Chart — Neonatal
Safe vs Unsafe Infant Sleep Chart
The safe-sleep environment, item by item, against the unsafe one. The one-line version: alone, on the back, in a bare crib, every sleep.
Educational use only. Reflects current AAP safe-sleep guidance; rare medical exceptions are provider-ordered and specific to a condition. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Feature | Safe | Unsafe |
|---|---|---|
| Position | On the BACK for every sleep, until age 1 | Prone or side-lying (side rolls to prone) |
| Surface | Firm, flat, non-inclined; fitted sheet only | Soft mattress, inclined sleeper, couch, armchair, car seat for routine sleep |
| Location | Own crib/bassinet in the parents' room (room-share) | Bed-sharing; sleeping on a sofa or chair with the infant |
| Bedding/items | Bare crib; sleep sack instead of blankets | Pillows, loose blankets, bumper pads, stuffed animals, positioners |
| Temperature | Dress one light layer more than an adult; cool room | Overbundling, hats indoors, hot room (overheating) |
| Protective factors | Breastfeeding, immunizations, pacifier at sleep onset, smoke-free | Smoke exposure (prenatal/postnatal); reliance on home monitors for safety |
Exam Traps
- ✦Back to sleep for EVERY sleep — naps included; side-lying is not a safe alternative.
- ✦Room-share, don't bed-share: separate sleep surface in the parents' room.
- ✦Bare crib — no bumpers, blankets, pillows, positioners, or toys; use a sleep sack.
- ✦Tummy time is awake and supervised; it prevents flat spots without breaking the rule.
- ✦Pacifier at sleep onset, breastfeeding, and immunizations are protective; smoke exposure and overheating are risks.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · Neonatal Resuscitation Program (NRP) · AWHONN. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →