Back to Sleep: The Best Bedtime Position for Baby

The AAP policy recommends back sleeping first and foremost for babies. But its other recommendations for healthy sleep include these:

• A firm sleeping surface is safest (such as a firm mattress covered by a sheet). Fluffy mattress covers or sheepskins should be avoided for sleeping.

• Skip loose bedding and stuffed animals. Make sure any crib bumpers are thin, firm, and securely attached to the crib sides.

• Don't smoke during pregnancy, and don't allow smoking in the house where the newborn lives. Likewise avoid other smoky situations (such as a daycare provider's) for the baby.

• Co-sleep safely. While there are many proponents of co-sleeping in Mom and Dad's bed, the AAP's recommendation is to let an infant sleep in the same room but not the same bed. A "sideca" arrangement or bassinet or crib in the mother's room is what the AAP deems safest, with the baby in the adults' bed only for nursing and comforting.

• Offer a pacifier at sleep time: It seems correlated with lower SIDS incidence. You might wait a few weeks to start this, so as not to add any confusion to breastfeeding habits. Offer the pacifier before laying the baby down. Don't try to insert it after Baby is asleep, and if Baby refuses it don't force it. The pacifier may help make Baby more arousable or hold the mouth in position to keep the airways open. Using it up to one year of age should not interfere with dental structure.

• Avoid overheating the room or overdressing the baby.

• Save your money and don't buy devices that are promoted as SIDS prevention. None have been tested rigorously enough to stand up to the claim, according to the AAP.

• Likewise, don't rely on audio, video, or movement monitors to prevent SIDS. There is no evidence that their use reduces the incidence of SIDS.