October is Safe Sleep and SIDS Awareness Month

While ensuring safe sleep for babies is a year-round responsibility, Furman notes that Safe Sleep and SIDS Awareness Month helps parents refocus on the essential steps to protect little ones during their most vulnerable moments.

She explains, "Educating ourselves about safe sleep is fundamental to protecting our babies from sudden infant death syndrome (SIDS). Parents should heed the guidelines provided because simple measures can greatly impact their baby's safety and provide reassurance for themselves. By being aware of these practices, including placing babies on their backs to sleep, using firm mattresses and opting for breathable mattresses, parents can create a safer sleeping space that helps lower the chances of SIDS."

Creating a safe sleep environment: A step-by-step guide

Choose the right sleep surface

Board-certified pediatrician Dr. Joel' Gator' Warsh, MD, recommends a firm, flat mattress in a crib or bassinet as the safest sleep surface for babies.  He explains, "The most suitable sleep surface for infants is a firm, flat mattress within a crib or bassinet that fits snugly into its frame. Parents should steer clear of soft mattresses or couches due to potential suffocation hazards. It is also essential to use a fitted sheet on the mattress and always select products that adhere to current safety standards to secure your baby's sleep environment."

Clear the crib

After choosing the appropriate sleep surface for your baby, Furman recommends clearing away any items that could lead to suffocation. "Instead of loose blankets, use a baby sleep sack or wearable blanket to keep your baby snug without the risk of suffocation," she explains. "Parents should always avoid placing pillows (including for head positioning), stuffed animals or bumper pads in the crib since these can be a suffocation hazard. There should also not be any cords or monitors too close to the crib as babies can grab these."

Prevent overheating

According to Dr. Warsh, ensuring your baby's comfort during sleep is equally important for minimizing the risk of SIDS. He notes, "Overheating has been linked to SIDS incidents; therefore, keeping the room comfortable for a lightly dressed adult—about 68-72°F—is recommended." To help regulate your baby's body temperature effectively, he suggests using suitable sleepwear such as sleep sacks or one-piece pajamas. You'll also want to steer clear of heavy blankets and avoid overdressing your baby, as these practices can contribute to overheating.

Opt for room-sharing over bed-sharing

Many first-time parents wonder whether their baby should sleep in the same room or bed as them. Dr. Warsh recommends that sharing a room is the safer alternative, as sleeping together in one bed can pose risks of accidental suffocation if precautions are not taken.

"The American Academy of Pediatrics advocates for room sharing as it diminishes the risk of Sudden Infant Death Syndrome (SIDS) by allowing parents to monitor their infant while ensuring a secure sleeping environment," he says. "Although bed-sharing can enhance bonding, it poses increased risks such as suffocation and overheating, rendering it a less secure choice."

Evidence-based safe sleep recommendations

As per Dr. Warsh, it's crucial to choose the correct sleeping position for your infant to minimize the risk of Sudden Infant Death Syndrome (SIDS). He explains, "Positioning your baby on their back during sleep is one of the most effective methods to reduce SIDS risk." Babies who sleep on their stomachs or sides are at an increased risk for suffocation and SIDS-related incidents.

In addition to sleep position, Dr. Warsh suggests that breastfeeding can also be beneficial. He notes that breastfed infants—particularly those exclusively fed with breast milk—tend to wake more frequently and have lighter sleep cycles, which help lower SIDS risks. Breastfeeding supports immune system development, offering further protection against negative health outcomes.

Another simple tool that should be in your SIDS prevention toolkit is a pacifier. Dr. Kristen Bechtel, MD, a pediatric emergency medicine specialist at Yale Medicine, explains, "Babies don't sleep as deeply when they have a pacifier, which helps wake them up if they're having trouble breathing. A pacifier also keeps the tongue forward in the mouth so it can't block the airway."

However, it's important to use pacifiers appropriately. Dr. Bechtel adds, "The American Academy of Pediatrics (AAP) recommends parents give pacifiers at naps and bedtime. If breastfeeding, wait until your baby is one month old to introduce a pacifier to ensure successful breastfeeding, and always clean the pacifiers regularly to protect your baby from infection."

Addressing cultural diversity and socioeconomic factors

Different cultures have unique perspectives on bed-sharing, crib safety and breastfeeding practices. Therefore, Dr. Bechtel says engaging in conversations about safe sleep practices with all caregivers is essential to ensure a unified understanding.

