Safe Sleep for Babies
The six Red Nose Australia principles, paediatric red flags, and where to find the detail.
- Last reviewed
- Sources cited
- 5 sources
- Author
- Dr Jubal John, FRACP
- Category
- medical guides
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Take-home
The Safe Sleeping (Back to Sleep) campaign launched in 1991. Sudden infant death rates have fallen from around 1.9 per 1,000 live births in 1990 to about 0.3 per 1,000 today: roughly 1 in 3,000. The six Red Nose Safe Sleep principles are the evidence-based backbone.
The six principles
Sleep baby on the back
From the very first sleep. Never on the tummy or side.
Keep the face + head uncovered
No loose blankets, pillows, bumpers, soft toys, sheepskins or hats indoors.
Smoke-free before + after birth
No smoking in pregnancy, and no smoking near baby after.
Safe sleep space, every sleep
Firm, flat, safe mattress in an Australian-standard cot. In the parents’ room for the first 6–12 months.
Don’t let baby overheat
Light layers; room temperature comfortable for a lightly dressed adult (16–20 °C).
Breastfeed if you can
Breastfeeding is protective against SUDI. Any amount helps.
- Sleep baby on the back: every sleep. Not side, not tummy.
- Keep head and face uncovered. A well-fitted sleeping bag beats blankets.
- Smoke-free, before and after birth. Vaping is not a safe substitute.
- Safe sleep environment. Firm, flat mattress; cot to Australian Standard. No bumpers, pillows, doonas, soft toys, positioners. Inclined sleepers, bean bags, couches, car seats outside the car, none are safe for sleep.
- Breastfeed where you can. Any amount lowers SIDS risk.
- Room-share for the first 6-12 months: baby in their own cot or bassinet, in your room.
Bed-sharing is never safe with
- Smoking by either parent
- Alcohol, cannabis or sedating medication
- A premature or low-birth-weight baby
- A soft surface (couch, armchair, waterbed)
- Duvets, pillows or heavy blankets near baby
Temperature: keep it simple
Dressing for sleep
- Room comfortable for an adult in light sleepwear (≈18-22°C).
- Baby dressed as you are, plus one layer (e.g. onesie + sleeping bag).
- Check the back of the neck or chest for warmth, not hands or feet.
When to ring, or call 000
Watch closely — MCH Line 13 22 29 for advice
Worth a review
- Uncertain about cot fit, mattress firmness or sleeping bag sizing
- Baby consistently uncomfortable on the back
- Strong head-turning preference or developing flat spot
Call 000 / seek urgent review
- Any episode of apnoea, colour change, or unresponsiveness
- Baby found unresponsive in sleep, call 000 immediately, start CPR if trained
- Previous near-miss event
Where to find the detail
The right next step
- Red Nose Australia: the six principles in full, FAQs, helpline.
- Raising Children Network — Safe sleeping: clear plain-English summaries.
- RCH safe-sleeping guideline: hospital-grade version.
- Infant CPR: see Choking & infant CPR — where to learn. Every parent of a newborn should learn this once, in person.
Related reading
- Tummy time, the awake counterweight
- Unsettled baby — the crying peak
- Positional plagiocephaly
- Choking & infant CPR
Unsure whether your sleep setup is safe?
Bring a photo of your cot to your first review, a practical safe-sleep check takes five minutes.