Safe Sleep Checklist: Ensuring the Safety of Our Littlest Sleepers (0-12 Months)

Updated to Reflect the American Academy of Pediatrics’ 2022 Recommendations

Before embarking on the journey to independent sleep, safety is paramount. This checklist serves as a quick reference to ensure a secure sleep environment for your baby.

Sleep Surface Essentials:

  • Firmness: The surface should be firm without additional mattress cushions or pillow tops.

  • Flatness: Suitable for all babies, including those with reflux, GERD, colic, or upper respiratory infections. An elevated position is not recommended.

  • Certification: Must be labeled as a crib, bassinet, portable crib, or play yard. Other types of loungers or sleepers are not approved.

  • Clutter-Free: No weighted products, loose bedding, blankets, stuffed animals, or pillows.

  • Device-Free: Avoid all positional devices like Boppy, DockATot, SnuggleMe Organic, etc.

  • Safe Distance: Positioned more than an arm’s length away from windows, furniture, and cords.

  • Individual Space: The baby should not share a bed with parents or siblings.

Crib Specifications:

  • Mattress Fit: No gaps around the mattress edges.

  • Bumper-Free: The crib should not have bumpers.

  • Sheet Security: Snugly fitted sheets only.

  • Slats: Ensure they are no more than 2 inches apart.

  • Mattress Height: Adjusted appropriately as the baby grows, especially when they begin to sit independently.

Bassinet Usage:

  • Specific Mattress: Use only the mattress sold with the bassinet (also applies to play yards).

  • Timely Transition: Move the baby when they outgrow the bassinet, either by weight/length limits or when they can sit, climb, or roll out.

Swaddling Guidelines:

  • Chest Comfort: Swaddle should be snug around the chest but allow a hand to slide inside.

  • Hip Health: The swaddle should be loose around the hips.

  • Security: Use swaddles with velcro or zippers for a secure fit.

  • Rolling Response: Discontinue swaddling when the baby shows signs of rolling, typically around 3-4 months.

  • Weight: Only use non-weighted swaddles.

Baby’s Sleep Positioning:

  • Back to Sleep: Place the baby on their back for sleep during the first year.

  • Tummy Time: Allow tummy sleeping only if the baby rolls there independently.

  • Accessory-Free: No bows, clips, hats, or mittens during sleep.

  • Blanket-Free: Avoid all blankets, weighted swaddles, or weighted sleep sacks.

  • Comfort Dressing: Dress the baby appropriately for the room temperature.

Considerations for Sleep Outside the Crib:

  • Alert Caregiving: If holding or snuggling a sleeping baby, the caregiver must stay awake.

  • Transitioning: Move the baby to a flat, firm sleep surface as soon as practical if they fall asleep in a car seat, swing, carrier, or stroller.

  • Car Seat Safety: Ensure safe car seat sleep by proper installation, usage, and buckling. Avoid swaddling in a car seat and refrain from adding positioners, padding, or toys not sold with the seat.

  • Visibility and Airflow: When outside the car, keep the baby’s face visible to the caretaker at all times, ensure proper buckling, and maintain good

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