Babysitting: the essentials for keeping babies safe
This might be the first time you have looked after a baby, or if you’re a grandparent, you might be very experienced. Over time, researchers are finding out more and more about the best ways to keep babies safe while they sleep, so use this page as a guide to the latest information.
Before 1991, the advice was to sleep babies on their front so that’s what many parents did. Research then showed that it was actually safer to sleep babies on their backs and this reduced the risk of sudden infant death syndrome (SIDS), which used to be known as cot death.
As people started to follow the new advice, along with other safer sleep guides, the rate of SIDS fell. Thankfully, SIDS is rare, but it can still happen and around 200 babies sadly die of SIDS every year. It’s important to be aware of the steps you can take to help reduce the risk and keep babies safe and well. Use this page to give you confidence while looking after a baby and put your mind at ease.
Our advice is based on the latest scientific evidence and is designed for babies up to 12 months of age. If the baby was born prematurely or of a low birth weight, follow the advice for 12 months from the due date.
Follow our safer sleep advice for every sleep
Speak to the parents about how they place their baby for sleep so that you can follow their routine. Routine is key, as doing things differently can actually increase the risk of SIDS, such as placing the baby on their front or side when they usually sleep on their back. It’s important to follow the same steps for every sleep, day and night.
Our advice for parents, and the safest way to get a baby ready for sleep, is to remember the ABCs:
Always sleep the baby on their back in a clear cot or sleep space.
Place the baby on their back in their own sleep space such as a cot or Moses basket with a firm, flat mattress, and keep it clear from any extra items such as toys or pillows which could cover their face. This is for every sleep, day or night.
If you’re a grandparent, this advice may be different from when you had your babies. This is because newer research shows that babies are actually safer on their backs, as it helps to keep their airways (ability to breathe) open and clear. This reduces the risk of SIDS, while placing them on their front increases it.
If you’re going to be looking after a baby, prepare in advance and make sure you have created a safe, separate sleep space for them ahead of time. The other essential you need to know, is to always keep the baby away from cigarette smoke.
Sleep baby in their own sleep space
The safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket:
- It should have a firm, flat mattress with no raised sides or edges. This means the baby’s face can’t get pressed up against the sides.
- It should have a wipeable, waterproof cover so it’s easy to keep clean.
- Keep the space clear of toys, pillows or any loose bedding, so there’s nothing that could cover the baby’s face and affect their breathing.
Beanbags, sofas, bouncy chairs, pods/nests, cushions and car seats are not suitable for sleep. They can allow the baby’s delicate airways to become folded or narrowed and significantly increase the risk of SIDS.
Keep the cot clear
Babies are at a higher risk of SIDS if they have their heads covered as it can block their breathing, and having extra items in the cot could risk things covering their face or head.
Keep the baby’s cot as clear as possible.
In particular, we advise:
- No pillows or duvets.
- No cot bumpers.
- No soft toys.
- No loose bedding.
- No pods or nests.
- No products that will keep the baby in one sleeping position, such as wedges or straps.
Never fall asleep on a sofa or armchair with a baby
This can increase the risk of SIDS by 50 times as it’s easy for them to slump into an unsafe position. If you feel like you might drift off with the baby on a sofa or armchair, place them on a clear, firm, flat surface.
Falling asleep on a sofa or armchair with a baby also puts baby at risk of accidental death as they can easily slip into a position where they are trapped and can’t breathe.
If you’re using a cot or Moses basket
If you’re not borrowing the baby’s own cot or Moses basket that they usually use, there are some things to check ahead of time to make sure it’s suitable – even if it’s one you have within the family.
- Make sure the cot or Moses basket has passed the necessary safety checks, and follow the manufacturer’s guidance.
- Make sure it’s still in good condition with no broken parts, or rips or tears in any fabric, and the mattress is still firm.
- Make sure it’s clean. If you look after more than one baby, for example if you have more than one grandchild, we advise wiping down the waterproof mattress cover and using a clean set of bedding for each child.
- If the cot or Moses basket has come from outside the family home, we recommend replacing the mattress with a new one.
Supervise them while they sleep
Stay in the same room as the baby every time they sleep, day and night. Babies should be in the same room as an adult for all sleeps until they are at least six months old.
You can still leave the room to make a cup of tea or go to the toilet, but for most of the time when they are sleeping, they are safest if you are close by. Often the easiest way is with a Moses basket or travel cot.
Don’t smoke around the baby
It’s important to keep baby smoke free whilst they are in your care. There’s strong evidence from studies worldwide that smoking during pregnancy and after birth increases the risk of SIDS. This also includes partners, so we know being around smoking, such as from carers or friends, also puts the baby at risk.
Cigarette smoke and all the chemicals it contains clings to clothes, hair and skin. Our advice is not to hold a baby after smoking.
There is currently no research on e-cigarettes and SIDS, though we are currently funding research to learn more. Giving up completely is the best option, but if you use an e-cigarette, keep babies and children away from e-cigarettes and their vapour.
Keep the temperature comfortable
Make sure the room the baby is sleeping in is a comfortable temperature – not too hot or too cold. The ideal is between 16-20°c. A thermometer can help you to make sure the room is at the right temperature, as it can be hard to guess the temperature.
