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Can my infant sleep with a blanket?
Q: When is it safe to give an infant a blanket to sleep with? My daughter is 15 months old and I wonder if a blanket would give her comfort during sleeping times.
A: All day long, you're tending to your baby's needs—feeding, changing diapers, playing—and constantly supervising your baby to make sure she's safe. And then at naptime or nighttime, have you ever hovered anxiously over your sleeping baby to listen for the sound of her breathing, just to make sure she's still okay? When you put your baby to sleep, you need to be sure your child's environment is as safe as possible so both of you can sleep peacefully.

Sudden Infant Death Syndrome or SIDS—when a baby dies during sleep—is rare, but it affects one-two out of 1,000 infants in the United States. SIDS is most common in the first 6 months of life. Although the cause of SIDS is often unknown, studies have found many factors that increase the risk of SIDS and many things parents can do to reduce the risk. Thankfully, since 1992, safety recommendations from the American Academy of Pediatrics and the U.S. Consumer Product Safety Commission have cut the rate of SIDS in the U.S. by almost one-half. Follow these recommendations for your baby's first year to help him or her sleep safely:
  • Have a healthy pregnancy: Eat well, take your prenatal vitamins; , and don't smoke cigarettes, drink alcohol, or take drugs. Be sure to get early and regular prenatal care.
  • Breastfeed your baby: Breastfeed for at least one year, if possible. Breastmilk contains nutrients and antibodies that help keep your baby healthy.
  • Ensure a smoke-free environment: Don't smoke, and make sure nobody else smokes around your baby, especially in your home and car.
  • Get a safe crib: Make sure your baby sleeps on a firm mattress, not a waterbed, comforter, sheepskin, or pillow which can smother the baby. The crib should comply with the current safety standards—the gap between the railings less than 2 3/8' so your baby doesn't slip through and strangle himself; and no cornerpost extensions greater than 1/16' because clothing can catch on them and strangle the baby. Don't position the crib next to window blinds or drapery cords because these can also strangle the baby. Many parents feel more comfortable with the baby sleeping in their room, and some studies have suggested that infants can sleep safely in bed with their parents. But the Consumer Product Safety Commission recommends that infants not sleep in their parents' bed since babies have died when they smothered in the bedding, an adult rolled on top of them, or they got trapped between the bed and the wall.
  • Put your baby to sleep on her back: Remember the slogan 'Back to Sleep,' and make sure your baby's other caregivers (e.g., relatives, babysitters, child care providers) do the same. This is the safest position for almost all babies—if your baby has a medical condition, talk with your pediatrician about the best sleep position. Once you've put your baby to sleep on her back, you don't need to constantly watch over her and reposition her if she rolls onto her side or tummy—once she's strong enough to roll over, the risk of SIDS is a lot less.

    Some parents worry that babies are more likely to choke on their backs, but this is not true. Some worry that their baby's head gets flattened, but this rarely causes problems and usually resolves after infancy. However, you will want to be sure to give baby enough 'tummy- time' play during the daytime.
  • Remove soft bedding: It's best to put your baby to bed in a sleeper outfit without a blanket, since some babies have smothered in blankets. If you use a blanket, tuck it in at the bottom and sides of the crib and away from your baby's face. Don't put stuffed toys or pillows in the crib because they can also smother the baby.
  • Don't overheat your baby: Overheating is unhealthy for babies. Keep the baby's room at a comfortable temperature for you, and dress the baby as warmly as you are dressed.
  • Follow the schedule for regular doctor visits: You baby's doctor will continue to check your baby's health, give him the necessary immunizations, and give you more advice on how to keep your baby safe and healthy.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician