At Avocado, we make products for the whole family, and we hear from parents who want to create a safe sleep space for their infant. This article summarizes the current infant safe-sleep recommendations from the American Academy of Pediatrics (AAP) and links to the AAP's own materials so you can read the full guidance directly. It is general education, not medical advice, for guidance about your child, please talk with your pediatrician.
The recommendations below come from the AAP's 2022 policy statement, Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, which remains the AAP's current guidance. They apply to the first year of a baby's life unless a pediatrician advises otherwise.
The AAP's core safe-sleep recommendations
The AAP frames these as a set of connected, evidence-based recommendations. According to the AAP:
Back to sleep, every time. Place a baby on their back for every sleep, every nap, and every night — for the first year. The AAP notes that side and stomach positions are not safe alternatives.
A firm, flat sleep surface. The AAP recommends a firm, flat, non-inclined surface (inclined no more than about 10 degrees) that meets current federal safety standards for cribs, bassinets, or play yards, with a fitted sheet and nothing else.
Room-sharing, not bed-sharing. The AAP recommends that a baby sleep in the parents' room, close to the parents' bed but on a separate infant-safe sleep surface, ideally for at least the first 6 months. (More on this below.)
Keep the sleep space bare. The AAP advises against soft bedding of any kind in the baby's sleep area — no pillows, blankets, quilts, comforters, bumper pads, soft toys, or weighted blankets or sleepers.
Avoid overheating. The AAP suggests dressing a baby in about one more layer than an adult would wear, and watching for signs of overheating.
The AAP also points to additional measures that may lower risk, including breastfeeding where possible, offering a pacifier at sleep time, keeping the baby away from smoke and nicotine, and giving plenty of supervised, awake tummy time during the day.
Room-sharing vs. bed-sharing
This is one of the questions parents ask us most, so it's worth stating plainly what the AAP recommends.
The AAP recommends room-sharing without bed-sharing: keeping the baby's separate sleep surface in the parents' room, rather than having the baby sleep in an adult bed. The AAP's position is that the safest place for an infant to sleep is on their own firm, flat surface — not on an adult mattress or on a couch, sofa, armchair, or other soft or cushioned surface. According to the AAP, room-sharing this way — on a separate surface in the parents' room, rather than in an adult bed — can reduce the risk of SIDS by as much as half.
The AAP describes certain situations as carrying meaningfully higher risk, including an infant sleeping on a couch or armchair with another person, sleeping alongside someone who is unusually tired or whose alertness is affected by medication, alcohol, or other substances, sleeping in the presence of smoking, and bed-sharing in the early months of life. The AAP's accompanying technical report details the evidence behind these points.
Approximately 3,500 infants die in sleep-related circumstances in the United States each year, which is why the AAP treats the sleep surface and sleep location as central to safe sleep. The AAP also encourages caregivers to approach these conversations supportively and without judgment, and that is the spirit in which we share this information.
Choosing a safe sleep surface
For infant sleep, the AAP recommends a product made and tested for infants — a crib, bassinet, or play yard that meets current federal safety standards — with a firm, flat mattress and a fitted sheet, and nothing else in the space.
Adult mattresses, mattress toppers, pillows, cushions, and other soft surfaces are not designed for infant sleep and are not recommended by the AAP as an infant sleep surface. If you are setting up a sleep space for a baby, the AAP recommends using a dedicated infant product that meets these standards.
Frequently asked questions
Can my baby sleep in my bed with me?
The AAP recommends room-sharing without bed-sharing — keeping your baby close, in your room, but on their own separate infant sleep surface rather than in an adult bed.
Is an adult mattress or a mattress topper a safe sleep surface for a baby?
No. The AAP recommends that infants sleep on a firm, flat surface made for infants — a crib, bassinet, or play yard that meets federal safety standards. Adult mattresses, toppers, and other soft or cushioned surfaces are not recommended for infant sleep.
What kind of surface does the AAP recommend for a baby?
A firm, flat, non-inclined surface (no more than about 10 degrees) that meets current federal safety standards, fitted with a tight sheet and nothing else — no pillows, blankets, bumpers, or soft toys.
How long should we room-share?
The AAP recommends room-sharing ideally for at least the first six months.
Where can I read the AAP's full guidance?
You can read the AAP's safe-sleep guidance written for parents on HealthyChildren.org, the AAP's parent-facing website, or review the full policy statement on the American Academy of Pediatrics website.
A note on this article
This article is general educational information drawn from the American Academy of Pediatrics' 2022 safe-sleep policy statement. It is not medical advice and does not replace guidance from your pediatrician or other qualified health professional. For questions about your child's sleep, please consult your pediatrician.
Source: American Academy of Pediatrics, "Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment," and the accompanying technical report (Pediatrics, 2022).