Safe Sleep

Infant sleep-related deaths are one of the leading causes of infant death in Baltimore City, and they are overwhelmingly preventable. 


Explore this page to learn more about keeping babies safe during sleep,

including stories, frequently asked questions, and support.

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Does your baby sleep safe?


Babies should never sleep with anyone else. Share a room, but not a bed with your baby.

Babies should always sleep on their backs. Babies are less likely to choke when on their backs.

Babies should always sleep in a crib – every night and every nap. The crib should be clean and clear. There should be no toys or blankets in the crib.

Never smoke cigarettes or marijuana in a home with babies, young children, or pregnant women. Smoke in the home makes it harder for babies to breathe well.

Don't Smoke

Safe Sleep Media Center


Why do I need to get a crib for my baby to sleep?

The crib is the ONLY safe place for your baby to sleep. Your baby shouldn’t sleep on an adult bed or couch or with pillows, cushions or stuffed animals. Your baby could be suffocated in these soft materials. Your baby also could become trapped in between cushions on a couch or get stuck between the bed and the wall. These tragic situations occur all too frequently in Baltimore City.

Why should my baby sleep alone? I feel safer with my baby near me.

We know that when parents sleep in the same bed as their baby, they are trying to do what they think is best. Unfortunately, co-sleeping is really dangerous. Most sleep-related deaths in Baltimore happen when babies sleep with an adult or with other children. Remember, it doesn't take much for a baby to suffocate. Co-sleeping is a common practice in some cultures. While it is wonderful to preserve most cultural traditions, some need to be adapted. For example, American beds are soft, high, and have a lot of blankets and pillows. These features make them unsafe for babies. If you are worried about bonding, keeping your baby's crib in your room is a great idea! Share a room, not a bed.

My mother and auntie are telling me they placed their babies on their stomachs while sleeping and that I slept on my stomach, so my baby should sleep on his stomach. Should I listen to them?

A lot has changed in the last 20 years and we now know a lot more about infant safety. We have learned that babies are a lot safer on their backs than on their stomachs. In fact, when pediatricians began recommending that babies sleep on their back, the number of babies dying in their sleep dramatically decreased.

But isn't my baby more likely to choke on their back?

Many parents believe that babies are more likely to choke if they sleep on their back. This is not true. In fact, your baby is LESS likely to choke on his or her back. This animation helps explain why back sleeping is safest:

My baby looks uncomfortable on his back. He can't sleep that way.

Put your newborn baby on his or her back to sleep from day one. Your baby will get used to sleeping like that way —soon it will seem natural. If your baby has been sleeping on his stomach, it may take a few days for him to get used to it, but rest assured—he will. You can also use a pacifier to calm your baby and help him or her go to sleep. Research suggests that pacifiers help reduce risk too. It may take some time, but babies adapt. With your baby sleeping safely, you will sleep better, too!

Won't my baby get cold without a sheet or blanket?

Dress your baby in a sleeper for warmth, but do not use blankets or allow your baby to get too warm. Overheating can be a risk for SIDS. A good rule of thumb is to dress your baby in the same amount of layers that you are wearing. If the room temperature is comfortable for you, then it is also comfortable for your baby.

What if my baby can roll over?

Once babies are able to roll over from back to stomach on their own, there is no need to watch or reposition them during sleep. Babies should still be placed on their backs for sleep, but you don't need to worry about keeping them that way. Do not use a pillow or rolled up blanket to keep your baby on his or her back. These items increase the chances of your baby suffocating.

What kind of crib should I get for my baby?

Your baby’s crib does not need to be fancy or expensive, but it must be safe. There are many types of stationary and portable cribs (such as a Pack ‘n Play™ or the portable crib given out by HealthCare Access Maryland) that are safe—you just have to make sure that it meets current safety guidelines. When purchasing a crib, look for Juvenile Product Manufacturers Association (JPMA) certification. If you borrow a crib, check to make sure that the slats are no more than 2-3/8 inches apart. Widely spaced slats can trap an infant's head. The mattress should be firm and fit snugly in the crib. The crib sheet should fit tightly all the way around and under the mattress. Nothing else should be in the crib with your baby – no quilts, blankets, comforters, pillows, bumper pads, stuffed animals, or soft toys. Car seats and infant carriers should not be used as your baby’s bed. Your baby could get knocked over or roll over. It’s just not worth taking a risk.

Doesn't my baby need to spend time on their tummy?

Yes! You can provide 'tummy time' when he is awake and being watched. This will help strengthen his neck and arm muscles and prevent flat spots on the back of his head.

Why is it important to have a smoke-free home?

Babies who breathe in smoke are more likely to have lifelong health problems. They are also more likely to die while sleeping.

Smoke is a houseguest that always overstays its welcome. Even if you open a window, it drifts around the house and even stays in fabrics and dust. Keep the air in your home clean by asking smokers to go outside.

Here are some tips to make your home smoke-free:

  • Ask smokers to smoke outside

  • Get all ashtrays, matches, and lighters out of your home

  • Post a sign on your front door so visitors know not to smoke 

My baby sleeps better when they’re next to me. What are some other ways to sooth them?

It can be tempting to bring a fussy baby into bed with you, but it is not safe. In Baltimore, most babies who die in their sleep were sharing a bed with a family member.

The sleep habits you set now will carry into childhood. When you put your baby to sleep in a crib from the beginning, they will get used to it. You will also be able to sleep better and more soundly knowing your baby is safe.

Here are some of the things that you can do to help your baby sleep peacefully in their crib:

The first few weeks with a baby are rewarding, but the lack of sleep can be challenging. Hang in there. It will get better.

Safe Sleep: FAQs

Sometimes safe sleep is not as simple as ABCD. These partners are here to provide extra support to make sure you have the knowledge and tools needed to create a safe sleep environment for your little one. 

Safe Sleep Resources


Free Portable Crib Program

If you can't afford a crib, HealthCare Access Maryland will help qualified families. 


24 Hour Parent Helpline

If you are feeling overwhelmed, The Family Tree will provide free and confidential support.


24/7 Substance Use/Mental Health Help

If you are in crisis, Baltimore Crisis Response, Inc. will connect you to help and services.


Smoking Cessation Support

If you need help quitting smoking, MD Tobacco Quitline will connect you to free support.