Science of baby sleep
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AAP sleep guidelines: Everything parents need to know in 2026
Cradlewise Staff
Safe sleep advice for babies can feel overwhelming, especially when recommendations change and every product claims to be “sleep-approved.” If you are a new or expecting parent, you have probably asked yourself what actually matters, what’s outdated, and how to keep your baby safe without overthinking every nap.
The American Academy of Pediatrics’ latest safe sleep guidelines for infants cut through the noise with clear, research-backed recommendations designed to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related infant deaths.
The newly revised recommendations that were first published in 2022 and later updated in 2025 are based on 159 scientific studies to promote safe sleep among babies and apply to children up to one year old.
“We want to reach new parents, grandparents and other infant caregivers so that everyone is aware about how best to keep their baby safe,” said Fern Hauck, MD, MS, a professor of family medicine and public health sciences at the University of Virginia School of Medicine and a member of the AAP’s Task Force on SIDS.
In this guide, we break down what the AAP says today, what’s changed in recent years, and what it means for your baby’s sleep setup, so you can make confident, informed choices and focus on what matters most: restful, safer sleep for your baby (and you).
The context and why it matters
According to the Centers for Disease Control and Prevention, there are about 3,500 sleep-related deaths among U.S. babies each year, including sudden infant death syndrome (SIDS), accidental suffocation, and other unknown causes.
In the 1990s, there were sharp declines in sleep-related deaths following the national “Back to Sleep” campaign, which was in 2012 renamed to the “Safe to Sleep” campaign. However, despite continued efforts to promote safe sleep in babies, the declines have slowed since then, and data from a report by the National Library of Medicine show the risk for babies persists.
Furthermore, families of color are disproportionately impacted. The rate of sudden unexpected infant deaths (SUIDs) among non-Hispanic Black and American Indian/Alaska Native infants was more than double and almost triple, respectively, that of non-Hispanic white infants in 2010-2013. You can find the details here.
AAP safe sleep guidelines 2025: Important takeaways
“ We’ve made great strides in learning what keeps infants safe during sleep, but much work still needs to be done. A baby’s death is tragic, heartbreaking and often preventable. If we’ve learned anything, it’s that simple is best: babies should always sleep alone in a crib or bassinet, on their back, without soft toys, pillows, blankets or other bedding.”
These AAP-suggested sleep guidelines can help prevent SIDS and keep infants safe during sleep.
Sleep surfaces
New safe sleep guidelines: Babies should sleep on a firm, flat sleep surface.
- According to AAP, “Sleep surfaces with inclines of >10 degrees are unsafe for infant sleep.”
- Parents are also advised against using devices such as car seats, strollers, swings, infant carriers, and infant slings as routine places to sleep, particularly for infants younger than four months.
- Only in an emergency, you can temporarily put your infant to sleep in a box, basket, or drawer, but it should have a thin, firm padding.
What the science says:
Sleep surfaces that are inclined more than 10 degrees increase the chances of a baby sliding down and their head slumping forward. This can cause positional asphyxia, which means the baby’s body position gets in the way of their breathing, and potential suffocation. Sleeping on a soft or fluffy surface is also dangerous for your baby as the soft bedding can come up and around the baby’s nose.
Many parents whose babies struggle with acid reflux resort to inclining the baby or putting a wedge underneath the baby or the mattress in order to help their little ones sleep more comfortably.
“This is not advisable. You do not want to place anything into the crib with the baby,” Dr. Nilong Vyas (MD, Pediatrician), founder of Sleepless at NOLA, says. “A lot of families will roll up blankets or towels, or beddings and place it either under the baby’s neck or head or put them under mattresses or under crib legs.”
Instead, she recommends that, “If your newborn is struggling with reflux, it is advisable to talk to a pediatrician and find out about treatment options.”
Did you know?
Check if your baby’s sleeping surface is firm enough by pressing your hand down and lifting it. If your hand leaves an indentation, then it’s too soft.
Swaddling guidelines
New safe sleep swaddling guidelines: Avoid swaddling after your baby can turn over (which usually occurs at three to four months but may occur earlier at two months of age as well).
Swaddling increases the risk of suffocation if the infant rolls over onto their tummy or side. Wrapping your baby may help encourage longer sleep stretches, but it’s important to do it safely.
What the science says:
There are conflicting studies regarding the benefits of swaddling. However, there’s no firm evidence to support the claim that it reduces the risk of SIDS.
Swaddling can also cause your baby to overheat, so make sure to monitor their temperature and keep the room between 68℉ and 72℉ (a fan can help circulate air).
Weighted blankets
New safe sleep guidelines: Avoid placing weighted blankets, weighted sleepers, weighted swaddles, or other weighted objects ON or NEAR the sleeping infant.
What the science says:
AAP states that dressing your infant with layers of clothing is preferable to blankets and other coverings to keep the infant warm while reducing the chance of head covering or entrapment that could result from blanket use. Using sleep sacks or wearable blankets are safer options to keep your baby warm.
Head coverings
New safe sleep guidelines: Refrain from putting hats on your infant when indoors except in the first hours of life or in the NICU.
What the science says:
Avoid overheating, over bundling and covering your baby’s face and head. An increased risk of SIDS is associated with excessive clothing or blankets covering an infant.
Bed-sharing and room-sharing
New safe sleep guidelines: Parents are encouraged to room-share (but not share a bed), ideally for at least six months.
Place your baby’s crib, bassinet, portable crib, or play yard in your bedroom, close to your bed.
If you bring your baby into your bed for feeding or comforting them, remember to put them in their own sleep space after the feeding or comforting. Never sleep with your baby in the same bed, especially if you have used substances such as alcohol or illicit drugs, or taken any medicines.
What the science says:
Room-sharing is especially important in the first six months because the rates of sleep-related deaths are highest during this vulnerable time.
As per AAP, room-sharing decreases the risk of SIDS by as much as 50% and is safer than bed-sharing or when the infant is in a separate room. It allows parents to be close to the baby, which helps facilitate “feeding, comforting, and monitoring of the infant.”On the other hand, the risk of sleep-related infant death while bed sharing is 5 to 10 times higher when your baby is younger than 4 months old.
According to Dr. Vyas, “It’s okay to share the bed when nursing or feeding a child, laying flat if mom needs to nurse that way, that’s okay. But after the feeding is done, bring the baby into his or her designated sleep surface.”
We know this is easier said than done when dealing with sleep deprivation. Dr. Vyas suggests that parents set a timer on their phones to alert them when feeding time is over. “It will help kind of to jar you awake a little bit in case you have fallen asleep and put the baby back in the bassinet or crib after feeding,” she says.
Did you know?
If you are sleeping on a couch, soft armchair or cushion with your baby, it increases the risk of infant death up to 67 times higher.<br>
Use of bedding
New safe sleep guidelines: Keep your baby’s sleep area clear of soft objects (like head pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like materials) and loose bedding (like blankets and non-fitted sheets).
Avoid crib bumpers.
Consumer Product Safety Commission (CPSC) reported injuries and deaths among children younger than five associated with cribs/mattresses, bassinets/cradles, playpens/yard plays, inclined infant sleep products, and infant carriers.
What the science says:
The aforementioned materials can obstruct a baby’s airway. Bedding in the sleeping environment increases SIDS risk, independent of sleep position.
Breastfeeding
New safe sleep guidelines: Breastfeed for the first six months and continue for two years of age (or longer, as mutually desired by the parent and baby).
AAP states “Feeding of human milk is recommended because it is associated with a reduced risk of SIDS.”
What the science says:
AAP advises breastfeeding because breast milk boosts a baby’s immune system. Breastfed babies are more easily roused from sleep, reducing their risk of SIDS. Physiologic sleep studies showed that breastfed infants are more easily aroused from sleep than their formula-fed counterparts.
Breastfeeding provides the baby with overall immune system benefits attributable to maternal antibodies and micronutrients in human milk.
Pacifiers
New safe sleep guidelines: Offering a pacifier at nap time and bedtime is recommended to reduce the risk of SIDS.
What the science says:
AAP quotes multiple studies that have reported a protective effect of pacifiers on the incidence of SIDS. Although the ‘why’ isn’t yet clear, a possible explanation is that pacifiers help keep the baby’s airway open.
Also, if your baby is breastfed, delay introducing a pacifier to them until breastfeeding is firmly established in terms of sufficient milk supply, and consistent, comfortable, and effective latch for milk transfer.)
Tummy time
New safe sleep guidelines: Parents are encouraged to place the infant in tummy time while awake and supervised for short periods of time.
You can start this soon after hospital discharge and increase your baby’s tummy time incrementally to at least 15 to 30 minutes total daily by seven weeks of age. However, it should be done under constant supervision by a caregiver.
What the science says:
Tummy time is good for babies. Babies may develop a flat spot on the back of their head (plagiocephaly) if their head position is not varied when placed for sleep. According to Dr. Vyas, “Tummy time helps strengthen the muscles in the neck and back and will help babies protect their airways when they start to roll.”
