When Can Baby Sleep with a Blanket?

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 in around the mattress in the crib.

Besides keeping the crib clear of objects, there are other things to keep in mind to provide a safe sleeping environment as your child grows:

• Keeping the crib clear of blankets, pillows, and toys also means keeping it clear of bumpers. They may look cute and match your nursery decor, but bumpers pose many of the same suffocation risks as toys and loose bedding and can also be used to aid older children in climbing out of the crib.
• Wedges, positioners, and special mattresses have not been found by the AAP to reduce SIDS, and may actually increase risk. However, pacifiers are believed to reduce the risk of SIDS and should be offered at sleeping times if your child uses one.
• Your child’s crib or bassinet be located in your bedroom for at least the first 6 months of their life (and ideally for the whole first year.) It’s not recommended to share your bed with your baby and you should definitely not share the bed if you have smoked, slept less than an hour in the last 24 hours, are on certain medications, or if your baby is of low birth weight. If you do choose to co-sleep with your infant, it is essential to remove all blankets, sheets, and pillows from the area where the baby will be sleeping.
• For bedtime or nap time, dress your baby in about one layer more than you’d wear yourself. To check to see if your child is too warm or cold, look for changes in breathing, check the back of their neck to see if it’s sweaty or cold, and look for flushed cheeks. (It’s recommended to keep your baby’s sleeping area on the cool side to avoid overheating.)
• Stomach and side sleeping is fine once they have sufficient muscle strength to support themselves and the ability to maneuver themselves into and out of a position. As your baby learns to roll, you may notice that they begin to roll onto their stomach before falling asleep. You don’t need to go in and flip them over: Even if your baby routinely flips themselves onto their stomach, the AAP recommends that you continue to put them on their back when you place them in the crib.
• Speaking of rolling… once your child begins to look like they may roll, it’s time to stop swaddling. The AAP recommends curtailing the swaddle around 2 months of age before your child is actually rolling. This is because your little one may need access to their hands to flip back over.
• With or without a blanket, it is not safe for your child to fall asleep on a couch or armchair. Your child should also not spend the night unsupervised in a swing, reclined chair, or their car seat. If you and your baby fall asleep during a feeding session, move your baby back into their crib or bassinet as soon as you wake up.
• Keep the area above and beside the crib clear of any mobiles, window treatments, or artwork. There is the potential of objects falling onto your child, and as your child becomes mobile, they can potentially pull these items onto themselves or become entangled. You can definitely still have the cute nursery of your dreams — crib placement just need to be considered in the decorating plan.
• As your child begins to pull themselves up and stand, remember to lower the crib mattress. The temptation to climb or jump out head first is a strong one for young children who don’t know any better!
• Keep your child’s room baby-proofed in case they do escape from their crib. It can be a shock the first time your child learns to climb out of their crib. By being prepared, you won’t have to worry that they’ll get hurt by something in their environment before you discover they’re out of bed!

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!