Safe sleep for babies in Singapore: setting up the cot step by step, what's safe by age, and the yao lan

Safe sleep for babies is a short routine you repeat at every sleep, naps included. Your baby goes down on the back, alone in a cot with a firm, flat mattress and nothing else in it, in your room, in a smoke-free home. HealthHub and KKH both follow the American Academy of Pediatrics (AAP) here, and the rules hold until your baby turns one.

This page covers where and how your baby sleeps. For how long, see our baby sleep schedule by age, and for the early days, newborn sleep in the first 6 weeks and newborn care basics.

How to set up a safe sleep space, step by step

1. Put the cot in your room, close to your bed. HealthHub says your baby is safer in their own cot for at least 6 months, and preferably a year.
2. Fit a firm, flat mattress with a well-fitted sheet. The AAP says a firm mattress shouldn't dip when your baby lies on it. Our baby cot guide covers slat gaps and safety standards.
3. Clear the cot. KKH advises no pillows, loose blankets, soft toys or cot bumpers until your baby is one.
4. Set the room to about 25 degrees C, as KKH suggests, and keep the cot away from any draught, aircon included.
5. Dress your baby in the layers you're wearing plus one light layer, which is HealthHub's rule, and use a sleep bag in place of a blanket. How to dress a newborn has the room-by-room detail.
6. Lay your baby on the back for every sleep, naps included, until the first birthday (HealthHub). Skip the side too. The AAP says it's as risky as the tummy.
7. Keep your home, your car and any carer's home smoke-free. HealthHub says cigarette smoke or fumes raise the risk of sudden infant death syndrome (SIDS).
8. If your baby falls asleep in a car seat, swing, pram or carrier, move them to the cot. The AAP says to do it as soon as possible, and KKH says car seats aren't recommended for routine sleep.
9. Give the same rules to everyone who puts your baby down: grandparents, a helper who does nights, the infant care teachers. Our nursery set-up checklist is a quick way to walk them through it.

Back to sleep, rolls and flat spots

The back is the safe position for every sleep in the first year. The AAP says that holds even for babies with reflux, who should also sleep flat on their backs.

Your baby will start rolling at some point. Keep laying them down on the back. Once they roll both ways on their own, back to tummy and tummy to back, the AAP says you don't need to keep turning them over, as long as the cot is clear. If you swaddle, stop once your baby can flip or turn, as HealthHub advises. Our swaddles and sleep sacks guide covers the switch.

Back sleeping can leave a flat spot on a young baby's soft head. HealthHub says heads round out naturally by 12 months. To help, change which way your baby's head tilts each time you lay them down, and give plenty of tummy time while they're awake. The AAP says an awake adult should watch.

Two other habits help. HealthHub advises breastfeeding, or feeding expressed milk, for at least 6 months. The AAP says a pacifier at nap time and bedtime lowers the risk of SIDS, even if it falls out once your baby is asleep. If you breastfeed, wait until feeding is going well. Our pacifier guide covers sizes and timing.

What can go in the cot, by age

Under one, the cot holds your baby, a firm mattress and a fitted sheet. After that, the sources relax the rules at different speeds.

KKH keeps bumpers out until one. Red Nose adds that older babies can stand on a pillow to climb out of the cot, one more reason to wait. When your toddler is ready for a bed, our cot to bed guide covers rails and timing.

The yao lan, sarong cradle and spring cot

The yao lan is the cloth cradle that hangs from a spring, and some families tie a sarong into a sling the same way. HealthHub says baby hammocks, sarongs and yao lans aren't safe for babies to sleep in unsupervised, especially once they can roll.

The problem is the shape. A hammock curves under your baby's weight, so it can't give the firm, flat surface every source asks for. The AAP says any surface that slopes more than 10 degrees isn't safe for sleep.

If your family uses one, here's how:

• Rock your baby in it only while an adult is awake and watching.
• Once your baby is asleep, move them to the cot, on the back.
• Stop using it once your baby starts to roll.
• Treat a spring cot with a fabric bed the same way.