The risk of SIDS is higher in babies who get too hot:
- Make sure baby’s cot is not positioned next to a radiator or a window in direct sunlight.
- Keep baby’s head uncovered when they’re inside. Babies lose heat from their heads so removing hats helps stop them overheating.
- Remove any outdoor clothing such as coats and snow suits when they’re inside.
To check baby’s temperature, feel the skin on their chest or the back of their neck. If their skin is clammy or sweaty, that means they’re getting too hot, so you will need to remove some layers. Don’t use their hands or feet as a guide as they will feel cooler than the rest of their body.
Make sure the bedding is not too big or bulky
Good options for bedding are sheets or blankets firmly tucked in no higher than shoulder height, or a baby sleep bag.
If you’re using sheets or blankets, sleep baby in the feet to foot position, which means baby’s feet are right at the bottom of the cot so they can’t wriggle down underneath the blankets. This helps prevent their their face from being covered.
Avoid using soft or bulky bedding such as quilts, pillows and duvets, as they can cause baby to get too hot or for their face to get covered. Remember that one blanket doubled over counts as two.
Offer baby their dummy if they use one
If baby uses a dummy at home, keep offering it to them for sleep while they’re in your care. Follow these simple rules:
- If the dummy falls out during sleep, don’t wake the baby to put it back in. But if the baby wakes, you can offer it to them again.
- Don’t force the baby to take a dummy or put it back in if they spit it out.
- Don’t use a neck cord.
- Don’t coat the dummy with something sweet.
More baby safety information
Car seats are essential for safe travel, but babies shouldn’t sleep in them for long periods. Many aren’t flat which can mean babies slump forwards, which can affect their breathing.
Follow these tips to keep baby safe while travelling in a car seat
- Avoid driving long distances with pre-term and young babies. Research has found that young babies may be at risk of breathing difficulties if they sleep upright in a seated position for too long.
- Stop and take regular breaks if you’re driving a long way. This will allow you to check on the baby, take them out of the car seat and let them stretch and move around.
- If possible, have a second adult in the back seat with your baby. If you’re travelling alone, use a mirror to keep an eye on them.
- If baby changes their position and slumps forward, stop straight away, then take them out of the car seat and sit them upright before continuing on your journey.
- Choose a rearward-facing baby seat. This is essential. They provide better protection for the baby’s head, neck and spine than forward-facing seats.
Car seats are designed to keep babies safe while travelling, but they’re not designed to be a main sleeping place so they’re not suitable for sleeping in for long periods. There is no published evidence which sets out how long babies should be kept in a car seat when travelling. Use them for transport only, not as an alternative to cots or high chairs.
It’s OK for baby to fall asleep in a car seat when travelling, but take them out as soon as you get to your destination and place them on a flat surface to sleep.
It’s important to protect babies from getting infections, especially in the first few weeks of life. Babies have immature immune systems which means that they’re more at risk. Infections that may be mild in older children or adults can be serious in babies and can even be life-threatening .
There are some key things that you can do to reduce the risk of serious infections: follow THANKS – Think Hands And No KisseS.
Don’t look after the baby if you are ill or have been ill recently – including with cold sores or illnesses that cause diarrhoea and vomiting. Stay away until you are fully recovered. This is a key part of keep babies safe from infection.
When babies feel unwell, with a cold or high temperature (fever), they may be warmer than usual. Dress the baby appropriately for their environment – don’t be tempted to wrap them up more than usual as they can get too hot. If your baby has a fever or you’re worried about the baby, call their GP or 111. If you’re very worried, go to an emergency department.
It can be difficult to tell when a baby has an infection as they can cause lots of different signs and symptoms, but they might have a more serious infection if they:
- are difficult to wake.
- appear floppy.
- are irritable and wont settle.
- have a mottled or blotchy appearance.
- have difficulty breathing or are breathing in an unusual way, such as: fast, noisily, ‘sucking in’ under the ribs, grunting or wheezing.
- have a rash, sores or blisters on their skin, eyes, inside their mouth or around their tummy button.
- have a temperature above 38°C or below 36°C, or their body is cold to the touch.
- have a high-pitched or abnormal cry.
- have had fewer than 2-3 wet nappies in 24 hours.
If you notice any of these signs and symptoms, seek medical help straight away.
Visit the NHS website for more information. If you’re very worried, call NHS 111, or visit an emergency department.
You may also find it helpful to use our Baby Check app. Our Baby Check app is free and features 17 simple checks you can do if a baby is showing signs of illness. Each check tests for a different symptom and, when completed, the app lets you know whether your baby needs to see a health professional.
Download the Baby Check app for free from Google Play or the App Store. Peace of mind, in your pocket.
Remember, we're here to support you
Whether you’re a first-time caregiver or an experienced grandparent, these simple actions can give you peace of mind. If you have any questions about safer sleep or you are worried about looking after someone else’s baby, you can contact us for advice and support. Call our free information line 0808 802 6869 or email [email protected]. Or read more about safer sleep for babies.
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