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Division of Agricultural Sciences and Natural Resources

Making sure babies sleep safely

STILLWATER, Okla. – Everyone likes curling into a favorite position for a nap or good night’s sleep and babies are no different. But, for little ones, the most comfortable position may not always be the safest.

Positional asphyxia occurs when babies cannot breathe because the position of their body blocks the airway.

“Caregivers should focus on putting infants to sleep in safe places and safe positions,” said Laura Hubbs-Tait, Oklahoma State University Cooperative Extension parenting specialist. “The safest way to accomplish this task is to place babies on their backs in a crib or basinet that has met U.S. Consumer Product Safety Commission standards.” 

Positional asphyxia may occur when a baby’s position blocks his or her nose and mouth such as when a baby’s face becomes wedged between a mattress and a headboard. Or, the passage of air from the mouth and nose to the lungs is blocked because the baby’s head is slumped over or the chin is pressing into the chest. 

Babies who experience reduced oxygen levels as a result of positional asphyxia may later face cognitive or behavioral issues. Positional asphyxia also can be fatal.

Although newborns and young infants are at highest risk for experiencing positional asphyxia, older infants and toddlers also may be affected by the condition.

“Newborns and young infants just aren’t strong enough yet to be able to move themselves if their airway becomes blocked, which puts them in danger of experiencing positional asphyxia,” Hubbs-Tait said. “Older infants and toddlers may be at risk if they’re slumping while sleeping in a car seat or if the car seat is placed on a bed or other furniture and overturns, trapping them.”

Recent research indicates car seats and sling carriers are associated with the highest frequency of positional asphyxia.

However, other carrying devices such as swings, bouncers and strollers also have been connected to incidents of the condition.

“Car seats are safe as long as they’re used correctly,” Hubbs-Tait said. “They are designed to protect babies in the event of a car accident. They are not designed for safe sleeping or unsupervised awake time.”

To reduce the risk of positional asphyxia when using car seats, sling carriers and other carrying devices, caregivers should read and follow all manufacturer’s instructions, said Gina Peek, OSU Cooperative Extension housing and consumer specialist.

“All caregivers, including family members, babysitters and childcare providers, should know how to install and correctly use carrying devices,” Peek said. “If necessary, set aside some time to practice until everyone is comfortable.”

Families can contact the state or county health department for specific assistance with safely installing and operating car seats.

For more information about positional asphyxia, contact the county Extension office and visit to download free of charge OSU Fact Sheet T-2383, “Protecting Infants and Toddlers from Positional Asphyxia: Car Seats and Sling Carriers.”


Leilana McKindra
Communications Specialist
Agricultural Communications Services
158 Agriculture North
Oklahoma State University
Stillwater, OK 74078
Phone: 405-744-6792
Fax: 405-744-5739

Oklahoma State University - Stillwater, OK 74078