Cardiorespiratory monitors
New safe sleep guidelines: Parents are recommended not to trust home cardiorespiratory monitors and devices as a strategy to reduce the risk of SIDS.
What the science says:
There is no current data to support that existing commercial devices that are designed to monitor infant vital signs reduce the risk of these deaths. Wellness devices don’t save lives. Medical devices do. Therefore, do not rely on these devices. Wearable heart rate and pulse oximetry monitoring devices are considered to be “wellness devices,” which do not meet the FDA criteria for medical devices.
Parents who use these monitors at home for peace of mind are strongly encouraged to still follow safe sleep recommendations. Most importantly, keep a physical watch. Nothing like the natural parental instinct to guarantee safety for your baby.
Conclusion
Creating a safe sleep environment for your baby can feel overwhelming, but the latest AAP guidance makes the path simpler: less is more. These guidelines are rooted in decades of research and backed by pediatric experts to help you rest a little easier too.
Remember, there’s no one-size-fits-all perfect routine, but these safe sleep practices give your baby the safest possible start while you grow into parenthood together. And as always, your pediatrician is there to answer questions and support you every step of the way.
FAQs
Q: Can my baby sleep in a swing, car seat, or stroller at home?
A: The AAP does not recommend swings, car seats, strollers, or carriers for routine sleep at home, as these positions can increase the risk of airway obstruction, especially in young infants.
Q: Are sleep positioners or wedges safe for babies?
A: No. The AAP advises against using sleep positioners, wedges, or rolled blankets because they can lead to suffocation and have not been shown to reduce SIDS risk.
Q: Do weighted blankets help newborns sleep better?
A: No. The AAP advises against using weighted blankets, weighted swaddles, or weighted sleepers for newborns and infants, as they increase the risk of suffocation and overheating without any proven sleep benefits.
Q: What is the AAP recommendation for sleep position?
A: Babies should sleep on their back, on a firm and flat sleep surface. According to AAP, “Sleep surfaces with inclines of >10 degrees are unsafe for infant sleep.”
Q: What are the AAP safe sleep guidelines for co sleeping?
A: The AAP safe sleep guidelines for co-sleeping recommend room-sharing with the infant sleeping in a separate crib or bassinet close to the parent’s bed, which has been shown to reduce the risk of SIDS, rather than bed-sharing.
Q: At what age is bed-sharing safe?
A: The AAP advises against bed-sharing for infants of any age, as studies have consistently shown an increased risk of SIDS and other sleep-related incidents associated with bed-sharing, even in older infants.
Q: Why is co-sleeping not recommended?
A: Co-sleeping is not recommended due to the increased risk of SIDS and other sleep-related incidents, such as accidental suffocation or entrapment, as supported by various scientific studies.
Q: Why does breastfeeding reduce SIDS?
A: Breastfeeding reduces the risk of SIDS due to several factors, including the protective antibodies passed from mother to baby through breast milk, a potential effect on infant immune function, and the mother’s ability to more easily detect and respond to her baby’s needs during the night. Breastfed babies are more easily roused from sleep, reducing their risk of SIDS. As per AAP, “Physiologic sleep studies showed that breastfed infants are more easily aroused from sleep than their formula-fed counterparts.”
Q: Can baby sleep on my chest?
A: Sleeping with a baby on your chest is not recommended due to the increased risk of accidental suffocation or overheating, as supported by studies highlighting the potential hazards of this sleep position.
Q: What is the difference between bed-sharing and co-sleeping?
A: Bed sharing refers specifically to sharing the same sleeping surface with the infant, such as a bed, couch, or armchair. Co-sleeping is a broader term encompassing both bed-sharing and room-sharing, with the infant sleeping in a separate crib or bassinet close to the parent’s bed.
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Sources:
- SIDS. AAP Publications. 2022. Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment.
- How to create a safe sleep area. CDC Reproductive Health. 2024. Helping Babies Sleep Safely.
- Chapter 19 A United States Perspective. National Library of Medicine. 2018. SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future.
- CPSC’s latest data show that between 2019 and 2021. CPSC. 2024. New CPSC Report Shows Unsafe Sleep Environments Are Leading Cause of Injuries and Deaths with Nursery Products.
- SIDS in breastfed and formula-led infants. National Library of Medicine. 2004. Comparison of evoked arousability in breast and formula fed infants.
- Protective effect of pacifiers on the incidence of SIDS. Maternal Child Health Journal. 2012. Pacifier use and SIDS: evidence for a consistently reduced risk.
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