HealthHub also points out that rocking can turn into a habit, so a baby who's rocked to sleep may find it hard to settle again at night without it.

Safe sleep in a Singapore home

You don't need a cold room. KKH suggests about 25 degrees C, and the AAP says overheating can raise the risk of SIDS. Your baby needs only one more layer than you'd wear in the same room. Feel the chest: the AAP lists sweating, a hot chest or flushed skin as signs your baby is too warm.

In an HDB flat, the cot often shares a room with your bed, an older sibling or both, which is fine if the older child's pillows and toys stay out of the cot. Keep the baby out of the big bed, though, since KKH says co-sleeping or bed-sharing raises the risk of SIDS. HealthHub's middle ground is to bring your baby into bed to feed or comfort, then put them back in the cot, on the back, before you sleep, and our co-sleeping guide covers the rest.

If you feed on the sofa at night and feel yourself nodding off, put your baby in the cot first. HealthHub says never to let a baby sleep on a sofa, an armchair or a nursing pillow.

If a helper or grandparent does nights, run through the cot set-up with them once, in the room, and agree that the back is the only position. Older advice, like tummy sleeping or a small pillow under the head, is worth talking through.

Some products sold for sleep don't make it safer. KKH says not to use wedges or infant positioners, and the AAP says home breathing and heart-rate monitors shouldn't be used to lower the risk of SIDS.

When to see a doctor

Call 995 straight away if your baby:

• Has stopped breathing or is struggling to breathe (HealthHub)
• Has skin and lips turning blue, purple or grey, or looks unusually pale and clammy (HealthHub)
• Is unresponsive, unconscious or unusually limp (HealthHub)

Stay on the line. SCDF says its 995 specialists can give you advice such as how to do CPR before the ambulance arrives. To learn infant CPR ahead of time, our baby choking first aid guide points you to courses.

See a GP or your polyclinic soon, or go to Children's Emergency, if your baby:

• Breathes differently: slower, faster, noisier or with more effort (KKH)
• Has a temperature above 37.5 degrees C (KKH)
• Refuses feeds several times in a row (KKH)
• Is lethargic, or unusually fussy and crying in a way you can't settle (KKH)
• Snores, especially if it's loud (KKH)

KKH Children's Emergency and NUH Children's Emergency are open 24 hours.

Frequently asked questions

What are the safe sleep rules for babies in Singapore?

HealthHub lists seven tips from the AAP: back to sleep until age one, room-sharing without bed-sharing, a firm surface, a clear cot, breastfeeding, a smoke-free home and the right clothes for sleep. KKH's advice is also based on the AAP. The step list at the top of this page puts them in the order you'd set them up.

Can safe sleep prevent SIDS?

It lowers the risk, though nothing removes it completely. The AAP says there's no guaranteed way to prevent SIDS, but a safe sleep space helps reduce the risk. KKH says babies under one are at greatest risk, which is why the rules run for the whole first year.

When can my baby sleep with a blanket?

After the first birthday. KKH advises no loose blankets in the cot until one, and the AAP says most experts see little risk from items like quilts after 12 months. Before that, use a sleep bag. If you use a blanket before then, KKH says to tuck a light one along the sides and foot of the mattress, no higher than the chest.

When can a toddler use a pillow?

Not before one, KKH says. Australia's Red Nose says to wait until your child is older than two and no longer sleeping in a cot, and that pillows aren't needed before then. Our toddler sleep guide covers bedtime once they're in a bed.

Is a baby hammock or yao lan safe for sleep?

Not for unsupervised sleep, HealthHub says, especially once your baby can roll. Rock your baby in it while you watch, then move them to the cot, on the back. A firm, flat cot is the safe place for every sleep.

Will my baby choke sleeping on the back?

No. The AAP says babies won't choke on their backs, because their airway and gag reflex prevent it. Even babies with reflux should sleep flat on their backs. KKH says to see a doctor for vomiting, as opposed to spitting up, especially if it's green or projectile.