Put babies on their backs on a firm, flat surface, sharing your room but not your bed, with no soft objects
Place the baby face upward on a firm flat sleeping surface in the same room as you but in a separate bed. Keep pillows, blankets, bumpers, stuffed toys and head-shaping pillows out. Inclined rockers and infant seats are not sleep spaces. Around 3,500 US infants die from sleep-related causes each year.
What it takes
The routine is free; replacing a mattress with a firm one may cost a few hundred RMB in China. Consistently resisting contrary family advice can be difficult.
What you may gain
The US has approximately 3,500 annual sleep-related infant deaths, including sudden infant death syndrome, unexplained deaths and accidental suffocation in bed. The American Academy of Pediatrics recommends supine sleep, a firm noninclined surface, room sharing without bed sharing, and avoidance of soft bedding and overheating. Breastfeeding, avoiding nicotine/alcohol exposure, routine immunization and pacifier use also reduce risk.
Context & considerations
“No soft objects” includes pillows, quilts, bumpers, toys, shaping pillows and nursing pillows. Inclined bassinets and seats are not beds. The author ranks this as the chapter's highest-impact action and one that may require firm boundaries with older relatives.
Research & references
Moon RY, Carlin RF, Hand I, Task Force on Sudden Infant Death Syndrome and the Committee on Fetus and Newborn (2022). Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. Pediatrics, 150(1), e2022057990. https://doi.org/10.1542/peds.2022-057990