Setting up a safe sleep space for your baby: a checklist

Safe sleep advice can feel like a long list of don'ts, but the underlying picture is simple: a baby on their back, alone, on a firm flat surface, in a crib, cradle or bassinet with nothing else in it, in your room. This checklist turns current Government of Canada and Canadian Paediatric Society guidance into things you can check off while setting up the nursery.

This is general information based on the public guidance linked at the end. If your baby was born early, has a health condition, or you have questions about your own situation, talk to your doctor, midwife or public health nurse.

The core guidance

• Always place your baby on their back to sleep, for naps and at night. Health Canada notes you don't need to reposition a baby who rolls over on their own.
• The safest place for your baby to sleep is alone in a crib, cradle or bassinet that meets current Canadian safety regulations.
• Keep that crib, cradle or bassinet in your bedroom for the first 6 months.
• The sleep space should be flat, firm, and free of soft bedding, extra padding, bumper pads, stuffed toys and pillows.
• Keep your baby's environment free of smoke, cannabis smoke and vaping.
• Breastfeeding is listed by Health Canada and the Canadian Paediatric Society among the things that help protect babies.
• Dress your baby in fitted sleepwear suited to the room temperature so they don't overheat.

Checklist: the crib, cradle or bassinet

• It meets current Canadian regulations. If you're buying new from a Canadian retailer this should be the case; if it's second-hand, check carefully.
• It was not made before September 1986. Health Canada says those cribs don't meet current regulations, including for slat spacing, and should not be used.
• It isn't a traditional drop-side crib. These have been illegal to sell, import, manufacture or advertise in Canada since December 29, 2016.
• It's ideally less than 10 years old. Health Canada recommends against using cribs older than that, as they're more likely to have broken, worn, loose or missing parts and missing instructions.
• Slats are no more than 6 cm apart.
• Corner posts are no more than 1.5 mm above the top of the sides.
• No parts are missing, loose, worn, broken or damaged, and it's assembled following the manufacturer's instructions.
• It hasn't been recalled. Check the Government of Canada recalls database.

Checklist: the mattress and sheet

• Use only the mattress made for that crib, cradle or bassinet — firm and flat.
• Crib mattress no thicker than 15 cm. Cradle and bassinet mattresses no thicker than 3.8 cm.
• Do the gap test: push the mattress firmly to one side. The gap on the other side should be no bigger than 3 cm.
• A tightly fitted sheet made for that mattress size, and nothing else.
• No mattress toppers, and no extra mattress or padding added — including in a playpen.

Checklist: what stays out of the sleep space

Health Canada's list of things to remove includes several that are sold as baby sleep products:

• Quilts, blankets and comforters.
• Bumper pads.
• Pillows, including nursing pillows.
• Sleep positioners and crib wedges.
• Stuffed toys.
• Loungers and baby nests.

Checklist: where the crib goes

• In your room for the first 6 months.
• Away from window blind, shade and curtain cords, which are a strangulation hazard. Keep cords of any kind away from the crib.
• If there's a mobile or toy bar, plan to remove it as soon as your baby starts pushing up on hands and knees.

Checklist: dressing for sleep

• Fitted sleepwear, like a one-piece sleeper. Check regularly for loose buttons, snaps or threads.
• If you use a sleep sack, you don't need a blanket. It must fit: too big and baby can slip down inside, too small and they can't move their hips and legs freely.
• If you swaddle, do it loosely so baby has room to breathe. The Public Health Agency of Canada says to stop around 2 months of age, before your baby can roll over; Caring for Kids says to stop as soon as your baby shows signs of rolling.
• No weighted swaddles, sleep sacks or blankets.
• No hats indoors, and take outdoor clothing off when you come inside.
• Room temperature: if it's comfortable for you, it's comfortable for your baby.

Not for sleep

Health Canada says never to use these for sleep: waterbeds, air mattresses, futons, sofas, armchairs, inclined sleepers, baby hammocks, crib wedges, swings, bouncers, strollers, car seats or high chairs.

Babies fall asleep in car seats and strollers all the time, and that's not a failure. The Public Health Agency of Canada's advice is to move your baby to a safe sleep space once you reach your destination, even if they're sleeping soundly, and to check on them often in a stroller, sling or carrier.

Playpens and travel

• In Canada, playpens are not recommended for unsupervised sleep, because they're not as durable as cribs.
• A playpen's bassinet attachment, assembled correctly, is a safe option until your baby can roll over or reaches its weight limit, whichever comes first.
• A travel bassinet needs to meet current Canadian regulations, and should sit on a firm, flat surface like the floor — not on a bed or sofa.

As your baby grows

• Move from a bassinet to a crib when your baby can roll over, or reaches the bassinet's weight limit.
• Move from a cradle to a crib when your baby can push up on hands and knees, or reaches the weight limit.
• Lower the crib mattress support to its lowest position once your baby can sit up or push up on hands and knees.

If you bed-share

Health Canada's position is that a baby's own crib, cradle or bassinet is safest. It also acknowledges that bed sharing happens, and says that if it does, the surface should be firm and flat with no gaps, soft bedding should be kept away from the baby, and the baby should be on their back. It's worth a frank conversation with your care provider about your own circumstances.

Readers in the US

• The American Academy of Pediatrics' core advice is similar: back to sleep, a firm flat surface with no soft objects, and room sharing for at least the first 6 months.
• The AAP is firmer on bed sharing, recommending that parents avoid it under any circumstances.
• The AAP also advises against weighted blankets, sleepers and swaddles.
• Under the Safe Sleep for Babies Act, in effect since November 12, 2022, crib bumpers and inclined infant sleepers are banned from sale in the US.
• Check for US recalls on the Consumer Product Safety Commission's site.

Share this with everyone who puts your baby down

Grandparents, babysitters and relatives may have learned different advice when they were raising children. The Public Health Agency of Canada has a page of safe sleep tips written specifically for grandparents, which is an easy thing to send rather than having the conversation from scratch.