"It is really important to have a dialogue with parents and caregivers, so we can understand their decisions as to where their baby sleeps, and not admonish or lecture them," she emphasizes. "We want to encourage parents and caregivers to adopt the safest practice possible, following the ABCs of safe sleep: alone, on the back and in an uncluttered crib.

Socioeconomic factors also influence safe infant sleep practices, as many lower-income families may lack access to resources for safe sleep environments. Dr. Bechtel notes, "Parents and caregivers experiencing homelessness often lack a consistent, safe place for an infant to sleep. These individuals should be provided with a portable crib (pack and play) to ensure a safe sleep space for the infant."

When a portable crib isn't available, Dr. Bechtel suggests that bed-sharing can be made safer with certain precautions. She recommends that parents avoid sleep-inducing medications or substances and limit bed-sharing to one adult. All blankets, pillows, and thick bedding should be removed from the sleeping area. For added safety, Dr. Bechtel advises placing the mattress in the center of the room, away from walls and headboards. She also recommends that "Smoking is strictly prohibited, and parents should never fall asleep while holding or feeding their infant in a chair or on a couch."

Debunking SIDS myths and outdated practices

Surprisingly, there are many myths related to SIDS. According to Dr. Bechtel, one of the most common is that many parents believe their child has a low chance of experiencing SIDS.

"The most significant misunderstanding is that it can't happen to my baby," she explains. Although SIDS is indeed rare, approximately 3,600 infants in the United States die during sleep each year. Parents and caregivers can make a meaningful difference during this critical period by taking steps to minimize their infants' risk during the first year of life."

It's also important to note that certain traditional sleep practices, particularly bed-sharing, are now considered outdated. Kristin Revere, MM, CED, NCS, owner of Gold Coast Doulas, advises against sharing a bed with your baby. Instead, she suggests that parents keep their infant in the same room for the first six months, using either a bassinet or a co-sleeper that attaches to the bed.

Revere also says that crib bumpers are no longer deemed safe and recommends avoiding toys with the baby in the crib. "There are risks of strangulation and suffocation," she explains. "Additionally, having a mobile hanging over the crib is seen as hazardous because it could fall or be pulled by the baby if it hangs too low."

To promote safe and consistent infant sleep practices, all caregivers, including grandparents and other family members, must be informed about the latest baby safety guidelines. According to Revere, "The landscape has changed dramatically regarding car seat safety, safe sleep practices, and feeding guidelines; this can make conversations with grandparents who are stepping into caregiving roles quite tough. At Gold Coast Doulas, we host a Modern Grandparents class that can be attended online or in person. This course covers how to check for recalled items, updates on newborn care practices related to sleep and feeding, as well as tips for baby-proofing their living spaces."

The role of healthcare providers and community resources

Engaging in conversations with your healthcare providers is a crucial element of your SIDS prevention strategy. Open communication helps prevent confusion and ensures that all parties are well-informed and coordinated.

As Revere explains, "It is important for everyone on your healthcare team to be on the same page with the latest research on safe sleep to avoid confusion and misinformation. Sometimes a lactation consultant and nurse may give different tips, and the parents don't know which info to trust."

Don't forget to look into local resources for continuous education and assistance. Revere suggests that hiring a certified sleep consultant is an excellent first step, but you can also join local and online support groups along with baby prep classes. Other helpful resources she recommends include the Facebook group SafeInfantSleep and websites such as HealthyChildren.org by the American Academy of Pediatrics, Baby Safety Month at jpma.org, and SAFE SLEEP BASICS on Safeinfantsleep.

Recognizing and responding to infant distress during sleep

Babies make all kinds of sounds: grunts, groans, and different cries, according to Debbie Gerken, RNC-NICU, a certified pediatric coach. This makes it essential to understand what's normal and what is actually a sign of distress. Here are some:

Breathing patterns

Gerken says that newborns will often have irregular breathing patterns, especially during sleep, which can be completely normal. "In the first few months, babies can experience short pauses in breathing," she says. "This periodic breathing is identified as occasional pauses in breathing that are 15 seconds or less."

