Should Newborns Sleep On Their Back

The Decision Whether To Cosleep With Your Baby Is Extremely Controversialand There Are Two Sides To The Story

Safe Sleep: Why Babies Should Always Sleep On Their Backs

Few parenting conversations in early childhood elicit as much angst and judgment as the one about our childrens sleep: Where should they sleep, and how do we get them to sleep through the night? We label newborn babies as good, or not, depending on how much they disturb us in the nighttime, or we believe babies sleep is a reflection of our parenting competence.

But our beliefs and decisions about childrens sleep are more a reflection of the culture we live in than the scientific evidence for whats best for children, says anthropologist James J. McKenna, in many of his 150 scientific articles on childrens sleep. McKenna is director emeritus of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, and author of Safe Infant Sleep: Expert Answers to Your Cosleeping Questions. He has devoted his career to understanding what happens to babies and their caregivers when they sleep together versus apart.

McKennas conclusions, supported by research from other anthropologists and developmental scientists over the last 30 years, have thrown him into direct conflict with the American Academy of Pediatrics over recommendations about where babies should sleep. Separately, say the pediatricians, while McKenna and his colleagues say, Together, but safely. McKennas easy-to-read book offers important insights about how cosleeping can be made safe and what kind of benefits it might promote for childrens development and parents well-being.

Why Should You Sleep Your Baby On Their Back

Here at Red Nose, one of our key safe sleeping recommendations has been to place baby on their back to sleep from birth. Its a recommendation that has largely contributed to an 85 percent reduction in SIDS deaths since the 1990s.

Research has found that placing your baby to sleep on their back greatly reduces the risk of sudden and unexpected death in infancy , which includes SIDS. This is because healthy babies placed on their back to sleep are less likely to choke on vomit than tummy sleeping infants.

In fact, Red Noses Chief Midwife Jane Wiggill explains, placing your baby to sleep on their back will actually provide them with airway protection.

When a baby is sleeping on the back, the upper respiratory airways are positioned above the oesophagus, which is the tube that carries food from the mouth to the stomach, she says.

Babies protect their airways by swallowing. Regurgitated milk from the oesophagus lies at the lowest level and can be easily swallowed.

It is actually difficult for the fluid to work against gravity and be pushed up and into the respiratory tract when babies are lying on their back. Hence, the risk of choking is reduced when baby is sleeping on the back.

When a baby sleeps on the tummy, the oesophagus sits above the babys upper airways. If a baby regurgitates or vomits milk or fluid, these substances will pool at the opening of the airways and are more likely to be inhaled into the babys airway and lungs, she says.

What If Baby Rolls Onto His/her Tummy

When your baby is old enough to be able to turn over in bed by themselves, dont worry at this stage, the risk of SIDS is significantly lower anyway. Its still best to tuck your baby into bed at night on their back, but don’t worry if they turn themselves over later.

You might feel more comfortable gently rolling them onto their back when you notice they have shifted positions, but there’s no need to get up all night to check and reposition them.

It’s been proven that the risk of SIDS is increased if parents smoke. Smoking is one of the main factors associated with SIDS, with scientists believing that the number of cases of SIDS could be reduced by 66 per cent if parents stop smoking.

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Not Recommended For Sleep

Using baby slings and carriers is popular, and babies often fall asleep while being carried in them. If you use one, be sure to use it safely. Babies, especially who are less than 4 months old, or who were born prematurely or with a medical condition, have poor neck control and are at a higher risk of suffocation.

Keep your baby visible at all times. Make sure your baby is in an upright position. You should be able to see your babys face make sure it is not pressed into your body, your clothes or the carrier. Check your baby often and watch for overheating. For more information, visit .

Overheating increases your babys risk of SIDS

Swaddling is sometimes used to calm babies, but can also be a risk. Babies can get tangled or covered in the blanket if it comes loose, or can roll onto their tummy while still swaddled. These are risks for suffocation. If you swaddle your baby, be sure to do it safely:

  • Use a lightweight blanket. Make sure it stays well away from the babys nose and mouth.
  • Wrap your baby so they can still move their hips and legs.
  • Leave your babys hands free so they can show you when they are hungry.
  • It is very important to stop swaddling before your baby can roll. Swaddling is not safe for babies when they are on their tummies.

Do Not Let Your Baby’s Head Become Covered

SIDS: How to reduce your baby

Babies whose heads are covered with bedding are at an increased risk of SIDS.

To prevent your baby wriggling down under the covers, place them in the “feet to foot” position. This means their feet are at the end of the crib, cot or moses basket.

To put your baby in the feet to foot position:

  • tuck the covers in securely under your baby’s arms so they cannot slip over their head use 1 or more layers of lightweight blankets
  • use a baby mattress that’s firm, flat, well-fitting, clean and waterproof on the outside cover the mattress with a single sheet
  • do not use duvets, quilts, baby nests, wedges, bedding rolls or pillows

If you use a sling or carrier, make sure you use it safely.

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The Psychological Benefits Of Cosleeping

Meanwhile, anthropologists observed that all mammals and primates, as well as the majority of non-Western societies around the world, coslept. Therefore, it was likely that the practice had some biological advantage.

