets, and being given one as a gift does not make it safe. The rule is simple: nothing in the cot that could cover their face.
Temperature
Overheating raises the risk. Keep the room between 16 and 20°C — cooler than most people expect, and worth checking with an actual thermometer rather than by how it feels to you.
How to tell if they are too hot
Feel their chest or the back of their neck — not hands or feet, which are normally cool and tell you nothing. If they feel hot or sweaty, take a layer off.
Never put a baby to sleep next to a radiator, a heater, or in direct sunshine. And take hats off indoors — babies lose heat through their heads, and that is how they regulate.
Co-sleeping, honestly
The safest place for a baby to sleep is their own clear, flat sleep space. That is the advice, and it does not change.
But a great many parents end up sharing a bed at some point, usually at 4am while feeding, and often without planning to. Pretending otherwise helps nobody — a parent who falls asleep on a sofa holding their baby because they were determined not to co-sleep in bed is in a far more dangerous situation.
Never share a bed if any of these apply
- You or your partner smoke — anywhere, even outside
- Anyone has drunk alcohol
- Anyone has taken drugs, or any medication that causes drowsiness
- Your baby was premature (before 37 weeks) or a low birth weight
- You are extremely tired — to the point of not trusting yourself
And never sleep with your baby on a sofa or armchair. That carries a much higher risk than a bed, because of how easily a baby becomes wedged. If you are feeding at night and think you might drop off, feed in bed rather than on the sofa — having cleared it first.
If you plan to bed-share, make the bed safe: firm mattress, no pillows or duvet near the baby, no gaps between the bed and the wall, and no other children or pets in the bed. Talk it through with your midwife or health visitor — they would far rather have that conversation than not.
Car seats, prams and slings
Car seats are designed for travelling, not sleeping. A young baby’s head can fall forward in a semi-upright seat and restrict their airway.
- Take your baby out of the car seat once you arrive, rather than letting them sleep on in it.
- Keep car journeys with very young babies reasonably short where you can, and break up long ones.
- In a sling, keep them upright, high on your chest, with their face visible and their chin off their chest.
- A pram laid flat is a reasonable place to nap, with the same rules: on their back, nothing over their face. Do not drape a muslin or blanket over the hood — it traps heat badly.
The questions everyone asks
Can I give a dummy?
Yes. Using a dummy to settle your baby to sleep is associated with lower risk. If you are breastfeeding, it is usually suggested you wait until feeding is established, around four weeks. If it falls out once they are asleep, leave it.
What about swaddling?
If you swaddle, keep them on their back, use thin material, never over the head or face, and leave the hips loose enough to move. Stop as soon as they show any sign of rolling. Watch for overheating — a swaddled baby needs fewer layers.
They keep rolling onto their front
Once they can roll both ways on their own, you do not need to spend the night turning them back. Keep placing them on their back, and keep the cot clear.
Are movement monitors worth it?
They are not recommended as a way of reducing SIDS risk and there is no good evidence they do. If one helps you sleep, that is a fair reason to have one — but it is not a substitute for the basics, and no monitor makes an unsafe sleep space safe.
Make sure everyone knows
The risk is highest when a baby sleeps somewhere unfamiliar, or is put down by someone who does it differently — a grandparent doing what they did in 1985, a friend putting them down for a nap on the sofa.
Tell everyone who looks after them
- Grandparents and family — kindly, and specifically. The advice genuinely has changed.
- Your childminder or nursery. Ask what their sleep policy says. Safer sleep is part of their statutory framework and any good setting will be glad you asked.
- Babysitters, and anyone having them overnight.
“On her back, feet at the end, nothing in the cot, and not too warm” is the whole message.
One last thing
Reading a page like this at 3am, on very little sleep, can make an exhausted parent feel that one wrong move is catastrophic. It is not like that. SIDS is rare, and it has become considerably rarer. You are not being asked to be perfect — you are being asked to get the sleep space right, which takes a minute and then stays right.