Safe Sleep Guidelines for Newborns in Australia

Safe sleep practices are among the most important things new parents can learn. In Australia, organisations like Red Nose Australia (formerly SIDS and Kids) have developed evidence-based guidelines that have dramatically reduced the rate of sudden unexpected death in infancy (SUDI), including Sudden Infant Death Syndrome (SIDS). This guide explains these guidelines in practical terms and shows how to apply them when using a bassinet.

The Six Safe Sleep Recommendations

Red Nose Australia's safe sleep recommendations are built on decades of research into infant sleep deaths. Following these guidelines significantly reduces your baby's risk of SUDI.

Sleep Baby on Their Back

The "Back to Sleep" campaign has been one of the most successful public health initiatives in history. Placing babies on their back to sleep reduces the risk of SUDI by a significant margin compared to stomach or side sleeping.

This recommendation applies to every sleep, including naps during the day. Even if your baby seems to prefer sleeping on their stomach, back sleeping is essential until they can roll independently in both directions—at which point they have the motor control to manage their own position.

Common Concerns About Back Sleeping

"Won't my baby choke if they spit up?"

Research shows that healthy babies sleeping on their backs are not at increased risk of choking. Babies have natural reflexes that cause them to swallow or cough up fluids, and their airway anatomy actually protects them better when they're on their back.

"My baby doesn't settle on their back."

Some babies do initially resist back sleeping, particularly if they've experienced tummy time or have reflux. Consistent practice, swaddling (for young babies who can't roll), and allowing baby to fall asleep in your arms before placing them down can help with the transition.

Keep Head and Face Uncovered

Overheating and covering the face both increase SUDI risk. The safest approach is to keep the sleep space completely bare—no pillows, no loose blankets, no toys, no bumpers, no sleep positioners.

If you're concerned about your baby being cold, the solution is appropriate clothing rather than bedding:

• Swaddle wraps: Suitable for young babies who cannot roll. Ensure the swaddle is snug around the chest but allows hip movement.
• Sleep bags (wearable blankets): Safe alternatives to loose blankets that cannot ride up over baby's face.
• Layered clothing: Multiple light layers are preferable to one heavy layer, allowing easy adjustment.

Room Temperature

The ideal room temperature for baby sleep is between 18-22°C. Babies regulate temperature less efficiently than adults and can overheat quickly. Signs of overheating include sweating, damp hair, heat rash, rapid breathing, and restlessness.

Check your baby's temperature by feeling the back of their neck or their tummy—these areas should feel warm but not hot or sweaty. Don't rely on hands and feet, which are often cooler than core body temperature in babies.

Keep Baby Smoke-Free

Exposure to tobacco smoke—both during pregnancy and after birth—significantly increases SUDI risk. This includes:

• Maternal smoking during pregnancy
• Secondhand smoke in the home or car
• Third-hand smoke (residue on clothes, furniture, etc.)
• Smoking by any caregiver who holds or sleeps near baby

If quitting smoking isn't immediately possible, never smoke in the house, car, or anywhere near the baby. Remove and change clothes after smoking before handling the baby. Even these steps don't eliminate risk entirely, but they reduce exposure.

Safe Sleeping Environment

Creating a safe sleep environment means ensuring the physical space where your baby sleeps meets specific safety criteria—every time, for every sleep.

The Sleep Surface

Your baby's sleep surface should be:

• Firm: No sagging, no soft spots, no memory foam
• Flat: No inclines, wedges, or raised sections
• Well-fitted: Mattress fits snugly with no gaps at edges
• Clean: Free from mould, mildew, or hygiene issues

For bassinets specifically, only use the mattress that came with the product. Aftermarket mattresses may not fit properly and can create dangerous gaps or change the sleep angle.

What Should NOT Be in the Bassinet

The only things in the bassinet should be the baby and a fitted sheet. Remove:

• Pillows and cushions
• Loose blankets, quilts, or doonas
• Bumpers or padded liners
• Toys, stuffed animals, or comfort objects
• Sleep positioners, wedges, or nests
• Anything attached to the bassinet sides that could come loose

Room Sharing Without Bed Sharing

Red Nose Australia recommends that babies sleep in the same room as their parents for the first six to twelve months, but in their own safe sleep space—not in the adult bed.

Why Room Sharing Is Recommended

Room sharing allows parents to monitor their baby during sleep, respond quickly to any issues, and facilitates breastfeeding. Studies show that room sharing is associated with reduced SUDI risk compared to babies sleeping in a separate room.

Why Bed Sharing Carries Risk

Adult beds are not designed for infant sleep. Risks include:

• Soft bedding and pillows that can obstruct breathing
• Gaps between mattress and headboard/wall where baby can become trapped
• Risk of overlay (adult rolling onto baby, especially when fatigued)
• Increased overheating from adult body heat and bedding

The safest setup is a bassinet or cot positioned next to the parent's bed, close enough for easy access but as a separate sleep surface. Bedside bassinets that attach to the adult bed can offer the benefits of proximity while maintaining separation.

If Bed Sharing Occurs

While bed sharing is not recommended, Red Nose Australia acknowledges that it sometimes happens, particularly during night feeds when parents are exhausted. If bed sharing occurs:

• Ensure baby is on their back
• Use a firm mattress (not water bed, beanbag, or sagging mattress)
• Keep pillows and blankets away from baby
• Never bed share if you've consumed alcohol, drugs, or sedating medications
• Never bed share on a couch or armchair (extremely high risk)
• Return baby to their own sleep space as soon as possible

Breastfeeding and Safe Sleep

Breastfeeding is associated with reduced SUDI risk. If breastfeeding isn't possible or isn't your choice, following all other safe sleep guidelines still provides significant protection.

For breastfeeding parents, having the bassinet close by makes night feeds easier and may help you avoid the temptation of bringing baby into bed and falling asleep together.

Supervised vs. Unsupervised Sleep

It's important to distinguish between supervised rest (when you're awake and actively watching baby) and unsupervised sleep (when you're also sleeping or in another room).

During supervised rest, you might hold baby on your chest or let them nap in a bouncer while you're right there. During unsupervised sleep, baby should always be in their bassinet or cot on their back with nothing else in the sleep space.

Creating Consistent Sleep Habits

Applying safe sleep guidelines consistently—for every sleep, day and night, regardless of location or caregiver—is essential. Make sure grandparents, babysitters, and childcare providers understand and follow the same practices.

Consider creating a simple checklist or visual reminder that you can share with caregivers: Back to sleep, bare sleep space, own sleep surface, same room as caregiver.