Safe
Sleep
Plan
Make
Your Baby’s
Healthy Living Program
1101 W. College Ave., Spokane, WA 99201
509.324.1538 | srhd.org
Informed by the American Academy of Pediatrics Updated 2022 Recommendations for Reducing
Infant Deaths in the Sleep Environment.
Spokane Regional Health District assures nondiscrimination in accordance with Title VI of the Civil
Rights Act of 1964 and the Americans with Disabilities Act. To le a complaint or to request more
information, reasonable accommodations, or language translations, contact 509.324.1501 or
visit srhd.org.
Photos courtesy: cribsforkids.org (pages 6, 7 & 15)
Booklet created: October 2023
All of us want our
babies to be safe.
A safe sleep plan is a an essenal part of lowering your
baby’s risk of sudden unexpected infant death (SUID),
including sudden infant death syndrome (SIDS).
Before their rst birthday, too many babies die suddenly and
unexpectedly during sleep or in their sleeping environment.
These deaths are cases of sudden unexpected infant death,
which is also called SUID. SUID includes deaths caused by SIDS,
accidental suocaon and strangulaon in bed, and causes that
are unknown or not well understood.
Creang and following a safe sleep plan is the most important
thing you can do to reduce your baby’s risk of SUID.
A safe sleep plan describes how a baby will sleep and includes strategies to
reduce the baby’s risk of SUID.
Your baby’s safe sleep plan should include:
The usual plan for how your baby will sleep, including:
• Where your baby will sleep.
• What surface your baby will be on when sleeping.
• What your baby’s sleep environment will be like.
• What your baby will be wearing during sleep.
• What posion your baby will be in when
laid to sleep.
How your baby might sleep and what you
will do in unexpected situations, like:
• When vising friends or family.
• When traveling.
• When you nd your baby asleep in a
way that is dierent than your usual plan.
Your usual plan for feeding or comforting
your baby at night, including:
• Who will feed or comfort your baby at night.
• How they will feed or comfort your baby.
• What they will do when your baby is done being fed or comforted.
Your baby’s safe sleep plan might also include other plans for reducing
your baby’s risk of SUID.
In the same room as
you, but not the same
bed as you
On their back at naps
and at nighme
With no pillows,
blankets, toys, or
other so objects
Wearing pajamas and/
or a nonweighted
sleep sack
On a rm, at, and
level surface
(crib, bassinet, pack-and-play,
or cradleboard)
The safest way for baby to sleep is...
A smoke and vape-free family
and environment decrease
your baby’s risk of SUID.
Thinking about quing to provide your baby a
smoke and vape-free space? Call 800.784.8669,
text READY to 200-400, or visit quitline.com for
free support.
If you and your baby are able
to, you can also decrease
your baby’s risk of SUID by
breaseeding.
Having a hard me or have quesons about
breaseeding? Ask your healthcare provider
if a lactaon consultant is available.
Oering your baby a pacier
at naps and nighme reduces
SUID risk.
• If your baby is exclusively breased, consider
waing to oer a pacier unl breaseeding
is working well for you and your baby.
• If your baby is bole-fed with breastmilk or
formula, you can oer them a pacier at
any me.
Other ways to reduce SUID risk:
Bedsharing
When a baby sleeps on the same surface as another
person, this is called bedsharing.
Bedsharing is not recommended
because, whether it is intenonal or
unintenonal, it increases a baby’s
risk of SUID.
There are many things that make
bedsharing even more risky.
It’s important for everyone making a safe sleep plan
to be aware of these details even if they are not
planning on bedsharing because bedsharing can happen
unintenonally, and making a safe sleep plan for your baby
involves preparing for the expected and unexpected.
Some of these
factors are easier
to control than
others, and some
can’t be changed
aer a baby is
born.
While bedsharing, a baby’s risk of SUID is...
Extremely higher
(more than 10 mes higher risk)
• The adult is very drowsy or fagued.
• The adult is impaired from alcohol,
prescripon drugs, or other drugs.
• The adult currently smokes, even if not in bed.
• The person who gave birth to the baby
smoked during pregnancy.
• The adult and the baby are sleeping on a
couch, armchair, waterbed, or older, soer
maress compared to sleeping on a rmer
maress.
Much higher
(5-10 mes higher risk)
• The baby is less than 4 months old.
• The baby is sleeping with a grandparent,
nonparental caregiver, or sibling.
Higher
(2-5 mes higher risk)
• Baby was born preterm
(before 37 weeks).
• Baby was born with low birth weight.
• Pillows, blankets, or other so objects
are in the sleeping environment.
In your baby’s safe sleep plan, focus on what is in your control and take action
to reduce your baby’s risk of SUID as much as possible in all scenarios.
Frequently Asked Questions
What is the safest way for me to feed
or comfort my baby at night?
Keep your baby’s sleep area, like a crib,
bassinet, or pack-and-play, close to your
bed while both of you are sleeping.
When your baby needs to be fed or
comforted at night, bring them into your
bed aer removing pillows, blankets, and
other so objects from the bed.
Do not feed or comfort your baby on an
armchair or sofa when you are both red.
If you accidentally fall asleep, your baby’s
risk of SUID is higher if you are in an
armchair or on a sofa compared to a rm
adult bed without any pillows, blankets,
or other so objects nearby.
Aer feeding or comforng your baby,
move your baby back to their usual
sleep area, like a crib, bassinet, or
pack-and-play.
If you fall asleep while feeding or
comforng your baby, move them back
to their own sleep space, like a crib,
bassinet, or pack-and-play, as soon
as possible.
Seng an alarm or mer on a
smartphone is one strategy for prevenng
yourself from falling too deeply asleep
when feeding or comforng your baby.
Why isn’t it safe for my baby to sleep
with a blanket and will they get cold
without one?
Blankets increase the risk of your baby
being accidentally suocated during
sleep.
Your baby’s sleep environment should
have no blankets, pillows, toys, or other
so objects for safety.
A ghtly ed sheet can be used on the
maress underneath your baby, but no
other bedding should be in their sleep
space.
Overheang also increases your baby’s
risk of dying suddenly and unexpectedly
during sleep.
Your baby will be comfortable and safer
during sleep when dressed in pajamas
and/or a nonweighted sleep sack.
Babies need about the same number of
layers as adults need to be comfortable.
To avoid overheang, your baby should
have no more than one extra layer
compared to adults, and they should not
wear a hat while sleeping.
Is my baby at a higher risk of choking
when sleeping on their back?
No. Although it may be surprising,
your baby is at a lower risk of choking
when sleeping on their back because of
anatomy and gravity.
When your baby is sleeping on their
back, any uids spit up, regurgitated, or
reuxed from the stomach would need
to work against gravity to get into their
breathing tube and cause them to choke.
When they are sleeping on their stomach,
these uids naturally pool at the opening
of the breathing tube, which makes
choking more likely.
It is safest for every baby to be placed on
their back to sleep for every sleep.
What should I know about cradleboards?
Babies in some Indigenous communies
have slept in cradleboards for
generaons.
If you are interested in connecng with
your culture with this tradional pracce
or have quesons, connect with Həłmxiłp
Indigenous Birth Jusce
by scanning or vising
helmxilp.org/cradleboards.
Can my baby safely sleep in a car seat,
swing, bouncer, or seated stroller?
It is not safe for your baby to regularly
sleep in any of these devices. If your baby
falls asleep in any of these devices, they
are at an increased risk of suocaon
because they are not on a at, level
surface.
If your baby falls asleep in a car seat,
swing, bouncer, or seated stroller, it is
safest to move them to their regular sleep
space as soon as possible.
If your baby falls asleep in one of these
devices and you can’t move them to their
regular sleep space soon, an alert adult
should watch them and make sure that
their face stays fully visible, with nothing
covering their nose or mouth.
After I place my baby on their back to
sleep, should I worry about them rolling
over in their sleep?
Once your baby can roll over on their
own from their back to stomach and from
their stomach to back, you don’t need to
reposion them if you noce they have
rolled onto their side or stomach
during sleep.
Before your baby can roll in this way, if
you noce they have rolled onto their
side or stomach during sleep, you can
reposion them so they are on their
back again.
All babies, regardless of whether they can
roll over on their own, should be placed
on their back to sleep for every sleep in
the rst year of life.
Is it safe to swaddle my baby
during sleep?
It is not safe to swaddle your baby during
sleep aer your baby starts to aempt
to roll over on their own (usually around
3 months of age) because their risk of
suocaon and strangulaon increases.
You can choose to swaddle your baby
during sleep before they start to roll over
on their own because it does not increase
or decrease their risk of dying suddenly
and unexpectedly.
How can I prevent my baby from getting
a at head when I always place them on
their back to sleep?
When your baby is awake and someone
is watching them, they should be placed
on their stomach for supervised, awake
tummy me sessions.
Giving your baby plenty of supervised,
awake tummy me can prevent them
from geng a at head.
Tummy me also helps your baby
strengthen their neck, shoulder, and
arm muscles.
Tummy me is important for your baby’s
development of movement and
motor skills.
Tummy me sessions can start a few days
aer birth. In the beginning, tummy me
sessions should be for short amounts of
me and get longer as your baby gets
older and has more pracce.
Learn more about tummy
me by scanning or vising
pathways.org/topics-of-
development/tummy-me/.
Ask your healthcare provider if you have
any quesons about tummy me.
How can I know if a product is safe for
my baby to use during sleep?
It can be hard to know which products
are safe for babies to use during sleep.
Some products are adversed as safe for
babies to use during sleep and later get
recalled due to being unsafe.
You can nd more informaon about
infant sleep product safety and sign up
to get emailed about newly recalled
products from the
Consumer Product Safety
Commission by scanning or
vising cpsc.gov/safesleep.
In general, be suspicious of products that
claim to prevent your baby from dying
suddenly and unexpectedly during sleep.
There are products that increase the
risk of this happening and products that
decrease the risk of this happening,
but there are no products that can fully
prevent this from happening.
Some products that have claimed to
prevent babies from dying suddenly and
unexpectedly during their sleep have
resulted in more deaths.
Always ask your healthcare provider if
you are unsure about which products are
safe for your baby to use during sleep.
This is different from what my parents
have told me and different than what I
did in the past. What changed?
This booklet has the most up-to-date safe
sleep recommendaons for babies as it is
being wrien.
Over me, recommendaons for how
babies sleep have changed because more
research has been done on why babies
die suddenly and unexpectedly during
sleep and in their sleep space.
When babies die in their sleep space,
the condions surrounding the death are
studied to learn how to improve keeping
babies safe when they sleep.
In the past, babies slept dierently
because we didn’t know what we
know now.
Even though we didn’t know it at the
me, these babies were at an increased
risk of dying suddenly and unexpectedly.
In your baby’s safe sleep plan, focus on
the most recent recommendaons to
keep them safer during sleep.
Your Baby’s Safe Sleep Plan
The usual plan for how your baby will sleep, including:
Where your baby will sleep: _____________________________________________________________________________
What surface your baby will be on when sleeping: ___________________________________________________________
What your baby’s sleep environment will be like: ____________________________________________________________
What your baby will be wearing during sleep: _______________________________________________________________
What posion your baby will be in when laid to sleep: ________________________________________________________
How your baby might sleep and what you will do in unexpected situations, like:
When vising friends or family: __________________________________________________________________________
When traveling: ______________________________________________________________________________________
When you nd your baby asleep in a way that is dierent than your usual plan: ___________________________________
____________________________________________________________________________________________________
Your usual plan for feeding or comforting your baby at night, including:
Who will feed or comfort your baby at night: _______________________________________________________________
How they will feed or comfort your baby: __________________________________________________________________
What they will do when your baby is done being fed or comforted: _____________________________________________
____________________________________________________________________________________________________
Other plans to reduce your baby’s risk of SUID:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Scan or visit
srhd.org/safesleep
to watch videos designed to help you
make your baby’s safe sleep plan.
Prefer to learn with videos?
Share your plan with
everyone who cares
for your baby.
1101 W. College Ave., Spokane, WA 99201 | srhd.org