However, if a baby experiences prolonged pauses lasting longer than that, gasps for air or has difficulty breathing, Gerken warns that this may indicate signs of respiratory distress and may require immediate medical attention. She continues, "If a parent is unsure, it is always best that they trust their instinct and seek medical attention. As medical attention is being activated, parents can try to reposition the baby, stimulate the baby by flicking their feet and begin CPR."

Noisy breathing can also occur with babies, especially when they are in certain positions or if there is nasal congestion present. If snoring, wheezing or laboured breathing occurs, Gerken suggests that this may indicate signs of a breathing obstruction, sleep apnea or other respiratory illnesses. "Parents should monitor for signs of struggling while breathing as indicated by flared nostrils, breathing fast or chest retractions (the chest sinks below the breastbone or between the ribs during each breath)," she explains. "It is equally important for parents to seek medical attention immediately to ensure the airway is not obstructed and is optimum for effective breathing."

Startle reflex and sleep myoclonus

According to Gerken, babies are born with a startle reflex that begins to fade around three to four months and is fully integrated by six months. Because this startle can cause babies to move or twitch suddenly, she says it can be normal for a baby to do this during sleep and when being put down on their backs.

Babies also have benign sleep myoclonus, which is a shaking of the hands when they are going to sleep. "These movements are normal and brief and will stop if baby wakes up or if the hands are held," explains Gerken. However, if a baby experiences sustained or repetitive twitching, jerking, shaking or body stiffness, she says it is important to consult a medical professional to ensure their well-being. If another person is with the parent or caregiver, she recommends having them take a video of the baby's movements as the parent observes and supports the baby so a medical professional can watch it.

Crying

"Babies cry and fuss, especially during sleep, as a common occurrence in response to overstimulation, hunger, discomfort or a full diaper," explains Gerken. Having said that, she recommends that parents quickly learn to distinguish their baby's cries and identify probable causes.

However, if parents assess the situation, try strategies to calm or soothe them, and still feel something is different or alarming about the crying based on their knowledge of their baby, she advises checking for signs of illness and consulting with the pediatrician for guidance.

Skin and temperature changes

Gerken explains that babies experience changes in their skin tone and slight variations in temperature depending on the time of day. While minor alterations in colour or temperature are normal, she emphasizes the importance of monitoring for more concerning changes.

"Due to a newborn's immature circulation, they can have brief periods when their hands turn purple, which is normal and temporary," she clarifies. "However, if this is consistent, parents should seek medical attention. If a baby's skin becomes pale or blue, especially around the lips or feels clammy, this may indicate a problem with circulation or oxygenation."

Similarly, Gerken suggests that if a baby becomes sweaty or their body feels hot to the touch, it may indicate overheating. "Overheating increases the risk of sudden infant death syndrome (SIDS)," she states. "If signs of overheating are noted, parents should adjust the environment and seek medical attention."

Spit-up

"Most babies spit up, even during sleep, as a normal occurrence due to their anatomy," explains Gerken. However, if a baby experiences gagging, coughing or spitting up when they are asleep, she suggests that parents should monitor their sleep, intervene as needed and ensure that they are sleeping on their back as recommended by the American Academy of Pediatrics for safe sleeping.

Safe sleep products: making informed choices

When choosing safe sleep products, Gerken explains that parents should adhere to considerations such as using products that meet safety standards, avoiding products that have been recalled, and keeping the sleep space free from blankets, bumpers, pillows and toys. These items increase the risk of suffocation or Sudden Infant Death Syndrome (SIDS).

"Some products to avoid for sleep are wedges, sleep positioners, inclined sleepers, soft bedding and baby lounger pillows," Gerken says. "The American Academy of Pediatrics does not recommend these as they can obstruct a baby's breathing and put a baby at increased risk for SIDS."

Gerken also suggests that parents should research products that claim to be breathable or reduce the risk of SIDS. "It is important to note that these claims may not be supported or backed by scientific evidence," she adds.

Seasonal considerations for safe sleep

To ensure safe sleep practices all year round, Christine Brown, a leading sleep consultant and parenting coach at Bella Luna Family, emphasizes that parents should consistently review and adhere to the safe sleep guidelines set by the American Academy of Pediatrics.

"For a quick reminder, think of the ABCs of safe sleep: Babies should be placed to sleep ALONE, on their BACK, in a secure CRIB environment," she advises.

