Cot death: How to reduce the risk

It’s not known why some babies die suddenly and for no apparent reason from what’s known as cot death or sudden infant death syndrome (SIDS). Experts do know that placing a baby to sleep on their back reduces the risk and that exposing a baby to cigarette smoke or overheating a baby increases the risk.

Cot death is rare, so don’t let worrying about it stop you enjoying your baby’s first few months. Follow the advice below to reduce the risks as much as possible.

To reduce the risk of cot death:

  • Place your baby on their back to sleep, in a cot in the room with you.
  • Don’t smoke during pregnancy or let anyone smoke in the same room as your baby.
  • Don’t share a bed with your baby if you’ve been drinking alcohol, if you take drugs or if you’re a smoker.
  • Never sleep with your baby on a sofa or armchair.
  • Don’t let your baby get too hot.
  • Keep your baby’s head uncovered. Their blanket should be tucked in no higher than their shoulders.
  • Place your baby in the ‘feet to foot’ position (with their feet at the end of the cot or pram).
  • The safest place for your baby to sleep is on their back in a cot in a room with you for the first six months.

Place your baby on their back to sleep

Place your baby on their back to sleep from the very beginning, for both day and night sleeps. This will reduce the risk of cot death. It’s not as safe for babies to sleep on their sides as on their backs. Healthy babies placed on their backs are not more likely to choke.

When the baby is old enough to roll over, don’t prevent them from doing so.

The risks of bed sharing

The safest place for your baby to sleep for the first six months is in a cot in a room with you. Don’t share a bed with your baby if you or your partner:

  • are smokers (no matter where or when you smoke and even if you never smoke in bed)
  • have recently drunk alcohol
  • have taken medication or drugs that make you sleep more heavily
  • feel very tired

The risks of bed sharing are also increased if your baby:

  • was premature (born before 37 weeks), or
  • was of low birth weight (less than 2.5kg or 5.5lb)

There’s also a risk that you might roll over in your sleep and suffocate your baby. Or your baby could get caught between the wall and the bed, or roll out of an adult bed and be injured.

Never sleep with a baby on a sofa or armchair

It’s lovely to have your baby with you for a cuddle or a feed, but it’s safest to put your baby back in their cot before you go to sleep.

Don’t let anyone smoke in the same room as your baby

Babies exposed to cigarette smoke after birth are at increased risk of cot death. Nobody should smoke in the house, including visitors.

Anyone who needs to smoke should go outside. Don’t take your baby into smoky places. If you’re a smoker, sharing a bed with your baby increases the risk of cot death.

Find help and support if you’d like to quit smoking.

Don’t let your baby get too hot (or too cold)

Overheating can increase the risk of cot death. Babies can overheat because of too much bedding or clothing, or because the room is too hot.

  • When you check your baby, make sure they’re not too hot. If your baby is sweating or their tummy feels hot to the touch, take off some of the bedding. Don’t worry if your baby’s hands or feet feel cool. This is normal.
  • It’s easier to adjust for the temperature by using lightweight blankets. Remember, a folded blanket counts as two blankets.
  • Babies don’t need hot rooms. All-night heating is rarely necessary. Keep the room at a temperature that’s comfortable for you at night. About 18°C (65°F) is comfortable.
  • If it’s very warm, your baby may not need any bedclothes other than a sheet.
  • Even in winter, most babies who are unwell or feverish don’t need extra clothes.
  • Babies should never sleep with a hot-water bottle or electric blanket, next to a radiator, heater or fire, or in direct sunshine.
  • Babies lose excess heat through their heads, so make sure their heads can’t be covered by bedclothes during sleep periods.
  • Remove hats and extra clothing as soon as you come indoors or enter a warm car, bus or train, even if it means waking your baby.

Don’t let your baby’s head become covered

Babies whose heads are covered with bedding are at increased risk of cot death. To prevent your baby wriggling down under the covers, place them in the ‘feet to foot’ position. This means that their feet are at the end of the crib, cot or pram.

  • Make the covers up so that they reach no higher than the shoulders. Tuck the covers in securely so that they can’t slip over the baby’s head. Use one or more layers of lightweight blankets.
  • Use a baby mattress that’s firm, flat, well-fitting and clean, and waterproof on the outside. Cover the mattress with a single sheet.
  • Don’t use duvets, quilts, baby nests, wedges, bedding rolls or pillows.

Feeding and dummies

Breastfeeding your baby reduces the risk of cot death. See Why breastfeed? for more information.

It’s possible that using a dummy at the start of any sleep period reduces the risk of cot death. However, the evidence is not strong and not all experts agree that dummies should be promoted. Don’t give your baby a dummy until breastfeeding is well established, usually when they’re around one month old. Stop giving them the dummy when they’re between 6 and 12 months old.

If your baby is unwell, seek medical help promptly

Babies often have minor illnesses, which you don’t need to worry about. Give your baby plenty of fluids to drink and don’t let them get too hot. If your baby sleeps a lot, wake them up regularly for a drink.

It can be difficult to judge whether an illness is more serious and requires prompt medical attention. See Spotting the signs of serious illness for guidance on when to get help.