Crib safety: a guide to preparing a safe sleeping environment

Updated Oct 07, 2022
Crib safety

If you’re unsure about safety and sleep, you’re not alone. It’s common to hear contradictory advice from well-meaning friends and family as sleep-safe guidance continually evolves. Great news for you: we’ve rounded up the most current information from the experts regarding crib safety, right here. 

IN THIS ARTICLE:

General overview of crib safety

7 Tips for crib safety

AAP crib safety standards

How to make a crib safe

Crib safety FAQ

Safe sleep guidance has changed quite a bit in the last few decades. Since 1992, the “Back to Sleep” public health campaign (now called Safe to Sleep) has urged caregivers to place infants down to sleep on their backs — a big departure from the common practice of placing babies to sleep on their stomachs. The campaign has been successful in raising safe sleep awareness. Sudden Infant Death Syndrome (SIDS) rates have decreased by almost 50% in the United States since the start of the campaign.

Additionally, the American Academy of Pediatrics (AAP) has continued to provide updated guidance to caregivers and medical professionals to reduce sleep-related infant deaths. In June 2022, the AAP’s Task Force on SIDS revised the previous 2016 guidelines. Research still supports placing babies “back to sleep” — meaning infants should be set down to sleep on their backs on a flat (non-inclined) surface, without loose blankets, pillows, or other soft objects in the baby’s sleep space.

Here are the most important things to consider when placing your baby in their crib to sleep — the non-negotiables. Note that these tips apply to babies in the first year of life unless otherwise noted.

Make sure to get the grandparents on board for this one. When it comes to sleep time, ensure that all caregivers know to lay your baby down on their back on a flat surface to reduce the risk of suffocation and entrapment in their sleep space. 

If your baby is now able to roll both ways (front to back and back to front), they can be allowed to remain on their stomach or side if they’ve moved into that position on their own (after you’ve placed them down on their back).

The crib mattress should be flat and firm. Inclines over 10 degrees aren’t safe, so skip the wedges and don’t place anything under the mattress to elevate one side. You’ll know it’s firm enough if it doesn’t change its shape when you lay something on it.

Ensure the mattress is designed for your specific crib and is tight-fitting. It should be the same size as the crib — without gaps to trap arms, body, or legs. Try the “two-finger test” if you have any doubts: you shouldn’t be able to fit more than two fingers in between the mattress and sides of the crib.

Stay away from bumper pads. They increase the possible risk of suffocation, strangulation, or entrapment for infants. Toddlers might also use bumper pads to help them climb and fall out of the crib. The Safe Cribs Act, which was signed into law in May 2022, bans the sale of crib bumpers in the United States.

Pillows, loose blankets, mattress toppers, stuffed animals, and other soft objects should not be placed in an infant’s crib as they’re a suffocation hazard. Your baby can still be kept cozy, though; swaddles or sleep sacks can be used for warmth and comfort. Be sure to transition away from the swaddle when your baby shows signs of starting to roll. 

Unfortunately, injuries from crib falls are fairly common. Here’s the good news, though: falls are often avoidable when the crib mattress is kept at the lowest appropriate setting. 

When it comes to adjusting the position of the mattress, you’ll want to stay ahead of developmental milestones. Lower the crib mattress before your baby learns to sit, so they can’t fall out either by leaning against the side or by pulling over it. Similarly, move the mattress to its lowest position before your child starts to stand. 

The AAP recommends moving your child out of the crib when they’re 35 inches tall to avoid injuries related to climbing out of the crib. 

Cords, necklaces, and strings are a strangulation hazard for babies and young children. It’s best to keep your child’s crib or bed away from windows so blinds or drape cords aren’t within reach. In fact, the Consumer Product Safety Commission (CPSC) recommends using cordless window coverings when possible. Likewise, keep any cords from monitors and white noise machines away from your child’s sleeping area.

Weighted blankets, weighted sleepers, and weighted swaddles should not be used on or placed near an infant. In their newly revised recommendations, the AAP notes that these are not safe and thus not recommended.

The AAP recommends that sleep surfaces adhere to federal safety standards set by the CPSC. 

Here’s what the AAP wants you to know when choosing a crib:

  • Cribs that were manufactured before 2011 should not be used.

  • Refrain from using cribs that are broken, modified, or have a drop-side design.

  • Crib slats are closer now. They should be no more than 2 3/8 inches apart to help prevent a baby’s body from fitting through the slats.

  • All of the screws, brackets, and hardware should be properly installed. Avoid cribs with missing, loose, broken, or improperly installed parts (even if they have been fixed). Do not attempt to fix broken cribs.

  • Corner posts should be flush with the railing (or really high like a canopy bed), so your child's clothing cannot catch.

  • Don’t use a crib with a decorative cutout in the headboard or the footboard, as they pose a risk of the baby’s head or limbs getting trapped.

Most children will be left unattended for long stretches in their crib, so parents will want to ensure that both the crib furniture itself and the space within the crib don’t pose safety risks. In a nutshell: use a crib made after 2011, and always place your baby to sleep on their back. The mattress should be firm, flat, and tight-fitting. Keep your baby’s sleep environment clear of everything but a fitted sheet. 

Crib safety FAQ

Q: What are the safety requirements for cribs?

A:

The current federal safety standards for cribs were set by the CPSC in 2011 and most recently revised in 2014. Choose a crib manufactured after 2011 and check the CPSC website for recalls.

Q: Are cribs from the 90s safe?

A:

The AAP recommends using a crib manufactured after 2011, as that’s when federal safety standards were updated. Older cribs likely don’t meet the current federal safety standards.

Q: What safety things should you look for when buying a crib?

A:

Choose a crib manufactured after 2011. Avoid cribs that are broken, modified, have decorative cutouts, or have a drop-side design.

Q: What is the most common injury due to cribs?

A:

Soft tissue injuries, typically to the head and neck, were among those most frequently seen, according to a 2011 study of injuries related to cribs, playpens, and bassinets in children under 2. These tend to be caused by falls from the crib, which is why it’s important to lower the mattress as your child grows and ensure there aren’t toys or bumpers in the crib that can be used to climb out of the crib.

Q: How can you help prevent crib-related accidents from happening?

A:

Use a crib manufactured after 2011, and check it for safety (i.e., a firm, tight-fitting mattress and no missing or loose pieces). Infants should be placed on their backs and sleep in a bare crib. In other words, keep pillows, loose blankets, and other soft objects out of the crib and use only a fitted sheet. Lower the mattress before your baby begins to sit unassisted and again before they stand.

Q: Are crib bumpers safe?

A:

Crib bumpers should not be used for infants or toddlers. They can increase the risk of suffocation, strangulation, or entrapment for younger babies, and older babies can use them to climb out — leading to falls.

Q: Are crib wedges safe?

A:

No, sleep surfaces with inclines of more than 10 degrees are not safe for infant sleep. Nothing should be placed under the mattress to elevate the baby or create an angle.

Q: Are crib tents safe?

A:

Maybe not. While the AAP hasn’t specifically addressed the use of crib tents, the CPSC announced a recall in 2012 after dozens of tent failures resulted in injuries and one fatality.

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Note: The content on this site is for informational purposes only and should not replace medical advice from your doctor, pediatrician, or medical professional. If you have questions or concerns, you should contact a medical professional.