Brown says you'll also want to be adaptable to seasonal weather changes. She advises, "As the seasons change, parents need to assess the temperature of their baby's nursery and make adjustments to keep them comfortable and safe. The ideal temperature range for bedrooms is between 68 and 72 degrees. This range will help prevent overheating, a risk factor for SIDS."

Managing parental anxiety and emotional well-being

Adapting to a new baby and safe sleep habits can indeed be stressful for new parents. However, Tamara Gold, MSW, LCSW, ACC, a licensed therapist and certified parent coach, stresses the importance of remembering that this is common and will pass. "I tell parents someone is going through this same thing right now, and millions of parents have been where you are. They will pass, I promise," she says. "Sometimes just focusing on knowing it's temporary helps."

Empowering families for safer sleep

Safe sleep habits are vital year-round, but October shines a spotlight on this crucial issue. During Safe Sleep and SIDS Awareness Month, parents and caregivers are encouraged to learn about and implement safe sleep practices. Though SIDS is rare, taking these precautions can make a real difference and may even save your little one's life.

Best baby monitors

Nanit Pro Smart Baby Monitor

This smart baby monitor stands out from traditional ones by offering a range of impressive features. It provides a 1080p HD video livestream, two-way audio communication, night vision, and alerts for sound and motion. Each purchase includes a wearable band that tracks your baby's breathing and movement in nearly any sleep position, all without using sensors.

CuboAi Plus Smart Baby Monitor

Also consider getting this AI-powered monitor, which provides real-time alerts if it senses that your baby’s mouth and nose are covered or if they are lying face down. It also features HD night vision, true cry detection and danger zone alerts. Plus, it is CTIA Cybersecurity Certified, ensuring your account and data are secure.

Maxi-Cosi Iora Bassinet

Bassinets are an excellent option for keeping your baby nearby at night, and this one offers everything you need. It's easy to move around, can be adjusted to different heights, and features a firm, flat sleeping surface that aligns with the Consumer Product Safety Commission's safe sleep guidelines. Additionally, the breathable mesh sides ensure your baby stays cool, and a large storage basket is underneath to keep baby essentials within reach.

Parents also love it for its high-quality design. Lindsay, a verified Amazon customer, writes, "Beautiful piece, feels like furniture, great quality, comes with a travel bag. Baby had no issue sleeping through the night on this when used for the first time at 12 weeks."

HALO BassiNest Soothing Swivel Sleeper 3.0

Take a look at this impressive bassinet from HALO if you want something that’s nearly flawless for your baby’s sleep. Its special design lets it swivel over your bed, providing the safest and closest sleeping arrangement for your child. The bassinet offers two vibration options and four calming sound choices to help ease your baby into slumber. Plus, it features a flat mattress, breathable mesh sides for better ventilation, and a robust frame designed for long-lasting use.

Parents can trust the HALO brand because it has received many accolades for its innovative, safety-focused products. It’s widely utilized in hospitals and recommended by the American Academy of Pediatrics as a safe choice compared to loose blankets in cribs.

babyletto Hudson 3-in-1 Convertible Crib

Looking for a crib that grows with your little one? This three-in-one convertible crib is a smart choice for your nursery. It's practical and safe, with a Greenguard Gold Certification that guarantees it's free from nasty chemicals.

Made from tough, eco-friendly New Zealand pine, this crib is built to stand the test of time. The low sides make it easy to reach your baby, and you can adjust the mattress to four different heights as your child grows. And with nine gorgeous colours, you'll easily find the perfect match for your nursery's style.

Guava Lotus Travel Crib

This portable crib weighing just 15 pounds is perfect for families on the move. Both foldable and lightweight, it allows you to easily set it up anywhere. Its high-quality aluminum frame and non-slip rubberized feet ensure stability and security, while the included insulated mattress with thick, soft foam provides a safe sleeping surface for children aged 0-3. To top it all off, this crib also comes with an airport-friendly compact backpack carrying case.

Saatva Dual-Sided Crib Mattress

According to information published by MedlinePlus, a service of the National Library of Medicine (NLM), part of the National Institutes of Health (NIH), a firm, tight-fitting mattress is recommended to help prevent your baby from getting trapped between it and the crib.

