Safe sleep comes down to a handful of simple habits. Once you know them, they quickly become second nature. This checklist follows the advice of Kind en Gezin, the Flemish child and family agency. On a few points, ONE, its counterpart in Wallonia and Brussels, or the Dutch sources say something different: you will find that here too.
The checklist at a glance
- Always put your baby to sleep on their back.
- Use an empty cot with a firm mattress: no pillow, duvet, cot bumper or large soft toys.
- Choose a sleeping bag that fits well.
- For the first 6 months, your baby sleeps in your room, in their own cot.
- Make sure your baby does not get too warm.
- Keep the environment smoke-free.
Lowering the risk of sudden infant death: what Kind en Gezin advises
Your baby is most vulnerable in the first six months, says Kind en Gezin (in Dutch). By following all the advice, at least during that period, you can greatly reduce the risk. The exact cause of sudden infant death is still unknown. The advice below comes from Kind en Gezin, with what ONE and the Dutch sources add.
Always on their back
Sleeping on the back is the only safe sleeping position, says Kind en Gezin (in Dutch). Sleeping on the tummy or the side is not safe. Lying on the side can help to comfort or settle your baby. When awake, your baby can change position, and that matters too.
Always put your baby down on their back. Can they roll over easily and roll back again? Then you do not need to turn them back during sleep. Medical reasons for a child to sleep on their tummy are rare.
An empty cot with a firm mattress
According to Kind en Gezin (in Dutch), you only need three things: a safe cot, a firm mattress and a sleeping bag that fits. Pay attention to the following:
- The mattress fits the cot: there is no more than 3 cm between the mattress and the side, whatever the position of the mattress. Preferably use only one mattress. A plastic sheet over the mattress is advised against.
- The bars are less than 6.5 cm apart (ONE, in French). The Dutch youth health care guideline (in Dutch) gives 4.5 to 6.5 cm.
- No pillow before 2 years. Kind en Gezin advises against a duvet before 1 year; VeiligheidNL, the Dutch injury prevention institute, says the first 2 years, and the Dutch guideline says never.
- No cot bumper, baby nest, baby hammock or nursing pillow in the cot. A comforter cloth or a small soft toy is fine.
- No tilted cot: your baby can slide down, which can restrict their breathing.
- Keep the cot away from heat sources, curtain cords, sockets and open windows.
Kind en Gezin also lists the European standards: EN 716 for a cot, EN 1130 for a cradle and EN 16890 for a baby mattress.
A sleeping bag that fits well
A sleeping bag helps stop your baby rolling onto their tummy before they can lift their head or roll back. Choose one with armholes that fit snugly. If the armholes and neck opening are too big, your baby can slip down inside the bag, get too warm and no longer breathe freely. Kind en Gezin recommends a sleeping bag that zips up from the feet. If its thickness suits the room temperature, you do not need an extra sheet or blanket.
Close to you, in their own cot
For at least the first 6 months, let your baby sleep in the room where you are. At night, they sleep as close as possible to your bed, in their own cot (Kind en Gezin, in Dutch). From 6 months you can consider their own room when you feel ready. There is no rush, says Kind en Gezin.
Sharing a bed is advised against, especially in the first 6 months. Kind en Gezin advises never doing it if you have had alcohol, drugs or medicines that make you drowsy, if you are overtired, if you or your partner smoke or you smoked during pregnancy, or if your baby is under 6 months, was born early or had a low birth weight. A bedside co-sleeper is, according to Kind en Gezin, a safe alternative: your baby is within reach.
Sleeping together on a sofa or in a chair is especially risky, because your baby can get trapped between you and the backrest, slip or fall. So feed your baby in bed if you can, not on a sofa or in a chair, and try not to fall asleep while feeding or comforting.
Not too warm
This is where the sources differ. Kind en Gezin (in Dutch) considers a room temperature of 15 to 18 °C warm enough. ONE recommends 18 to 20 °C where possible, and VeiligheidNL (in Dutch) gives 16 to 18 °C. If it is warmer, ONE advises covering your baby less, and Kind en Gezin advises adjusting clothing and bedding.
- Indoors, your baby does not need a hat.
- Cool hands and feet are normal. If the back of the neck or the tummy feels warm, your baby is not too cold.
For more on temperature, light and noise, read our article on the ideal sleep environment.
Smoke-free, before and after birth
Your baby needs a smoke-free environment during pregnancy and after birth, says ONE. Kind en Gezin also lists a smoke-free environment among the measures that reduce the risk of unexpected death during sleep. For those who really cannot stop, the Dutch guideline advises at least keeping the nursery smoke-free and not exposing the baby to smoke anywhere else.
Swaddling: temporary at most
Kind en Gezin sees swaddling as a temporary aid for some babies. Closeness, comfort and predictable routines matter at least as much in helping your baby settle. If you think your baby would benefit, always talk to a health professional first. Kind en Gezin (in Dutch) gives these rules:
- Do not start straight after birth, and do not start once your baby is 4 months old.
- Wind down from about 4 months and stop completely at 6 months. If your baby starts rolling earlier, stop straight away.
- Always put a swaddled baby down on their back, and leave room for the hips to move freely.
- Do not swaddle with a fever or illness, a respiratory infection, in the first 24 hours after a vaccination, or with an increased risk of or problems with hip development.
A swaddle bag, a sleeping bag without armholes, is on Kind en Gezin's list of products that are not safe for sleep. Kind en Gezin says never to use one for a baby older than 3 months. VeiligheidNL says the same, and advises stopping earlier if your baby starts to roll.
Dummies and breastfeeding
According to Kind en Gezin (in Dutch), studies show that a dummy reduces the risk of sudden and unexpected death during sleep, if you offer it at every sleep. If it falls out during sleep, you do not need to put it back. Do not attach a cord or chain to it. If you are breastfeeding, only start with a dummy once breastfeeding is well established.
Breastfeeding also lowers this risk, says Kind en Gezin. Breastfed babies do sleep in their parents' bed more often, which raises the risk again. So the safe sleep advice still applies.
Sleeping away from their own cot
A nap in the pram or the sling on a walk is fine, because your baby sleeps close to you and under supervision. Their regular place to sleep remains their own cot. The same goes for the car seat: limit the time in it to the journey itself and keep an eye on your baby. If your baby sleeps in a baby carrier, make sure their nose and mouth stay clear and their face stays visible (VeiligheidNL). When visiting or travelling, Kind en Gezin asks for extra supervision if your baby is not sleeping in their own cot.
What about a baby monitor or camera?
Look, listen and feel: that is how you know everything is fine, according to Kind en Gezin. A baby monitor or camera can help. It does not replace your senses. If your baby sleeps in the same room as you, you do not need a baby monitor.
If you use an Owlet Dream Sight, all the advice above still applies. The Dream Sight streams video to your phone and also tracks the temperature and humidity in the nursery. More questions about using it? See our FAQ.
Not sure?
If you have questions about your baby's sleep, talk to your Kind en Gezin team, ONE's child health clinic or your GP. In Flanders you can also call the Kind en Gezin line on 078 150 100. How much a baby sleeps at each age, and when to see a doctor, is covered in our article on baby sleep patterns. In an emergency, call 112.