2. Crib, Bassinet, Play-Yard
SAFE SLEEP SPACE FAST FACTS
- Babies should only sleep in a safety-approved bassinet, play-yard, or crib.
- Baby’s sleep surface should be firm. Soft bedding increases the risk of suffocation and rebreathing.
- Baby should never sleep in an adult bed, on a couch, or in a car seat.
- Twins should each have their own separate sleep space.
- Baby’s sleep surface should be flat. Babies who sleep in an inclined sleeping position are at a higher risk for “positional asphyxiation”.
Continue reading below to learn more…
What is a Safe Sleep Space?
Babies should only sleep in a safety-approved sleep environment with a firm, flat, and non-inclined surface. Approved products include bassinets, play yards (like Pack ‘n Plays or Cribettes), bedside sleepers with rigid sides, and cribs.
Babies should never sleep in places like adult beds, couches, recliners, in-bed sleepers, nursing or infant loungers (like Boppy pillows), swings, inclined sleepers, or car seats, as these increase the risk of suffocation and positional asphyxiation.
A safety-approved sleep environment is any product classified as a bassinet, play yard, or crib and free of recalls. These products meet the Consumer Product Safety Commission (CPSC) guidelines. Products not labeled as a bassinet, play yard, or crib are not considered safe for sleep under CPSC standards.
Learn more about product safety here.
A bassinet is a small bed designed for infants, typically supported by a frame, and often intended for the first few months of life. A bassinet must meet the following safety standards:
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- The sleep surface must be flat (no more than a 10-degree incline).
- Must have adequate side height to prevent falls as the baby moves.
- Stability testing to ensure it won’t tip over or collapse.
- No small parts or sharp edges that could harm the baby.
- Firm mattress or pad specifically designed for the bassinet.
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Any bedside bassinet that attaches to an adult bed should be secured according to the manufacturer’s instructions. The bassinet should have all four sides in place during sleep. If a side is removed for breastfeeding or care, it must be replaced before the baby is put back to sleep to prevent suffocation hazards from entering the sleep environment.
A play-yard is a portable enclosure, such as a Cribette or Pack ‘N Play, with a floor and mesh or fabric sides, often used as a sleep or play area for infants and toddlers. A play yard is a safe sleeping environment. A play-yard must meet the following requirements:
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- The mattress or pad must be firm and thin to reduce suffocation risk.
- Side height requirements to prevent climbing or falling out.
- Mesh openings must be small enough to prevent entrapment or strangulation risks.
- Stability testing to ensure the play yard doesn’t tip over.
- Materials must be durable and free of toxic substances.
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A crib is a bed designed for infants or your children with high sides to prevent the child from falling out. A crib must meet the following safety standards:
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- Slats must be no more than 2 3/8 inches apart to prevent entrapment.
- Corner posts cannot be taller than 1/16 inch to prevent clothing snags.
- No drop-side rails are allowed to ensure structural integrity.
- The mattress must fit snugly with no gaps larger than two finger widths.
- Durable construction that passes rigorous impact and strength testing.
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Why does the sleep surface matter?
A firm AND flat sleep surface is essential for safe sleep because it reduces the risk of suffocation and positional asphyxiation.
Image Above: Shared with permission from Safe Infant Sleep.
Why is my baby’s sleep surface firm?
Image Above: Shared with permission from Safe Infant Sleep.A firm sleep surface prevents the risk of suffocation by reducing the indentation a baby makes when laying on the surface. A firm sleep surface maintains its shape while a soft surface, such as an adult bed or a couch, conforms to the shape of the baby and creates a bowl-shaped indentation. If a baby rolls over onto their stomach on a soft surface, the risk of suffocation is increased because the soft surface can cover the baby’s airway and lead to suffocation. The bowl that is created by the indentation is also likely to trap the child’s exhaled breath (carbon dioxide) which increases the risk of death by rebreathing.
Image Credit: StandInBaby
Why does my baby’s sleep surface have to be flat?
A flat sleep surface reduces the risk of positional asphyxiation. When babies sleep on inclined sleep surfaces such as swings, car seats, and other inclined loungers.
