Publication - Advice and guidance

Safer Sleep for Babies 2024 A Guide for Parents and Carers

Published: 30 September 2024
From: Minister for Public Health and Women's Health
Directorate: Children and Families Directorate
Topic: Children and families, Health and social care
ISBN: 9781836018018

Updated Scottish Government and NHS Safer Sleep for Babies resources developed in partnership with the Lullaby Trust, UNICEF Baby Friendly Initiative and BASIS, Baby Sleep Information Source based at Durham University. Includes strengthened messaging on bed sharing and smoking, alcohol and drug use.

Supporting documents

Safer Sleep for Babies : a guide for parents and carers

Safer sleep for babies

The information in this booklet about safer sleep has saved many babies’ lives. It is all backed by research that has shown how to reduce the chance of babies dying suddenly with no explanation (known as sudden infant death syndrome, SIDS, or cot death). To reduce the chance of SIDS, families should follow this key advice for baby sleep. It is important that all parents and anyone involved in the care of a baby are aware of this advice.

Put them on their back for every sleep
In a clear, flat, separate sleep space
Keep them smoke free day and night

Babies need a sober carer to respond to their needs

Always place your baby on their back for sleep

Put your baby down on their back – not their front or side – for every sleep
No special equipment or products are needed to keep them on their back
Once they start to roll from front to back by themselves, you can leave them to find their own position for sleep
Tummy time while awake can help to strengthen the muscles they need for rolling

Reason: many more babies have died suddenly when placed to sleep on their front or side, rather than on their back. Since the Back to Sleep campaign in 1991 the rate of SIDS has dropped by 80%.

Give your baby a clear, flat, separate sleep space in the same room as you

The safest place for a baby to sleep is in their own clear, flat, separate sleep space such as a cot or Moses basket.

Scotland’s Baby Box has its own safer sleep information.

Whatever space you choose, follow these guidelines:

A firm, flat mattress with no raised or cushioned areas
No pillows, quilts, duvets, bumpers or weighted bedding
No pods, nests or sleep positioners
Ensure that the sleep space is kept clear of all items and there is nothing within reach of the space e.g., blind cords, soft toys or nappy sacks
Babies should always be in the same room as you for the first six months for sleep, day and night. This doesn’t mean you can’t leave the room to make a cup of tea or go to the toilet if your baby is in their cot or Moses basket, but for most of the time when they are sleeping they are safest if you are close by
Babies should not be allowed to sleep in bouncy chairs and babies should not be left sleeping in the car seat when not travelling in the car. Car seats are not to be used as sleep spaces in the house
Make sure your baby’s head is kept uncovered so they don’t get too hot. Try to keep the room temperature between 16 and 20 degrees so your baby does not get too hot or cold and make sure bedding is appropriate for the time of year
Place baby at the bottom of the cot so that they cannot wriggle under covers – this is called ‘feet to foot’

Reason: soft or raised surfaces, pillows or quilts can increase the chance of SIDS by making it difficult for babies to breathe or cool down. The chance of SIDS is lower when babies sleep in a room with an adult than when they sleep alone.

Remember: if using a sleeping bag, no extra bedding is needed.

Keep your baby smoke free before and after birth

Smoking in pregnancy greatly increases the chance of SIDS – all pregnant women should make every effort to take up the help to stop smoking provided locally
You should also avoid being exposed to others’ smoke when you are pregnant - if your partner smokes they can get help to quit too
Keep your baby away from smoke in your home, car and out and about

Reason: babies who are exposed to tobacco smoke before or after birth have a much greater chance of SIDS than babies who are kept smoke-free.

Breastfeeding

Breastmilk and breastfeeding provides all the nutrition your baby needs for the first six months and protects them against infections and diseases
Breastfeeding lowers the chance of SIDS

If you need more help with breastfeeding talk to your midwife or health visitor or call the National Breastfeeding Helpline on 0300 100 0212

Reason: SIDS risk is halved in babies who are breastfed for at least two months.

Bedsharing more safely

Whether you choose to bedshare, or it is unplanned, there are some key risks you should avoid.

It is dangerous to share a bed with your baby if:

you or anyone in the bed has recently drunk any alcohol
you or anyone in the bed smokes or the baby was exposed to smoking in pregnancy
you or anyone in the bed has taken any drugs that make you feel sleepy
your baby was born prematurely (before 37 weeks of pregnancy) or weighed under 2.5kg or 5½ lbs when they were born

In these scenarios, it is always best to put baby in their own clear, flat, separate sleep space, such as a cot or a Moses basket. Keeping the cot or Moses basket next to the bed might make it easier to do this.

Reason: studies have found that bedsharing with your baby after drinking alcohol or using drugs has a very high risk of SIDS. Sleeping close to a smoker also greatly increases the chance of SIDS. Premature and very small babies have a greater chance of SIDS when they share a bed with an adult.

Things to remember if bedsharing

Check that baby cannot become trapped in the bedframe or headboard, wedged, fall out of bed or get stuck between the mattress and the wall
Do not bring other children or pets into bed with you
Remove slatted/decorated headboards and keep pillows and adult bedding away from your baby
Never leave your baby alone in an adult bed

Never sleep with your baby on a sofa or armchair

Sofas and armchairs are dangerous places to fall asleep with your baby – move somewhere safer if you might fall asleep.

Reason: The risk of SIDS is 50 times higher for babies when they sleep on a sofa or armchair with an adult. They are also at risk of accidental death as they can easily slip into a position where they are trapped and can’t breathe.

Think Ahead

Reason: Planning ahead means you can ensure your baby has a safe sleep place. Unplanned changes to routine can lead to increased risk to babies.

Babies need a sober carer to be able to respond to their needs. Sometimes alcohol and drugs like cannabis and even some medicines make this harder for carers to do. Planning ahead to have another adult like a close family member or a partner around to take care of the baby can be a good idea for those times. It’s also really important to plan for babies to sleep in their own safe, clear, flat, separate sleep space such as a cot or Moses basket if their carer has had any alcohol or drugs, or if they smoke.

Any time you think you might fall asleep with your baby make sure they are on their back in a clear, flat, separate sleep space. If you are breastfeeding whilst lying down, make sure your baby cannot roll on their front. Try and keep your baby on their back, or move them onto their back once they have been fed.

If you follow the advice in this leaflet for every sleep, the chance of SIDS is very low. Do not worry alone – if you have a question ask your midwife or health visitor or contact The Lullaby Trust or Basis.

Please use these links for further information on the following:

When babies start to roll lullabytrust.org.uk/sleepingposition

Scotland’s Baby Box parentclub.scot/baby-box

Premature babies lullabytrust.org.uk/premature

Slings rospa.com/home-safety/advice/product/baby-slings

For guidance on safe sleep for twins, triplets or more, visit: twinstrust.org/safe-sleep-factsheet

Remember: if you think your baby is showing any signs of being unwell, always seek medical advice. The Lullaby Trust Baby Check app can help parents or carers determine how ill their baby is. Available free from Google Play or the App Store.