Safe Sleep Guidelines

Every Family Is Different

Where your baby sleeps is a personal decision. What matters most is that wherever they sleep, they’re safe.

This page covers safe sleep guidelines for: – Crib sleep – Room-sharing – Bedsharing – Floor beds

General Safe Sleep Guidelines

These apply no matter where your baby sleeps:

• Back to sleep. Always place baby on their back to sleep.
• Firm, flat surface. No soft mattresses, pillows, or cushions under baby.
• Clear sleep space. No loose blankets, pillows, stuffed animals, or bumpers in baby’s sleep area.
• Smoke-free environment. No one in the home should smoke.
• Comfortable temperature. Room should be 18-22°C (64-72°F). Baby should not be overdressed.
• Breastfeed if possible. Breastfeeding is associated with reduced SIDS risk.

Room-Sharing

Both Canada and the United States recommend room-sharing (baby sleeping in the same room as parents, on a separate surface) for at least the first 6-12 months.

Benefits: – You can respond quickly to your baby’s needs – You can monitor your baby easily – Feeding at night is easier – Reduces SIDS risk

Room-sharing doesn’t mean you have to keep baby in your room forever. But for the first several months, it’s the safest option.

Crib Sleep Guidelines

If your baby sleeps in a crib or bassinet:

• Use a firm, flat mattress that fits snugly in the crib
• Use only a fitted sheet — nothing else in the crib
• No bumpers, pillows, or blankets
• No toys or stuffed animals (until baby is older)
• Keep crib away from windows and cords
• Use a sleep sack instead of blankets to keep baby warm
• Place baby on their back

A note about cribs: Babies are designed for closeness. If your baby protests the crib, they’re not being difficult — they’re protesting separation. This is normal and healthy, even if it’s exhausting.

Bedsharing

Many families bedshare, whether they planned to or not. Research shows 60-75% of breastfeeding mothers bedshare at some point.

Bedsharing can be done safely when guidelines are followed — but it’s not safe for everyone.

Do NOT bedshare if:

• Anyone in the home smokes (even if not in the bedroom)
• You or your partner have consumed alcohol
• You or your partner have taken any drugs (including prescription medications that cause drowsiness)
• You are formula feeding (breastfeeding mothers have natural protective instincts and positioning)
• Your baby was premature or low birth weight
• You are extremely exhausted to the point of impairment

How to bedshare safely:

• Firm mattress on the floor (or very close to the ground)
• Move the bed away from walls — no gaps where baby could get trapped
• Baby sleeps next to breastfeeding mother only — not between two adults
• Mother sleeps in protective position: on her side, knees pulled up to baby’s feet, bottom arm above baby’s head
• No thick blankets or comforters — use light layers
• Baby on their back (they may roll to side to nurse, that’s okay)
• No pillows near baby’s face
• Baby directly on mattress — not on a pillow, nursing pillow, or baby nest
• Do not overdress baby — your body heat keeps them warm
• No cords or hazards near the bed
• No pets in the bed

The Safe Sleep Seven

La Leche League International developed the “Safe Sleep Seven” — a simple checklist for safer bedsharing:

A bedsharing mother who is: 1. Non-smoking 2. Sober (no alcohol, drugs, or sedating medications) 3. Breastfeeding

And her baby who is: 4. Healthy and full-term 5. On their back 6. Lightly dressed

And they: 7. Share a safe surface (firm mattress, no soft bedding, no gaps)

What About Japan?

In his book Safe Infant Sleep, researcher James McKenna, PhD, points out that Japan has: – One of the lowest infant mortality rates in the world – One of the lowest SIDS rates in the world – Very high rates of bedsharing

What makes the difference? In Japan: – Maternal smoking rates are very low – Breastfeeding rates are very high – Bedsharing is done on firm surfaces (futons on the floor)

This tells us it’s not bedsharing itself that’s dangerous — it’s HOW it’s practiced.

Floor Beds

A floor bed is a mattress placed directly on the floor. This can be a good option for families who: – Want the benefits of closeness without the risks of a high bed – Have babies who struggle with cribs – Are transitioning from bedsharing

Benefits: – You can lie beside your baby to help them sleep – If baby rolls off, the fall is minimal – Supports independence as baby grows

Safety considerations: – Baby-proof the entire room — treat the whole room as the sleep space – Firm mattress directly on floor – No gaps between mattress and walls – Block any stairs with baby gates – Remove hazards — cords, heavy furniture that could tip, small objects

Swaddling

Swaddling is a personal choice. Here’s what to know:

Reasons some families swaddle: – Can help startle reflex – May help some babies feel secure

Reasons to be cautious: – Risk of hip dysplasia if done too tight on hips – Risk of overheating – Must stop as soon as baby shows signs of rolling – Some research suggests it may affect arousal (which is protective) – Breastfeeding babies use their hands to locate the nipple and self-calm

If you swaddle: – Stop as soon as baby shows any signs of rolling – Keep hips loose – Don’t overdress baby underneath – Watch for overheating

The Most Important Thing

Whatever you decide about where your baby sleeps — respond to them.

Your responsiveness keeps them safe. Your presence regulates their breathing, their heart rate, their temperature. You are designed to be close to your baby.

For more information: – Book: Safe Infant Sleep by James McKenna, PhD – Book: Sweet Sleep by La Leche League International

For personalized support: https://islagrace.ca/sleep-coaching/

Use code SLEEP10% for 10% off any course.