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Newborns: Safe Sleep & Injury PreventionNewborns: Birth - 2 Months

Introduction

On this page, you’ll learn how to create a safe sleep environment to protect your baby. If you choose to swaddle your baby, don’t miss our step-by-step video to reduce risks.

You’ll also find information about the areas to watch to keep your newborn safe from injuries.

Safe sleep for the first year

Reduce the risk of SIDS

Babies spend a lot of time sleeping and need a safe sleep environment. Research tells us that creating a safe sleep environment will help reduce the risk of sudden infant death syndrome (SIDS) and prevent other sleep-related injuries and death in babies. Below, you’ll learn what you can do to protect your baby in their first year.

Put your baby on their back to sleep, for every sleep

Whether it’s nap time or nighttime, at home or with their caregiver, the safest position for your baby to sleep is on their back. This helps lower their risk of SIDS. Even when your older baby can roll over on their own, research tells us it’s safest to put them on their back to sleep. If they roll over, you don’t have to move them back.

Use a crib, cradle or bassinet that meets Canadian safety standards

The safest place for your baby to sleep is in a crib, cradle or bassinet. Learn more about things to consider when buying cribs, cradles or bassinets.

Playpens are for play

Playpens should not be used for unsupervised sleep—they don’t meet the same safety requirements as cribs, cradles and bassinets.

Keep your baby’s crib, cradle or bassinet free of clutter

A clutter-free space reduces your baby’s risk of SIDS and helps prevent them from being trapped, strangled or suffocated. A safe crib, cradle or bassinet has:

  • a firm, flat mattress that’s in good condition and fits snugly into the frame
  • a tight-fitting bottom sheet for the mattress that is designed to fit the crib, cradle or bassinet
  • no soft items such as stuffed toys
  • no plastic mattress cover or bumper pads, and no loose bedding such as pillows, heavy blankets, quilts or sheepskins
  • no positioning devices such as wedges, towels, rolls or positioning pillows

Putting a blanket over top of the crib, cradle or bassinet to block out light is not advised, as it can cause the baby to overheat. If the blanket falls on your baby, it can also decrease airflow and could smother them.

Baby, dressed in a sleeper, sleeping on their back in a crib that is free of blankets, toys, and other items. Crib mattress fits snugly in crib and is covered by tight-fitting bottom sheet.

A note about infants sleeping in car seats

Car seats are designed to keep babies safe during travel. It’s not safe for babies to sleep in a seated position—their head can fall forward because their muscles are underdeveloped, and this can make it hard for them to breathe. When you get to where you’re going, take your baby out of the car seat, and put them on their back to sleep on a safe sleep surface.

Keep your baby warm, not hot

When babies get too hot (overheat), it increases their risk of SIDS. Your baby is too hot if they’re sweating or if their chest feels too warm to the touch.

Babies are safest when the room temperature is comfortable for an adult wearing light clothing. If your home is cool, choose a warmer sleeper for your baby. Try not to over-bundle or over-dress your baby. Babies don’t need blankets. If you choose to use a blanket, make sure it’s:

  • light-weight
  • firmly tucked under 3 sides of their mattress
  • only reaches up to your baby’s chest
Baby placed on back to sleep on a firm, flat mattress. A light-weight blanket is firmly tucked in and reaches only to the baby’s chest. Baby’s arms are outside of the blanket.

A note about sleep sacks

Sleep sacks come in a variety of thicknesses and materials. Choose a lightweight sleep sack to reduce the risk of overheating. If you’re using a sleep sack, you don’t need a blanket. Make sure the sleep sack is an appropriate size for the baby’s weight and fits properly around the neck and armholes. If the sleep sack is too large or loose, it could strangle and suffocate your baby.

What about hats?

Babies don’t usually need to wear hats when they’re indoors. Your health care provider may have put a hat on your baby right after birth to keep their temperature stable. When you’re at home however, your baby will not need a hat as it might make them too hot. Learn more about using hats when it’s cold outside and when it’s warm outside.

Keep spaces smoke-free

Help keep your baby healthy by being smoke-free. Babies whose parents smoked while pregnant are at a much greater risk of SIDS. Babies who are exposed to second-hand smoke, both before and after birth, are also at a greater risk of SIDS. Make sure no one smokes around your baby—at home, during travel or while being cared for by others. Learn more about tobacco and tobacco-like products.

