Peering at the baby monitor watching your little one sleeping, you may feel a twinge seeing their little body all alone in the big crib. You may feel worried that they’ll get cold and think, “Wouldn’t they feel more comfortable with a blanket or pillow?”
You likely know from all the books you read during pregnancy that you should put your baby to sleep on their back in their crib on a firm mattress with only a fitted sheet.
Your baby’s doctor may have even told you during an appointment that babies shouldn’t sleep with blankets, pillows, or anything else in their crib to reduce the risk of sudden infant death syndrome (SIDS). But when is it safe to start giving them a blanket?
When can your baby sleep with a blanket?
It is not safe for babies less than 12 months old to sleep with blankets, according to the American Academy of Pediatrics. The American Academy of Pediatrics (AAP) recommends keeping soft objects and loose bedding out of the sleeping area for at least the first 12 months. This recommendation is based on data around infant sleep deaths and guidelines for reducing the risk of SIDS.
Beyond this guidance from the AAP, once your child is old enough, some other factors to consider when determining if it’s safe for your child to have a blanket in their crib include the blanket’s size, thickness, fabric type, and edging. Larger blankets can present strangulation and suffocation hazards that smaller blankets do not present — even after your child has turned 1.
The fabric of the blanket may influence its safety and whether it is appropriate to offer your sleepy baby. Blankets made from fabrics like muslin that can be breathed through are a better option for little ones than thick, quilted blankets. Weighted blankets that are sometimes used for older children with sensory concerns are not safe for use with infants. Even when a child is older, a blanket with long strings or ribbons on the edges can wrap around and choke the child, so those are not safe to use as a bedtime blanket.
If you’re thinking about allowing stuffed animals or other toys into the sleeping environment, in addition to the AAP’s age recommendation, it’s important to consider the weight of the object, the material it is made of, and if there are any small parts.
Larger objects — even stuffed toys — that can suffocate or crush should stay out of sleeping areas. Likewise, objects with small parts, such as sewn-on eyes or buttons, may be choking hazards that should be avoided in the sleeping area regardless of age.
Small children can be active sleepers. If you find that your child likes to rock and roll around their bed during the night, a sleep sack or footed pajamas may be safer than a blanket until they are older.
If you decide that your child is ready to use a blanket, make sure that the blanket is placed no higher than chest level and tucked around the mattress in the crib.
How can I keep my baby warm without using a blanket?
Before looking for alternatives to the blanket, it is important to know that the recommended temperature for a healthy and safe sleeping environment is between 20ºC and 22.2ºC all year round. Overdoing the layers of clothing or using heaters in the baby’s room can also increase the risk of sudden infant death from hyperthermia. You can use yourself as a yardstick to know whether or not your baby needs extra layers of clothing to sleep comfortably. This means that if you are cold, your baby probably will be too.
In these conditions, you can dress him with more layers of clothes, put on warm pyjamas and use sleeping bags. A sleeping bag is a safe dressing blanket that offers an extra layer of warmth to your baby’s body without the dangers that a regular blanket or sheets offer.
And the pillow, from when can baby use it to sleep?
At birth, babies’ necks are still very small and their heads are much larger compared to the rest of their bodies, so there is no need for a pillow. However, since the American Academy of Pediatrics started recommending that babies sleep on their stomachs, the number of deaths due to Sudden Infant Death Syndrome has dropped by half. Despite the decrease in deaths, pediatricians have noticed a significant increase in cases of babies with cranial asymmetries, i.e. with flattened heads.
The baby pillow helps to reduce the effects of Plagiocephaly, or Flat Head Syndrome, so, in this sense, from 6 months on, it is already possible to introduce a small, soft pillow just to support the head and avoid deformities,
After the first year, the little ones already start to present wider shoulders than their heads, which forces the children’s neck bone structure when sleeping on their sides. The ideal at this stage is to include a pillow a little higher to fill the space between the baby’s head and the mattress, which will keep the spine aligned and the respiratory tracts free.
The change from the cradle to the bed is another moment when the pillow must be changed. In this phase, children should be told to always sleep on their sides, changing from one side to the other, with a pillow that is more similar to an adult’s and which can completely fill the space between their head and the mattress. Parents should opt for a very soft and low product, no more than 8cm high.
Another piece of advice to help you identify the time to change the pillow for a higher one is to observe the child’s posture. When lying down, if you notice that the child’s neck is inclined downwards, it’s time to replace the pillow with another one.
While blankets look comfy and inviting, they can also be dangerous in a crib with a baby. Before adding anything to your child’s sleeping space, it’s important to consider whether or not it’s safe. If you’re wondering whether your child is ready for a pillow or blanket, remember the AAP’s recommendations, consider how mobile your baby is, and chat with their doctor at their next appointment.
As the person putting your child to sleep every night, you’re the one ensuring that they are safe and need to feel comfortable with your decision about using a blanket. The decision ultimately is yours to make!