According to this study, about fifty-five percent of babies in America sleep with unsafe bedding.
As a new parent or caregiver, you want to give your baby all the comforts he or she needs, but even more than that, you want to make sure your baby is always safe. That said, you’ve likely accumulated a mountain of snuggly blankets and adorable stuffed animals, all of which would undoubtedly make adorable additions to your nursery. It’s almost impossible to resist the urge to dress up your baby's crib with all things soft and furry! After all, as adults, we like our beds to be as cozy as possible.
Don’t worry: the time will come when you can load up the crib with blankets and pillows. But while your baby is under a year old, you need to be very careful when it comes to bedding.
Soft bedding and SIDS
SIDS (Sudden Infant Death Syndrome) is a big concern when it comes to soft bedding, including blankets, in an infant’s bed. Studies have shown that soft bedding can increase the risk of SIDS by 2-3 times, making it a primary contributing factor in these tragic cases.
A 2003 NICHD-supported study showed that:
Babies sleeping on soft bedding had 5 times the risk of SIDS as babies placed on firm bedding (i.e. a firm mattress).
Babies sleeping on their stomachs on soft bedding had 21 times the risk of SIDS as babies who slept on their backs on firm bedding.
While there are still some things about SIDS we don’t completely understand, we do know that a baby’s inability to rouse may be related. If a young baby rolls onto a soft blanket or into a fluffy stuffed animal, their airway could get blocked. When our bodies are presented with a lack of oxygen, our natural response is to wake up and adjust. If a baby is unable to rouse and adjust due to blankets or other objects in their crib, SIDS becomes a risk.
While thinking about SIDS may be frightening, remember that SIDS is brought on by a number of different contributing factors, some of which are genetic and out of your control. The key is focusing on the things that are within your control in order to protect your baby. Also, remember that babies are at the highest risk of SIDS between the ages of 2 months and 4 months. The risk of SIDS goes steadily down after 4 months until 12 months, when the risk of SIDS becomes negligible.
At that time (12 months), you can start to consider putting your child to sleep with blankets and/or stuffed animals, as long as you follow certain guidelines (which we’ll discuss later).
Soft bedding and suffocation
SIDS isn’t the only thing you’re risking by having your baby sleep with soft bedding or other soft items. Suffocation is also a serious concern.
In fact, as this study points out:
Unintentional suffocation is the leading cause of injury death among infants <1 year old in the United States, with 82% being attributable to accidental suffocation and strangulation in bed.
Additionally, the study examined the reasons behind infant suffocation during sleep, and found that by far, the most common cause of suffocation was “soft bedding,” compared to “overlay” (another person unintentionally suffocating the baby while co sleeping) or “wedging” (the baby being stuck between two surfaces, such as the mattress and the wall). In short, soft bedding is to blame for most infant suffocation cases.
As we discussed with SIDS, at 12 months, healthy babies are able to maneuver fairly well in the crib and are able to re-adjust if a blanket or a stuffed animal is restricting breathing. Any younger, and they might not be able to sufficiently adjust themselves in order to clear the airway.
What constitutes “soft bedding?”
Soft bedding can include (but isn’t limited to) the following:
Stuffed animals
Pillows
Loose fitted sheets
Light blankets
Heavy blankets
Sleeping wedges
Crib bumpers
Soft mattresses
Is Swaddling Safe?
If you are swaddling an infant, always position them on his or her back. Check out our post on proper sleeping positions for more info about the supine sleep position.
A properly swaddled baby doesn’t present a SIDS or suffocation risk because of the position of the blanket. It’s okay to swaddle—as long as it’s done correctly.
Here’s a helpful video on swaddling; the more you practice, the better you’ll be at it.
If your baby begins to break out of the swaddle on a regular basis, then we recommend that you stop swaddling, since the loose blankets can present a SIDS hazard. Most babies stop requiring a swaddle around 3-4 months. If your baby prefers to be swaddled when sleeping, a wearable blanket or sleep sack can offer the same security without the risk of a loose blanket.
Will my baby be cold if I don’t let him sleep with a blanket?
Your baby doesn’t need a snuggly blanket for warmth. In fact, overheating is another risk factor for SIDS, and the perfect room temperature for your baby may be lower than you think.
Check out this post on optimal room temperatures for babies to find out more.
What can I use as an alternative to soft bedding?
Instead of soft bedding, you can keep your little one at the right temperature by using:
Sleep Sacks / wearable blanket - a wearable blanket designed to keep babies warm while reducing the risk of SIDS. Get a sleep sack here.
Sleepers - a soft, one-piece outfit designed to keep babies warm while sleeping. You can find sleepers at almost any store that sells baby clothing. Sleepers are available in lighter fabrics (for warmer climates and seasons), and heavier fabrics (for colder seasons). It may take some trial and error to find a style and fabric that suits both you and your baby.
When can babies have pillows and blankets?
Ultimately, most professionals recommend the following:
0-4 months - no blankets or soft bedding.
4-12 months - no blankets or soft bedding.
12+ months - it’s snuggle time!
What do I need to know when my one-year-old starts sleeping with a blanket or soft bedding?
After 12 months of age, you’re out of the higher-risk zone for SIDS and sleep suffocation. That said, there are still some best practices you should follow when determining what to add to your child’s crib—if you choose to add anything at all.
Avoid weighted blankets, which are designed for older children and adults
Don't use large blankets, which can still get twisted up and may end up blocking a baby’s airway
Avoid blankets with strings or ties, which can present a strangulation hazard
Position the blanket correctly—no higher than chest level, and tucked under the mattress on three sides
Keep large or heavy stuffed animals out of the crib, as they could still present a suffocation risk
Be aware of choking hazards, including eyes, noses, or buttons on stuffed animals
Keeping your child safe is your number one priority, and creating and maintaining a safe sleep environment plays a large role in that. So remember: don’t let your baby sleep with a blanket or other soft bedding before the age of 12 months. If you follow that golden rule, you’re doing a lot to keep your baby safe.
What's Next?
Take one of our professional CPR courses for babies online. You can be trained and certified within 30 minutes.