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Sleep sacks with sleeves can be used safely when following recommendations:

1. Choose a sack specifically designed for sleep with proper arm openings.
2. Use an appropriate TOG rating for room temperature to prevent overheating.
3. Dress baby lightly underneath in breathable fabrics like cotton.
4. Do not add loose blankets on top of or under the sack.
5. Discontinue use if showing signs of rolling over or escaping.
6. Follow all manufacturer guidelines for sizing and transitioning out.

Yes, babies can sleep in long sleeves as long as the clothing is appropriate for the room temperature. Long-sleeved sleepwear can help keep babies warm and comfortable during colder nights. However, it's crucial to ensure the baby doesn't overheat, as this can be a risk factor for Sudden Infant Death Syndrome (SIDS).

Babies do not necessarily need layered clothing under a sleep sack. Many sleep sacks are designed so baby can sleep comfortably wearing just a diaper, especially in warmer weather. For cooler temperatures, add only a single layer like footed pajamas or a lightweight bodysuit sleeper underneath. Avoid overdressing by checking the TOG rating of the sack and recommended layering. More than 1-2 thin layers can cause overheating. Pick breathable fabrics like cotton. You want enough warmth without bulk under the sack.