For help to cut down and quit smoking, visit AlbertaQuits or call them toll-free at 1-866-710-QUIT (7848).

Share a room with your baby

Room-sharing means that your baby sleeps in the same room as you or another person, but on a separate sleep surface like a crib, cradle or bassinet. It’s recommended that you share a room with your baby for at least the first 6 months.

Room-sharing:

  • keeps your baby close and safe
  • supports the bond between you and your baby
  • makes it easier to learn and respond to your baby’s cues
  • makes it easier to feed your baby, especially at night. If you bring your baby into bed for feeding, put them back in their own crib, cradle or bassinet before you go to sleep.
Baby sleeping on their back in a crib that is free of blankets, toys, and other items. Baby is dressed in a sleeper. Parent is sleeping in the same room in a bed beside the crib.
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Do not share a bed, sofa or any other sleep surface with your baby

Bed sharing means that a baby sleeps on the same surface, like a bed or a sofa, with another person. This includes a parent, caregiver, child or even a pet. Bed sharing increases your baby’s risk of SIDS and other sleep-related injuries and death.

Bed sharing also creates risks related to falls, strangulation or suffocation if your baby gets:

  • trapped between a mattress and headboard or footboard
  • wedged against a wall or a person
  • tangled in bedding, pillows or cushions

Twins and other multiples are also safer when sleeping on their own and not sharing a sleep surface. The risk is that one infant may entrap the other causing them to suffocate, in the same way an adult or older child could if they were sleeping together.

If you choose to bed share:

  • Never sleep with your baby on any soft or padded surface such as a sofa, upholstered chair, bed with a soft mattress or bedding, or water or air-filled mattress.
  • Keep bed covers, blankets and pillows far away from your baby.
  • Make sure you and your partner always know when your baby is in the bed with you.
  • Never share a bed with your baby if you or your partner:
    • smoke
    • have used alcohol, cannabis, other drugs, or any prescription, over-the-counter or herbal medicine that makes you sleepy or less able to respond to your baby’s needs
    • are overtired from stress or lack of sleep

If you choose to bed share, make sure you follow all the information provided. Remember that taking these steps may reduce some of the risk, but it does not make bed sharing safe.

Sleeping on the same surface is not safe

Sharing a bed, sofa or any other surface with your baby while sleeping is not recommended. This has been a factor in a number of deaths related to SIDS.

Breastfeed your baby

Breastfeeding may offer some protection against SIDS. Exclusive breastfeeding for the first 6 months of life is recommended.

Taking your baby into bed for feeding or for comfort is risky if you fall asleep. Lying down to feed is an effective feeding position for many parents. However, it’s easier to fall asleep if you’re in this position, especially if you’re tired. To stay awake while feeding your baby in your bed, try wiping your face and neck with a wet cloth or keeping the room lights, TV or music on. Put your baby on their back in their own crib, cradle or bassinet if you feel sleepy. If you choose to sleep with your baby on the same sleep surface or feel you may fall asleep while feeding your baby, follow these recommendations to reduce some of the risks.

A note about soothers and SIDS

Research tells us that using soothers (pacifiers) may help reduce the risk of SIDS. However, the research is not clear if soothers interfere with breastfeeding. Learn more about soothers.

Cribs, cradles and bassinets

All new and used cribs, cradles and bassinets must meet Canadian safety regulations. If you’re borrowing or buying one, make sure it comes with the manufacturer’s instructions or that they’re available online. The instructions should include the model, date of manufacture, assembly instructions and warnings. Always follow the manufacturer’s instructions when putting it together.

Crib safety laws

Cribs made before September 1986 do not meet current Canadian safety regulations and should not be used. It’s against the law to advertise, sell or give away such cribs.

Standards and recalls

To learn more about crib, cradle, bassinet and playpen standards and recalls, visit the Government of Canada – Cribs, Cradles and Bassinets.

Whether new or used, make sure your baby has a safe crib, cradle or bassinet. Here are some do’s and don’ts to think about to ensure the safety of your baby’s sleep surface.

