DEAR DOCTOR K:

I have a newborn daughter, and I'm worried about keeping her safe while she's sleeping. Please give me some advice.

DEAR READER:

The biggest concern with newborns is sudden infant death syndrome (SIDS). To reduce the risk of SIDS, always place your baby on her back to sleep. In the past, some authorities said it also was OK for babies to sleep on their sides. Today, most authorities do not agree with this. Incidentally, it's fine for babies to rest on their bellies when they're awake. This actually helps build up the strength of their shoulders.

You might run across devices called "sleep positioners." The intention of these devices is to keep babies sleeping on their backs. However, most experts think these devices cause more harm than good.

Likewise, you might hear about devices that monitor your baby's heart and breathing while she is asleep. These also have not proven to be of value.

Overheating also increases the risk of SIDS. Don't put your baby to sleep wrapped tightly. Don't cover her with a heavy blanket or quilt. If you use a thin blanket, place your baby toward the foot of the crib, tuck the blanket around the mattress, and pull the blanket up only to her chest.

Soft bedding also increases the risk of SIDS. Your baby should sleep on a firm mattress. Don't let the baby sleep on a waterbed, sofa, pillow, quilt or other soft material. And don't place soft stuffed toys or pillows in the crib with her. The baby could roll onto them as if they were a mattress.

Next, consider the crib itself. All new cribs meet stringent safety standards. If you're looking for a secondhand crib, one that might not meet today's safety standards, check that:

-- The slats are no further than 2 3/8 inches apart. Wider slats could allow a baby's head to become trapped between them.

-- The crib is not painted with a lead-based paint, which could cause lead poisoning.

-- All the screws and bolts that hold the crib together are present and tightly fixed.

-- The crib does not have drop side rails. If a drop side rail detaches or becomes loose, your baby could become trapped between the mattress and railing.

The crib mattress should not only be firm, but also should fit snugly, with no room for your baby to become trapped between the mattress and the crib. Don't cover the mattress with plastic or a quilt. And avoid crib quilt bumpers, which also pose a risk for suffocation.

Should your baby sleep in bed with you -- so called "co-sleeping"? This is a common practice, but it's not safe. The baby could roll out of the bed. Worse, a parent could roll over onto the baby. I definitely advise against co-sleeping.

Fortunately, fewer than one out of a thousand babies have SIDS. You can lower the odds further by taking the simple precautions I've described.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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