Positional asphyxiation happens when a baby’s body is in a position that makes it hard for them to breathe because their airway gets blocked. The best way to think of this is imagining that the airway is like a straw that air travels through to get to their lungs. If the straw is bent or pinched, air can’t flow through it easily.
For example, if a baby’s head falls forward onto their chest while they’re sleeping in a sitting position, like in a car seat or swing, it can pinch their airway and make it hard for them to breathe. Babies don’t have strong enough neck muscles to lift their heads back up, so they might not be able to fix their position.
This is why babies need to sleep on a flat, firm surface on their backs, where their airway can stay open, just like keeping a straw straight so air or liquid can flow through easily.
Even babies with reflux should be placed on their backs on a flat, firm surface. Inclined sleeping will not make reflux better but will instead put babies at a greater risk for positional asphyxiation and aspiration.
What about twins or multiples?
Families with twins or multiples often face added challenges when it comes to safe sleep. It may seem logical – or even necessary due to space constraints – to place twins in the same crib or on the same sleep surface. However, this increases the risk of suffocation and death due to overlay. Babies can, and do, roll onto each other, especially as they grow and begin to move during sleep, which can block each other’s airway. Sharing a bed with a twin or multiple can also lead to overheating when they are placed too close together.
The safest way for twins or multiples to sleep is in separate, individual sleep surfaces. Each twin or multiple should have their own bassinet, crib, or play yard for sleep.
Why are car seats not safe for sleep?
This image shows a car seat placed on a couch, outside of a vehicle. When used on soft or elevated surfaces, car seats can tip or fall, creating a serious injury risk. Car seats should only be used for travel and never as a sleep space outside the car.
A car seat is designed to keep a baby safe during car rides. When traveling in a car, babies should always be in a car seat. The risk of death or injury from a car accident is a much bigger risk than sleep-related death when the car is in motion.
When installed properly in a vehicle, the car seat is secured at the correct reclined angle (around 45 degrees) to keep the baby’s airway open and their body in a safe position. Even if the baby falls asleep in the car, the motion of the vehicle and the vibration help to keep their head stable, reducing the chances of their airway becoming blocked.
However, a car seat becomes unsafe for sleep once it is removed from the car. When placed on a flat surface, the base of the car seat is no longer secured, and it can rock or tilt forward. This can cause the baby’s head to fall forward, increasing the risk of positional asphyxiation—when the baby’s airway is pinched off, like a straw that’s bent, and they can’t breathe properly.
While car seats are safe for travel, they are not a safe place for a baby to sleep outside of the car. Always transfer your baby to a flat, firm sleep surface like a crib or bassinet when you arrive at your destination.
Why are couches unsafe for sleep?
Couches are unsafe for babies to sleep on because they increase the risk of suffocation, entrapment, and injury. Couches have soft, uneven surfaces which increase the risk of suffocation and rebreathing due to the indentation of the baby’s weight. Additionally, the uneven surface and the gaps between the cushions make it more likely that the baby will roll into unsafe positions, even if started on their back to sleep, and become trapped between the cushions, leading to suffocation. In addition, couches are unsafe for babies because they can roll off and be injured from the fall.
Couch sleeping increases the risk of death by 50 times!
The danger increases even more if an adult is sharing the sleep surface with the baby. Learn more about the dangers of surface sharing here.
Creating a Temporary Sleep Space in an Emergency
If a safe sleep space is unavailable, a temporary solution can be used in an emergency. This alternative must still have a firm, flat, and non-inclined surface and be free of pillows, blankets, or soft objects.
Examples of Temporary Emergency Sleep Spaces:
- A sturdy box (without a lid and placed on the floor)
- A laundry basket (without a lid and placed on the floor)
- A dresser drawer (pulled out of the dresser and placed on the floor)
You can add a thin, firm layer of padding, such as a pillowcase tightly wrapped and secured around a piece of cardboard, to provide a barrier between the baby and the hard surface.
These temporary solutions are only meant for short-term use and should be replaced with a safety-approved sleep space as soon as possible.
Many local organizations in the U.S. offer free or low-cost safe sleep spaces to families in need. To find a crib, visit: cribsforkids.org/find-a-crib.