Do use a crib, cradle or bassinet if it:

  • has a mattress with the right thickness
    • a crib mattress that’s firm and not thicker than 15 cm (6 inches). Some crib mattresses have a soft side and a firm side—make sure the firm side of the mattress is facing up.
    • a cradle or bassinet mattress that’s firm and not thicker than 3.8 cm (1 ½ inches)
  • has corner posts that do not go higher than 1.5 mm (1⁄16 inches) above the crib rail
  • has a tight-fitting mattress with a gap less than 3 cm (1 3⁄16 inches) between the sides and the mattress. Push the mattress firmly against the sides to test this.
  • has spacing between the bars that is 6 cm (2 3⁄8 inches) or less

Don’t use a crib, cradle or bassinet if it:

  • has any missing, loose, worn, broken or damaged parts
  • is older than 10 years
  • has any fabric on its sides that does not attach securely to the frame
  • has any decorative cut-outs
  • has corner posts that are higher than 1.5 mm (1⁄16 inches) above the crib rail
  • has spacing between the bars that is more than 6 cm (2 3⁄8 inches)

Drop-side cribs do not meet Canadian safety regulations and should not be used.  Since December 2016, it is illegal to sell, import, manufacture or advertise them in Canada. If you have a drop-side crib, consider replacing it. If you continue to use it, make sure it has not been recalled. Ensure that both sides of the drop-side crib are in the up and locked position when your baby is in the crib. Stop using it if it has any loose or missing parts.

Move your baby from their cradle or bassinet to a crib when they reach the maximum weight recommended by the manufacturer or when they start to roll over—whichever comes first.

If being able to buy a suitable crib, cradle or bassinet for your baby is a concern for you, call Health Link at 811 or talk with your health care provider. They can help you find local organizations that can help.

Playpens

Playpens are designed for supervised play, and are not meant to be used for unsupervised sleep. They don’t have the same safety standards as cribs, cradles or bassinets.

Here are some things to think about to keep your baby safe when choosing and using a playpen:

  • Choose a playpen with tightly woven mesh. Your baby’s little fingers can get caught in mesh with large holes.
  • Only use the mattress pad that comes with the playpen. Check that it’s firm, not worn in any area, and fits snugly into the corners and sides.
  • If the playpen comes with attachments like a change table or bassinet, always follow the manufacturer’s instructions for putting it together and using it.
  • Keep blankets, pillows, soft toys and extra mattresses out of the playpen as these can cause your baby to suffocate.
  • Never put a baby to sleep on the change table attachment or put them in the playpen when the change table or bassinet is still attached. Their head can become trapped in the gap between this accessory and the playpen, and they can suffocate or get strangled.

Before you buy a used or new playpen, check online to see if there are any safety recalls on it. Always follow the manufacturer’s instructions for putting the playpen together and for using it. If you’re borrowing or buying a used playpen, make sure there are no tears in the vinyl rail coverings, mesh panels or mattress pad. Do not use the playpen if it’s damaged or has broken or loose parts.

Head shape

In the first 2 months, flat areas on a newborn’s head can develop very quickly. This is because their skull bones are soft, they have weak neck muscles, and they will usually rest their heads one way when lying on their back. These flat areas and possible neck stiffness can be prevented and treated.

Flat areas can be on the right or left side at the back of the head (plagiocephaly) or across both sides of the back of your baby’s head (brachycephaly), depending on how your baby likes to rest their head. These flat areas can change the shape of your baby’s head and face, and can be permanent if not treated early.

Changes to head shape do not affect your baby’s brain growth or development. The changes could make it more challenging for them to wear sports or safely helmets when they’re older.

Viewed from the top, normal newborn head shape is quite symmetrical with rounded areas around the front and back.Illustration of positional plagiocephaly. In the first 2 months, flat areas on a newborn’s head can develop very quickly. Viewed from the top, newborn head has a flat area on the back left corner, skewing the head shape diagonally.Illustration of brachycephaly. In the first two months, flat areas on a newborn’s head can develop very quickly. This is because their skull bones are soft. Viewed from the top, newborn head is flat across the entire back of the head.
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If your baby sleeps with their head turned consistently to one side, position them to encourage turning their head to the other side (their non-preferred side). Each night, place your baby in their crib with their feet in the opposite direction, as the previous night (see photos below). As babies tend to turn their head to look for you, positioning them in opposite directions will help them turn their non-preferred side to see you.

