When Can My Baby Sleep With A Blanket And Pillow?

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

I get the question all the time at my office in Forest 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 12 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