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A Blog from Your Kaiser Permanente Pediatricians in Northern California

Your FAQs about Infant Sleep Answered, Part 1

They say the one thing all new parents have in common is feeling exhausted. All. The. Time. I know I was! So it makes sense that parents have lots of questions about how to help their babies sleep better.

Here are some of the questions I hear the most with answers from me, my fellow pediatricians, and pediatric health educators.

Is it okay to bring our baby into bed with me/us? 
No. The safest place for a baby to sleep is in a safe crib (firm mattress, no bumpers, pillows, or blankets) – not in the parent’s bed.

Why is sharing your bed unsafe?
You (or your partner) may unknowingly roll over on your baby. Your bed’s soft mattress, pillows, or fluffy blankets can increase the risk of suffocation.

It’s fine to bring your baby to bed with you to nurse and/or snuggle but be sure to return them to their own safe bassinet or bedside sleeper when you feel tired. 

Does my baby really need to sleep face up?
Yes, please put your baby down on their back and face up! Doing this dramatically reduces their risk of SIDS. Sleeping on the stomach can make it harder to breathe. Other safety and comfort tips:

  • Avoid side sleeping. Babies placed on their sides can easily tip over onto their stomachs.
  • Turn your baby’s head to one side or the other as you lay them down if this makes you feel better. There’s no evidence that babies are more likely to choke when on their backs.
  • Reposition your baby throughout the night as needed, until they can roll over on their own.

Is it okay for our baby to sleep in the car seat or swing? 

  • Don’t let them sleep in a car seat or swing as a usual practice. This is especially important for young babies who are less able to lift their heads if they’re slouched down.
  • Be sure to move them to their own safe sleep space as soon as possible if they happen to fall asleep in the car, stroller, or swing. It’s okay to leave them there for a few minutes if you’re watching them.

When should we switch from a bassinet or bedside sleeper to a crib?
When your baby starts to seem crowded in the bassinet, switch to a safe crib in your room.

When should we move our baby into their own room? 
The AAP recommends that your baby sleep in the same room with you until at least 6 months to 1 year. Some families who want to sleep train their babies coordinate training plans around the shift out of the parents’ room.

I heard we shouldn’t use blankets in the crib. Won’t our baby be cold?
You can keep them warm with zip-up sleepers or sleep sacks. Loose blankets, pillows, and bedding are hazardous.

How long can we swaddle our baby? 
Try to ease your baby out of the swaddling by around 2 months. Once they can roll over, a tight swaddle can be dangerous. Leave an arm loose, so if your baby flips over, they can push up to breathe, instead of being stuck face down. Or only swaddle from chest down. Once your baby starts rolling over, it’s time to stop swaddling, for safety reasons.

Is it ok to use a pacifier? 
Yes. Pacifiers satisfy your baby’s need to suck and will help them self-soothe. These also reduce the risk of SIDS. Follow these guidelines:

  • Offer your baby a pacifier at nap and nighttime, but don’t force them to take it – some babies just don’t like them. Offer it again another time.
  • Consider putting multiple pacifiers in the crib, so one is always within reach. Pacifiers will drop out once your baby falls asleep.
  • If you’re breastfeeding, wait until it’s going well (usually after a few weeks) before you introduce a pacifier.

How do we encourage good sleep if our baby still needs nighttime feedings?
It’s normal for young babies to wake in the night to feed. About half of 2- to 3-month-old babies are ready to go without eating for a 6-hour stretch at night. Others aren’t ready until 4 or 5 months. You know your baby best.

Make nighttime feedings brief and boring – only about business so your baby knows it’s time to sleep – not play! Here’s how:

  • Don’t turn on bright lights, move slowly, and be quiet with little talking.
  • Avoid diaper changes unless your baby seems very wet or uncomfortable. (Some parents will double-diaper at night to prevent leaks.)
  • Most babies can sleep for at least 6 hours by the time they’re 6 months old.

Our baby wants milk all night long to sleep. How can I stop this? 
If your baby is 4 to 5 months or older, this is likely “comfort nursing” rather than true hunger. Some things to try:

  • Move the bassinet or bedside sleeper further away from your bed.
  • Encourage your partner to be “on duty” for soothing during stretches of the night.
  • Feed more often during the day and evening.
  • Decrease the number of times you feed in the middle of the night, and shorten each feeding, until you’re down to one late at night and in early morning.

Find more resources for parents:
Pediatric Sleep Council
American Academy of Pediatrics

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.