Continue to put your baby on their back to sleep. Do not use positioning devices during sleep, like wedges, towels, pillows or rolls as these can smother your baby.

Baby sleeping in a clutter-free crib with their feet pointing to the left side of the crib. If your baby sleeps with their head turned consistently to one side, position them to encourage turning their head to the other side (their non-preferred side).Baby sleeping in a clutter-free crib with their feet pointing to the right side of the crib. If your baby sleeps with their head turned consistently to one side, position them to encourage turning their head to the other side (their non-preferred side).

When your baby is awake:

  • Give them supervised tummy time every day, starting at birth.
  • Change the arm you use to carry your baby—right one day, left the next.
  • Carry your baby close to your body, facing over your shoulder.
  • Offer your baby both breasts at each feeding.
  • Alternate the arm you use during feeds if you’re feeding with a bottle.
  • Limit the amount of time your baby spends in a car seat, bouncy seat or swing. If you use these, position your baby’s head so it’s supported and is not always turned to one side.

If your baby always wants to look in one direction, use bright toys or the sound of your voice to encourage them to look in the other direction. If your baby always wants to look in one direction, they may have tightness in their neck muscles and may need treatment for this to improve.

Back to sleep, tummy to play

When your baby is awake and with you, place them on their tummy to play several times every day.

Call Health Link at 811 or your health care provider if you notice any of the following:

  • your baby only looks in one direction, or their head is tipped to one side
  • your baby has ongoing trouble breastfeeding on one side
  • you have trouble turning your baby’s head to one side
  • you notice a flat area on your baby’s head

Swaddling

To swaddle a baby means to wrap them snugly in a light blanket. Swaddling is often used to calm and soothe a baby, but babies don’t need to be swaddled for sleep. No matter which way you choose to swaddle, doing it properly can help reduce risks.

If you choose to swaddle your baby:

  • Always place your swaddled baby on their back—never on their tummy or side. This helps reduce the risk of SIDS.
  • Use a light-weight, breathable blanket to swaddle. Make sure your baby doesn’t get too hot. If their skin feels warm or your baby is sweating, remove the swaddle. A baby who is too hot is at a higher risk of SIDS.
  • Leave enough room for your baby’s legs and hips to move. A swaddle that’s too tight can cause problems with their hips, a condition called developmental dysplasia of the hip.
  • The swaddle must be secure enough for the blanket not to come loose and cause your baby to suffocate or become strangled. It should not be so tight that it makes it hard for them to breathe. Once you’re done swaddling, make sure you can fit your finger between your baby’s chest and the blanket.

When to stop swaddling

Swaddling must be stopped when your baby shows any of the following:

  • they no longer need swaddling to settle or calm themselves
  • they’re able to roll over
  • they’ve wiggled out of a swaddle even once—usually around 2–3 months of age

How to swaddle your baby

There are different ways to swaddle your baby. One way is called the ‘hands to heart’ method. In this method, your baby’s hands are tucked in to stop their arms from moving and startling themselves.

Here’s how to swaddle using the ‘hands to heart’ method: (swipe, tap or click the dots to move through the steps)

Step 1

Spread a light-weight, breathable blanket around 112 cm x 112 cm (42 inch x 42 inch) into a diamond shape. Fold the top corner in towards the centre. Place your baby on their back on top of the blanket. Their shoulders should be level with the folded edge so that the blanket is kept away from your baby’s face and their head and neck can move. Make sure the swaddling blanket does not cover your baby’s head.

Viewed from above, a square blanket is spread in a diamond shape, with the top corner folded in towards the centre. Baby is lying on the blanket on their back with their shoulders level with the folded edge and their feet in the middle of the blanket. The swaddling blanket does not cover the baby’s head.
Click dots for more

Preventing injuries

Newborns are at risk of injuries even though they don’t move much. Injuries often happen because parents are not aware of the risks to their baby. Wherever your baby is, there are many ways you can help keep them safe.

For their age and stage of development, here are some areas that need attention to keep your baby safe from injuries:

Learn more about preventing injuries in the early years.

Changing their baby on a change table, a parent keeps one hand on the baby to prevent a fall while they open a drawer with the other hand.