Fort Worth, Texas,
11
July
2017

When Can My Baby Sleep With A Blanket And Pillow?

Let's Learn Something: Safe Sleep For Your Baby

From Dr. Diane

Tears were dripping down my face after I read this. 

This sweet baby died at age 7 months by getting tangled in a blanket in his crib. 

Please don't put blankets (or anything other than a paci) in your baby's crib. 

With a heavy heart, Dr. Diane

Ok. Let's get real about the stuff in your kid's crib.

I get the question all the time at my office in Willow Park - "When can my baby safely have a blanket/pillow/lovey/stuffed animal in the crib with her?" I'll try to answer that here.

Don't we pediatricians seem silly sometimes? We're always lecturing you about what not to do. DO NOT put your baby on their stomach to sleep. DO NOT put anything in your child's crib. DO NOT sleep with your baby in your bed! DO NOT use those darn crib bumpers!

We seem mean, right? And strict. And out-of-touch with surviving the sleep deprivation involved in raising a small person.

I'm here to tell you that the reason we tell you these things is because we don't want your baby to die. Dramatic, I know. And I'm not trying to fear-monger. Hear me out.

A recent study by the American Academy of Pediatrics found that over half of American sleep environments for babies under 1 do not follow recent "safe sleep" recommendations. That's so scary to me.

Babies have died by suffocating under stuffed animals, blankets, and bumpers in bed. I know it seems silly, but it's happened. Open up your web search engine and do a quick search. I've personally done CPR on a 4-month-old infant who had gotten their little head trapped between a bumper and a crib rail. I will never forget the look on the mother's face of another child, a newborn who suffocated on a pillow in the crib. These memories haunt us, folks. These babies' deaths were preventable.

The reason these tragedies happen, and the reason we harp on "safe sleep environments" is because before age one, babies still have not developed the muscle strength and coordination to deal with crib items the way an older child or adult can. And their brains are still not old enough or developed enough to wake them up to change a dangerous situation, like their face being mashed into a soft mattress, or a blanket covering their head. They are not coordinated enough or strong enough to unwrap a tangled loose sheet, or unwedge their head from a loose bumper.

I don't think you should put anything in the crib with your baby, other than a wearable/zip-up blanket and a pacifier, until they are 12 months old.

After that, have at it. My 3 year old sleeps with no less than 15 animals/blankeys in his bed at night. My 18 month old has a small blanket and a lovey she adores and needs right now to soothe herself to sleep. The incidence of crib deaths drops drastically after age 1 - typically if a toddler dies suddenly in bed, it is due to a medical issue (though there are very rare exceptions out there).

Before age 1, put a wearable blanket on your baby. They're in all the baby stores and online, are washable, and they're affordable. They should have arm holes and a hole for the head, and should zip up. They come in linen, fleece, you name it. They keep kids warm enough in the winter.

Pacifiers are OK in the crib anytime. In fact, studies in recent years have shown a paci used at night drastically reduces the chance for SIDS death.

Loveys are a tough one. I consider a "lovey" to be one of those small pieces of cloth with a little soft animal head attached. I think they're safe to introduce around 6-9 months - when a child's core muscles are nice and strong and they're easily able to roll, prop up to sitting, and self-soothe. Some of them are bigger than others. I'd be worried if one was long enough to wrap fully around a child's head or neck.

You could do a little experiment to see if your baby is ready for a lovey. After they fall asleep, take the lovey and put in on their face, then observe. Do they breathe easily? Do they eventually swat it to the side? If the answer is yes, it's ok to keep it around!

I am a big believer in healthy baby sleep practices and children learning to self-soothe when they are ready. I hope this helps guide you in what can safely go in the crib!

Hugs,

Dr. Diane

Get to know Diane Arnaout, M.D.

Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. You can stay connected with Dr. Arnaout and the Willow Park practice on Facebook. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She attended college at Texas A&M University and medical school at the UT Health Science Center in San Antonio. She did her pediatric internship and residency at Children's Memorial Hermann Hospital and M.D. Anderson at the Texas Medical Center in Houston, TX where she served as a leader on the medical education committees. She is a board-certified pediatrician. Click to learn more.

Comments 1 - 5 (5)
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Amy
10
January
2017
Our babies will not sleep unless on their tummies. I know this can be an issue but they turn their heads in their sleep very well. If we flip them over to their backs, no sleep for anyone. They are 9 months now. Should we keep trying to break this habit and just go with it as it's the only real sleep anyone gets?
Dr. Diane
10
January
2017
Thank you for the great question. The minute a baby can flip from their back to their tummy, it’s perfectly fine to let them sleep on their belly. This proves to me that they are strong enough to avoid suffocation and move their head easily if their face is pressed into a mattress.
sophie
09
March
2017
my baby is going to be a year old in one month, i found that this pass 4 months she has been making a sort of pillow with her blankey. my question is is she ready for a toddle breathable pillow ? or should i just wait until shes older ? my baby sits and stands and rolls over on own and now already walking with a help.
Paul
04
July
2017
Doc, I have a house that constantly hovers between too hot and too cold. Even the different rooms vary. My baby is 14 months old. He typically sleeps in shorts and a short sleeved shirt. He weighs around 23 pounds. I wouldlove to give him a blankie, but we are, understandably, terrified of the unthinkable. Think I could start introducing a blankie? We have a monitor with a movable camera that stays beside us at night. Bonus: He sleeps from about 9:30 to 8 AM
Chris Green
13
July
2017
How is it that products like Docatot are so popular? My granddaughter has slept on the docatot for 7 months and it scares me so! They are outrageously expensive and so dangerous according to this summary. Are parents just not paying attention?
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