Infant sleeping conditions

Red Nose is often asked by parents about appropriate sleeping conditions for their babies, such as what sort of bedding to use, and what room temperature is best. These are important issues as babies control their temperature through the face and head. Sleeping baby on the back and ensuring that the face and head remain uncovered during sleep is the best protection from overheating and suffocation.

The association between overheating and Sudden Infant Death Syndrome has been known for several years. Current research suggests that if your baby becomes too hot, the risk of SUDI is increased. Overheating can be caused by room heating, high body temperature and excessive clothing or bedding.

Here are some answers to these questions and advice on safe sleeping.

What bedding should we place on baby when in a sleeping environment?

• Sleeping baby in a safe baby sleeping bag will prevent bedclothes covering the baby’s face
• If using blankets instead of a sleeping bag, use layers of lightweight blankets that can be added or removed easily, and which can be tucked underneath the mattress
• Soft bedding such as quilts, doonas, duvets, sheepskins or lambs wool, pillows and bumpers and fluffy toys should be removed from baby’s sleep environment
• Keep baby’s head uncovered when indoors or in a car: no bonnets, beanies, hats or hooded clothing

Can we say exactly how many blankets to use when baby is placed in bed?

• The simple answer is no – many factors need to be considered before deciding how much bedding or clothes should be used
• Use layers and dress baby as you would for yourself: to be comfortable, neither too hot nor too cold
• Dress baby for sleep and add/remove lightweight blankets to ensure baby’s chest feels comfortably warm to the touch
• Make up baby’s bed so baby sleeps at the bottom of the cot and the blankets can only reach as far as baby’s chest, ensuring baby cannot move down during sleep and get his/her head covered by bedding
• Research has shown that baby’s risk of dying suddenly and unexpectedly is increased if baby is sleeping on the tummy, and particularly under heavy bedding, or if baby’s head becomes covered by bedding in any position

What temperature should the room be where infants sleep?

• Red Nose does not recommend a specific room temperature for healthy babies. To date, there is no evidence to show that maintaining a specific room temperature prevents sudden infant death and there is no evidence to show that thermal factors are implicated in SIDS as long as:

  – the baby is placed to sleep on the back

  – the baby is dressed appropriately for the room temperature (not over or under dressed)

  – the baby’s head and face remain uncovered

• It is not necessary to monitor the room temperature or to leave the heating or cooling on all night or day as long as the baby is dressed appropriately for the room temperature
• To prevent overheating of infants, parents need to use their own judgement depending on:
  – where you live (the climate, whether it is summer or winter)
  – the temperature in the room where baby is sleeping
  – whether the infant has a cold or illness (hence raised body temperature).
• A good way to check baby’s temperature is to feel baby’s chest, which should feel warm (don’t worry if baby’s hands and feet feel cool, this is normal). If baby is sweating or has a red face, remove some bedding or clothing. This may be necessary if baby is unwell, in which case you should seek medical attention

Best practice to avoid overheating

• Dress baby as you would yourself – comfortably warm, not hot or cold
• Use a baby sleeping bag
• Sleep baby on the back
• Ensure that baby’s head and face cannot become covered
• If using bedcoverings, use layers of lightweight blankets that can be added or removed easily and which can be tucked underneath the mattress
• Remove baby’s head covering as soon as you go indoors or enter a warm car, bus or train, even if it means waking the baby
• Never use electric blankets, wheat bags or hot water bottles for babies