Is it safe to co-sleep? Can babies use pillows? We answer your biggest questions about baby sleep

Where should my baby sleep?

The Lullaby Trust advises the safest place to put a baby’s crib or cot is in the same room as caregivers for the first six months.

"For safe sleep, all babies need is a firm, flat, waterproof mattress in good condition in a cot or moses basket, and a sleeping bag or firmly tucked-in sheets or blankets,” says Kate Holmes, Head of Support and Information at The Lullaby Trust, the charity that provides parents with expert advice on safer sleep as part of its mission to raise awareness of SIDS (Sudden Infant Death Syndrome).

“We would not recommend any sleep surface that does not conform to these guidelines. Pillows or any other extras, such as toys or quilts, duvets or cot bumpers can increase the risk of an accident."

Loose items in your baby's cot increase the risk of SIDS if the item accidentally manages to cover your baby's face and nose whilst they sleep.

The Lullaby Trust has listed the below as being unsafe for your baby's sleeping area:

• Pillows and duvets.
• Cot bumpers.
• Soft toys or comforters.
• Loose bedding.
• Weighted or bulky bedding.
• Any products (such as wedges or straps) that will keep your baby in one sleeping position.
• Pods or baby nests, rolled up towels or anything soft placed on top of the mattress.

What are the safe sleep rules for babies?

According to The Lullaby Trust, you should follow these rules for safer sleep:

• Lie your baby on their back at the foot of the cot.
• Keep their cot clear of unnecessary items.
• Use a firm, flat, waterproof mattress.
• Keep the house and your baby smoke-free.
• Avoid letting your baby get too hot.
• Sleep your baby in the same room as you for at least the first six months.

What’s the best position for my baby to sleep in?

The single most important and effective action that parents can do is to place your baby on their back to sleep at night and for daytime naps.

That's because your baby's SIDS risk greatly increases if they are sleeping on their front, rather than their back. Since the Back to Sleep campaign began in 1991, when official NHS advice changed from prone (front-down) sleeping to supine (front-up) sleeping, the 'cot-death' rate in the UK has dropped by 80%.

So, make sure you place your baby down on their back for every day and nighttime sleep from day one (unless your doctor explicitly advises otherwise). And keep doing it: safe-sleep experts at The Lullaby Trust say the SIDS risk substantially rises for babies who are usually placed on their back to sleep, but are sometimes put down on their side or front instead.

If your baby rolls onto their tummy, gently turn them back again. But, once your baby is able to roll over onto their tummy and back again (which usually happens at about the age of six months), it’s fine to let them find their own sleeping position once you've put them down on their back.

What if my baby gets a flat head from sleeping on their back?

It’s very common for babies to get a slightly flattened head shape as a result of sleeping on their back (the recommend safe-sleeping position) – but it’s not painful and it nearly always corrects itself over time.

"We do get calls from many parents asking if they can use pillows as they are worried about their baby getting flat head syndrome," says Kate from The Lullaby Trust. "We tell them it's quite normal for babies to develop a slightly flat head when they sleep on their back, and, in the vast majority of cases, it resolves itself within a few weeks or months."

There are also other, much safer, things you can do to help prevent your baby's head looking flat. Rachel Harrington, a physiotherapist and clinical specialist in paediatric orthopaedics, suggests you:

• Give your baby plenty of tummy time.
• Cut down on the amount of time your baby spends lying on their back when they are awake; try using a bouncy chair or a baby carrier as alternatives.
• Alternate between pram and baby carrier when you're out and about.
• Swap sides, and maybe even types of hold, regularly if you're breastfeeding, so your baby gets used to using different muscles.

"If you are concerned about the shape of your baby's head," says Dr Philippa Kaye, an NHS GP, "or notice your baby only turns their head to one side, then do see your GP. They might want to run some tests or refer you to a physiotherapist."

Is it safe to co-sleep with my baby?

In recent years, co-sleeping has become recognised as a risk factor for cot death or SIDS. The American Academy of Pediatrics recommends that parents don’t co-sleep at all.

Recent research points towards the risks of co-sleeping. Most of this research highlights where you co-sleep and your state whilst sleeping. Falling asleep on a sofa is very risky for your baby and has been conclusively linked to cot death.

Likewise, if you’ve had even one glass of wine or a painkiller you shouldn’t co-sleep with your baby as suffocation is much more likely when a co-sleeping parent sleeps deeply.

If you’re choosing to co-sleep, you can help make it safer and feel more confident in your decision by taking the following into consideration:

• Your baby must sleep on their back.
• Don’t have a pillow near your baby.
• Don’t cover your baby with your duvet, or use an electric blanket or hot water bottle.
• Place your baby on the outside of the bed next to you, not between you and your partner.
• Don’t co-sleep if your baby is exposed to cigarette smoke during the day.
• Don’t drink alcohol or take any form of pain medication before bedtime.

What should my baby wear to bed?

What your baby wears for bed or for naps is determined by their age, room temperature and the weather.

During summer:

• A breathable, cotton, footless babygrow or sleepsuit with short sleeves.
• Newborns can be swaddled but use a thin, breathable swaddle blanket.
• Older babies can use a sleeping bag with a lower tog rating.

During winter:

• A breathable, cotton, footed babygrow or sleepsuit with long sleeves.
• Newborns can be swaddled in a swaddle blanket.
• Older babies can use a sleeping bag with a higher tog rating.

Can babies sleep with blankets?

During colder months, your baby may need some blankets and a sheet as well as wearing their sleepsuit. The blanket should be firmly secured into the sides of their cot (never above their shoulders) to prevent suffocation if the blanket was to shift onto their face.

In warmer months, and depending on the room temperature, your baby may only wear a vest and a tightly secured sheet over them.

Lightweight cotton is the way to go for any kind of layers your little one will be using as it's breathable and gentle on baby's skin.

What temperature should my baby’s bedroom be?

Newborn babies are not able to regulate their body temperature as well as older children and adults can. They can be prone to overheating if they have too many layers of clothing on or if the room is too warm.

A room temperature of between 16ºC to 20ºC (60.8°F to 68ºF) is recommended by the safe-sleep experts at the Lullaby Trust and the NHS.

For peace of mind, consider buying a room thermometer, that’ll let you know whether the toom is too hot or cold.

How do I know if my baby is too hot at night?

If you're feeling hot, your baby will likely be too. As a guide, think about what you'd be comfortable sleeping in, and add one extra layer for your baby.

Signs that your baby may be too hot:

• Sweating (some babies sweat more than others. If your baby feels very sweaty, check to see how hot they are by feeling the back of their neck).
• Damp skin or hair.
• Flushed, red cheeks.
• Heat rash.
• Heavy breathing.
• Their stomach feels hot to the touch.

If your baby’s hot to the touch, wipe them down with a clean damp towel – on the face, neck, arms and legs – and open internal doors and windows, so a natural, flowing breeze is created.

How do I know if my baby is too cold at night?

Signs that show your baby may be too cold:

• Feeling cold to touch on their stomach, back or neck.
• Waking up frequently.
• Pale, blotchy or blue skin.
• Shivering (usually shows up in babies over six months).
• Slow movements or lethargy.

If any of these occur, add some layers to your baby making sure that it's not too much to make them overheat. If they're awake, you can partly undress and hold your baby onto your bare chest and wrap the both of you in a blanket. Skin-to-skin contact is a great way to regulate your baby's body temperature.

Can I put my baby’s crib next to a radiator?

The short answer is no.

Sheila Merrill, public health advisor at RoSPA (The Royal Society for the Prevention of Accidents) said: “We recommend keeping baby’s cot away from radiators due to the potential for serious, life-changing burns.

“A child’s skin is four times thinner than an adult’s so even the slightest contact with hot surfaces can cause serious pain and scarring."

Can my baby sleep in a headband?

"We recommend that babies do not have their head or face covered while sleeping," says Kate from The Lullaby Trust.

"Head-covering can lead to suffocation or overheating which can increase the risk of SIDS."

We're not saying baby headbands aren't safe; they're fine when your baby is awake. But you should remove them before your baby goes down for a nap, as well as thinking about taking them off whenever you can't watch your baby closely – for example, if you have them in a car seat.

When can my baby sleep with a pillow?

“You should never let any baby under the age of 12 months sleep with a pillow,” says Dr Philippa.

"Generally, it is considered safe to use pillows after the age of one," agrees Kate.

Saying that, there is no reason to rush out and buy one on your baby's first birthday if your child seems quite happy sleeping without one.

And it's worth knowing that the American Academy of Pediatrics³ advises US parents not to use pillows before their child turns two.

If you do decide to buy a pillow for your toddler, make sure that it's toddler-size and that it's firm, washable and made of breathable materials. Be especially careful if you're buying online: look for labels that show it conforms to British Standards for safety and flammability.

Is a dummy at night safe for my baby?

There is some research suggesting that giving your baby a dummy when you put them down to sleep could reduce the risk of SIDS.

If you're breastfeeding, it's generally advised that it's best to wait till your baby is about four weeks old (by which time breastfeeding is usually well established) before introducing the dummy. And it's also recommended that you then stop offering a dummy when your baby is six months to one year old.

It's important to choose a dummy with an orthodontic teat and to only use it for sleeping (or napping) – to avoid any damage to those baby teeth.

Is swaddling safe for my baby?

Swaddling can be safe if done with thin materials and not too tightly or above the shoulders. Always place a swaddled baby on their back to sleep.

You should stop swaddling as soon as your baby shows signs of trying to roll over, which is often around four months old.

What else can I do to reduce my baby’s risk of SIDS?

• Keep your baby smoke-free before and after birth. Being a smoker greatly increases the chance of SIDS if you bed-share – even if you do not smoke in the bedroom.
• Never sleep with your baby on a sofa or armchair. Your baby can slip into gaps between the cushions, or you may roll or slip down on top of your baby.
• Breastfeeding, even for a short time, can help reduce the risk.
• Share a room with your baby for at least the first six months, but not the same bed.
• Always follow the safe sleep guidelines for every sleep, day and night.