This is where this Saatva crib mattress can help. Although it comes with a higher price tag, the mattress is crafted from top-notch materials and has an extra firm sleeping surface that helps prevent SIDS and other sleep-related accidents. This mattress also boasts numerous safety certifications, including GOTS® certified organic wool, Cradle to Cradle GOLD Certification® and GREENGUARD® Gold certification. Additionally, it features reinforced double-edge support to ensure your baby or toddler stays securely in the center of the crib, and it has a removable, washable cover for easy cleaning.

HALO DreamWave Baby Crib Mattress

HALO is back on our list with an impressive hypoallergenic baby crib mattress. This product strikes the right balance of firmness and features a dual-sided design, all while being GREENGUARD-certified to help you feel secure about harmful toxins or VOCs. Thanks to its core, it also promotes a cool and comfortable sleeping environment for your baby, which allows heat and moisture to escape easily. Additionally, it’s machine-washable—a huge advantage when dealing with inevitable accidents and messes sure to arise.

With a 4.7-star rating, parents find that this mattress offers great peace of mind. Stinger 22, a verified Amazon customer, writes, "We have been LOVING it, and it gives me so much peace of mind, especially since my daughter has started to roll in her sleep. So if you want something similar to the Newton baby mattress but don’t want to spend that kind of money, this mattress is your answer!"

aden + anais Essentials Swaddle Blanket

Swaddling is a technique where you wrap your baby snugly in a blanket to help them feel calm and sleep better. It’s important, however, to swaddle safely. According to the Public Health Agency of Canada , ensure the swaddle is loose enough for your baby to breathe comfortably and move their hips and legs freely. Additionally, it’s advisable to stop swaddling around the two-month mark, as babies typically begin to roll over.

To ensure a safe swaddling experience for your little one, you might want to consider getting a set of swaddle blankets. This particular set includes four blankets made from organic cotton muslin, which are lightweight and breathable. Each blanket measures 47 inches by 47 inches and can be easily washed in a machine for convenience. You can choose from eight colours and patterns, including ocean themes and animal designs.

Miracle Blanket Swaddle Wrap

These cozy, lined swaddles are a fantastic option for parents who want to encourage their little ones to sleep safely on their backs. Made from soft, stretchy cotton, they come in a one-size-fits-most, super-convenient design. Plus, there are no pesky zippers, buttons, or snaps to disturb your baby's peaceful slumber.

This swaddle is available in 31 colours, with unisex options for parents looking for gender-neutral items. It is also machine washable for easy cleaning, and it is thick but not too heavy for warmer months.

HALO SleepSack SuperSoft Wearable Blanket

According to a 2022 article by The Cleveland Clinic, sleep sacks are a safe and cozy choice for keeping babies warm at night. These wearable blankets provide warmth, promote proper hip positioning, and help prevent face-down sleeping, which can reduce SIDS risk.

The HALO crib blanket is worth considering for parents seeking a trustworthy sleep sack. Available in four sizes and colours, it's made from a soft, breathable mix of viscose and bamboo. The convenient two-way zipper makes diaper changes a breeze, and its versatile insulation works well in any season.

HALO Easy Transition Sleepsack Wearable Blanket

Prioritize safe baby sleep with the HALO wearable blanket, a cozy alternative to potentially dangerous loose crib blankets. This sleeper's unique 3-layer design combines a soft cotton exterior, polyester filling, and safe weighted sleeves for extra comfort. Its two-way zipper makes diaper changes easy while supporting healthy hip development.

Parents also love that this 4.4-star rated blanket allows babies to move freely and self-soothe, enhancing safety and sleep quality. Rachel Tesmer, a verified Amazon customer, shares, "My 3/4 month old was STRUGGLING coming out of swaddle, those arms were going wild at night. I didn't want other brand sleep suits because I heard they are tough to transition out of as well, so I went with the Halo option. I really like the quilted material and the arms are enough to just calm his movements down enough that he doesn't startle himself. "

Experts

• Elina Furman is a certified infant massage instructor and holistic practitioner
• Dr. Joel 'Gator' Warsh, MD, is a board-certified pediatrician
• Dr. Kirsten Bechtel, MD, is a pediatric emergency medicine specialist at Yale Medicine
• Christine Brown is a lead sleep consultant and parenting coach at Bella Luna Family
• Kristin Revere, MM, CED, NCS, is the owner of Gold Coast Doulas
• Debbie Gerken, RNC-NICU, is a certified pediatric coach
• Tamara Gold MSW, LCSW, ACC, is a licensed therapist and certified parent coach