Baby sleep on cold nights: a wearable blanket instead of a loose one, and nothing in the crib but a fitted sheet

The bare crib

• Back to sleep, every sleep. NICHD says to place babies on their backs for naps and at night until they’re 1 year old, including babies born early and babies with reflux. If a baby usually sleeps on their back, putting them on their stomach or side, even for a nap, raises the risk of SIDS by up to 45 times. [S1]
• Side isn’t a middle ground. The AAP says the side position is as dangerous as the stomach, partly because a baby on their side can roll onto their stomach more easily. [S4]
• Firm, flat and level. NICHD describes a safe surface as firm (it springs back quickly when you press it), flat like a table rather than a hammock, and level, not tilted. The AAP says a firm surface shouldn’t dent when baby lies on it. [S1] [S4]
• Fitted sheet only. CPSC sums it up as “Bare is Best”: nothing but a fitted sheet in a crib, bassinet or play yard. NICHD says a crib with nothing else in it may look bare, but it’s the safest option. [S2] [S6]
• The right mattress. The AAP says to use a mattress made for your crib that fits tightly, and not to use a crib that’s broken, missing hardware or without instructions. CPSC says to check for recalls at SaferProducts.gov. [S4] [S6]

Warm without blankets

• Why no blanket. CPSC says many young babies can’t lift their heads to pull away from soft things like blankets and pillows. NICHD says sleeping under quilts, blankets and other soft coverings raises the risk of suffocation and strangulation. [S2] [S6]
• Tucked in still counts. NICHD lists anything that isn’t fitted as a danger in the sleep area, even if it’s light, small or tucked in. That includes tucked-in blankets and loveys. [S2]
• Put the warmth on the baby. NICHD says to dress baby in a wearable blanket or an extra layer of clothing to keep them warm without adding anything to the sleep area. The AAP says the same: layers of clothing or a wearable blanket. [S1] [S4]
• One more layer than you. The AAP’s rule of thumb is to dress your baby in only one layer more than you’re wearing in the same room. NICHD puts it as dressing baby for the room temperature. [S1] [S4]
• Heating the room. If a space heater warms the nursery, our space heater guide covers plugging it into the wall, and our CO alarm guide covers alarms outside sleeping areas.

Not too hot

• Overheating is a risk too. NICHD says babies wearing too many layers of clothes and bedding for the room temperature, sometimes called overbundling, can overheat, and overheated babies are at higher risk of SIDS. The AAP says overheating can raise SIDS risk. [S1] [S4]
• No hat indoors. NICHD says hats indoors can make baby too hot, so take the hat off inside. The AAP says not to put a hat on your baby indoors once you’re home from the hospital. The CDC says not to cover baby’s head. [S1] [S4] [S5]
• The signs. Check for sweating, flushed or red skin, or a chest that feels hot to the touch. [S1] [S4] [S5]
• Weighted sleep products. NICHD says weighted swaddles and blankets have no safety standards beyond general children’s product rules and could be made of heavy, thick materials that raise the risk of overheating. [S3]

Swaddling and rolling

• Swaddling doesn’t lower SIDS risk. NICHD and the AAP both say so, though some babies are calmer and sleep better swaddled. [S1] [S3] [S4]
• Always on the back. A swaddled baby may have trouble moving out of the stomach or side position, NICHD says, so back sleeping matters even more. The AAP says the swaddle shouldn’t be so tight that it makes breathing or hip movement hard. [S1] [S4]
• Stop at rolling. NICHD says to stop swaddling when baby starts to roll over, usually around 3 months. The AAP says to stop when baby looks like they’re trying to roll, usually around 3 to 4 months, and that it can happen earlier. After that, a wearable blanket or an extra layer keeps them warm. [S1] [S4]
• Nothing weighted. NICHD, the AAP and CPSC all say not to use weighted blankets or weighted swaddles. NICHD explains that a baby’s ribcage is still developing, so weight could make it harder to breathe, and harder to roll back over. [S1] [S3] [S4] [S6]

Where baby sleeps

• Share the room, not the bed. NICHD says to room share for at least the first 6 months, with baby in their own crib, bassinet or play yard in your room. Both NICHD and the AAP say room sharing can cut the risk of SIDS by as much as 50%. [S1] [S2] [S4]
• Never the couch. The AAP says the risk of sleep-related death is up to 67 times higher when a baby sleeps with someone on a couch, soft armchair or cushion. NICHD says couches and armchairs are especially dangerous when an adult dozes off while feeding. [S2] [S4]
• Tired at a night feed. NICHD says if there’s a chance you’ll fall asleep while feeding in bed, first clear pillows, blankets and unfitted sheets from your side, then move baby back to their own space as soon as you wake. [S2]
• Car seats are for the car. NICHD says not to use car seats, strollers, carriers or slings for regular sleep and to move baby to their own sleep space as soon as you can once you’re out of the vehicle. Never leave a baby alone in a vehicle, whatever the temperature. Our winter car seat guide covers coats and harnesses. [S1]

Products to skip

• Bumpers and inclined sleepers are banned. Since November 12, 2022, CPSC treats crib bumpers and inclined infant sleepers as banned hazardous products, no matter when they were made. Selling them is illegal. An inclined sleeper is one with a sleep surface tilted more than 10 degrees for babies up to 1 year. [S7]
• Rockers and swings aren’t beds. CPSC says inclined products over 10 degrees, such as rockers, gliders, soothers and swings, should never be used for infant sleep. A semi-reclined position can tip the head forward and block the airway. [S6]
• Positioners and wedges. NICHD says many wedges, positioners and other products that claim to hold babies in place or lower SIDS risk don’t meet federal guidelines, and no product can prevent SIDS. [S1] [S3]
• Monitors. NICHD says heart, breathing and motion monitors aren’t effective at detecting or preventing SIDS. The AAP says it’s fine to use one if you want, as long as it doesn’t replace the safe sleep rules. A regular baby monitor that lets you see or hear baby is a different thing. [S1] [S3] [S4]

Quick decision

Pick what fits tonight to see what the sources say in one place. [S1] [S2] [S4] [S6]

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Before bedtime tonight

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