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Safe Sleep and Breastfeeding



The American Academy of Pediatrics (AAP) recently updated its policy statement on breastfeeding and the use of human milk. The revised policy updates recommendations on breastfeeding, highlights special considerations, and notes how pediatricians can support breastfeeding parents.


Breastfeeding not only provides key nutrition for development, but it also reduces the risk for SIDS. Research shows that feeding only human milk by breastfeeding directly or by giving milk pumped from the breast reduces the risk of Sudden Infant Death Syndrome (SIDS).


The research also shows that feeding human milk some of the time is more protective than not feeding human milk at all, and feeding only human milk, with no supplements or additives, offers the best protection against SIDS. The longer a baby is fed human milk, the lower their risk of SIDS.


In most cases, pediatricians and other healthcare providers recommend exclusive breastfeeding for at least baby’s first 6 months. Recommendations may be different for babies born preterm, with certain health conditions, or for those families for whom breastfeeding is not an option. After 6 months, AAP recommends continued breastfeeding, with appropriate complementary foods, for as long as mutually desired by parent and child.


Learn more about ways to reduce baby’s risk for SIDS on the Safe to Sleep® website. For more information on breastfeeding and SIDS risk reduction, check out these doctor’s tips for breastfeeding moms.


Members of the AAP Task Force on SIDS are committed to answering your questions about safe infant sleep. Q. Why are weighted swaddles or blankets not recommended for babies? A. Weighted blankets and swaddles are not recommended because there is not enough evidence of their safety for use with infants, and because—based on what we know about infant health, SIDS, and sleep-related infant deaths—they could actually cause harm. Consider the following:

  • An infant’s ribcage is still developing. Adding weight could make it difficult for baby to expand their chest to take in air, reducing their ability to breathe properly. There are no studies on what amount of weight, if any, is safe to place on baby’s chest.

  • Weighted swaddles and blankets are a new product category, meaning there are currently no safety standards for them beyond the general rules for children’s products (for example, lead content, likelihood of catching on fire, etc.). There are also no studies regarding the use of these products and the risk of sleep-related death.

  • If an infant rolls over during sleep, the additional weight could make it more difficult for them to roll onto their back again. Sleeping on the stomach carries the highest risk of SIDS. That risk is very high among infants who are used to sleeping on their back but who are placed onto their stomachs for sleep, and among swaddled infants who are placed or roll onto their stomachs.

  • Because there are no safety regulations for these products, they could be made with heavy/thick materials that increase the risk of overheating. Overheating from excessive clothing or blankets and high room temperature is associated with increased SIDS risk.

  • Claims that these products are safe for infants during sleep are based on a single study of 16 infants with neonatal opioid withdrawal syndrome who were in a neonatal intensive care unit (NICU), where they were constantly monitored and covered with a weighted blanket for only 30 minutes at a time. Because this tightly controlled situation is very different from using a weighted product on an infant for an hour or more at a time, outside of the NICU and without constant monitoring, the safety of using these products in the home cannot be assumed.

  • Suggested benefits of weighted blankets and swaddles for infants are unproven. Although there is some evidence that the products may be beneficial in certain groups of older children or adults, there are no studies that show any benefits specifically in infants.

Until mandatory product standardization is in place and convincing evidence of safety and efficacy regarding weighted swaddles/blankets/sleep sacks is available, the Task Force cannot support their use for infants.


The U.S. Breastfeeding Coalition (USBC) is an independent nonprofit coalition of more than 50 organizations that collaborate on policy and practice efforts to create a landscape of breastfeeding support across the United States. For years, Safe to Sleep® and the USBC have worked together to develop and share consistent, integrated messaging for all caregivers about safe infant sleep and breastfeeding.


This National Breastfeeding Month, the USBC reminds families and caregivers that Together We Do Great Things! Throughout the month, the USBC is celebrating all efforts in service to babies, families, and human milk feeding. Join the USBC and Safe to Sleep® in celebrating the power and impact of our collective efforts.


Visit the Coalition website to learn more about the USBC’s National Breastfeeding Month resources.

In case you missed it, a recording of the July 21 SIDS Awareness Month Activities Webinar, along with featured partner resources, will soon be available on the Safe to Sleep® website.



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