One of McKenna and his colleagues greatest scientific contributions has been to show how parents serve as a kind of biological jumper cable, or outsourced regulator, to a newborn baby when she is completing her gestation outside her mothers body. When parents and babies sleep together, their heart rates, brain waves, sleep states, oxygen levels, temperature, and breathing influence one another.

To a biological anthropologist, this mutual influence implies that the offsprings growth is intended to occur most safely inside that biological system, near an adults body, especially in the first few months of life while the babys own physiology is the most immature. For example, animal studies found that when baby monkeys were separated from their mothers, their bodies went into severe stress. A small study of 25 four- to ten-month-old babies who were separated for sleep training showed that even though the babies behavior quieted on the third night, their levels of cortisol remained high.

Should I Call My Doctor If Repositioning Isnt Helping

Flat head syndrome can be corrected or minimized with infant repositioning techniques. Starting early and staying consistent helps. If repositioning isnt working, or if your babys neck muscles seem tense, call your healthcare provider. Physical therapy or a helmet may help.

A note from Cleveland Clinic

Repositioning is a useful technique to help babies recover from plagiocephaly, or flat head syndrome. You should never put a baby to sleep on the stomach or side positions associated with SIDS. Ask your healthcare provider about keeping your baby healthy while sleeping.

Last reviewed by a Cleveland Clinic medical professional on 10/12/2020.


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Is It Safe To Sleep With My Baby On My Chest

Holding your baby skin-to-skin is such a powerful bonding experience that its recommended by the American Academy of Pediatrics for up to an hour after birth. Beyond this time, its still considered safe with one exceptionyou must be awake. The AAP warns that falling asleep while your baby is sleeping on you greatly increases the risk of sudden infant death syndrome .

How And Where Should A Newborn Sleep

Why should my baby sleep on his back?

According to the AAP, the safest place for newborns to sleep is on a firm surface in their parents bedroom. To reduce the risk of SIDS, babies should always be placed on their backs to sleep. Cribs, bassinets, portable cribs, and play yards are all recommended as long as they are free from soft objects like bedding, bumpers, blankets, and toys.

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When Can The Baby Be On Its Stomach

The baby may be put on the stomach, but under supervision, when awake. Giving tummy time for babies is a good way to strengthen their stomach, back, and neck muscles.

According to Dr. Karen Sokal-Gutierrez, clinical professor, community health and human development, University of California Berkeley-UCSF Joint Medical Program, SIDS risk is lowered with babies spending more tummy time when they are awake . Moreover, the baby would develop upper body strength needed to lift the head and roll over in sleep.

Never Sleep On The Couch With Your Baby

A staggering 53 percent of moms in our poll report they share the couch with their infant, a number that astonished our experts. It’s by far the most dangerous choice because couches can be softer and more plush than an adult bed, and Mom or Dad could accidentally roll over and suffocate Baby, Dr. Moon says. Ironically, some parents think couch-sharing is relatively safe because if they put Baby between their body and the back of the couch, she can’t fall off like she could in a bed. In reality, the child can become trapped between the parent’s body and the couch, and that can be much more dangerous, Dr. Moon says.

As a safety upgrade, bond with your baby before bed, and then put her in her crib, Carr says. When you’re wiped out or if it’s nighttime, avoid nursing or feeding your baby on the couch. You’re more apt to doze off there than in a less comfy spot, Dr. Mindell says. If your sweetie falls asleep and you’re tempted to snuggle her while you browse your Netflix queue, think twice.

Finally, never place a sleeping baby on a couch. About 18 percent of moms say their baby has slept on a couch alone, but even if you’re awake, it’s never safe. It takes only a minute for suffocation to occur.

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Baby Sleeping On Side Vs Back

Is it safe for babies to be put down to sleep on their sides or tummies? The short answer is no. You should put baby to sleep on his back from birth and continue to do so until he is 1 year old. While the incidence of SIDS is highest for the first six months, the recommendation of back to sleep applies for the whole first year.

Even with this basic message down-pat, you might be wondering why side and tummy sleeping positions are so risky before baby rolls himself over. Heres a look at the potential dangers.

Stomach sleeping increases the risk of SIDS up to 12.9 times, research shows. Side sleeping, too, makes SIDS more likely, though SIDS is still very rare, with an incidence rate of .035 percent, or 35 deaths in 100,000 live births, according to the Centers for Disease Control and Prevention .

Infants tend to sleep more deeply on their stomachs, which experts suggest may mute their arousal responses. That could prevent them from waking up during normal episodes of sleep apnea, so they can resume normal breathing patterns.

Stomach or side sleeping can also set the stage for rebreathing, where a baby breathes in his own exhaled air, causing his oxygen levels to drop and his carbon dioxide levels to rise. Rebreathing might be even more likely to happen if a baby is sleeping on a soft mattress or with blankets, pillows or stuffed animals near his face.

Can Babies Ever Safely Side Sleep

Baby safest sleeping position: why the back is best

As a rule, you should always lay your baby down to sleep on their back until they are at least 12 months old. However, its okay to leave your baby on their tummy if they roll that way once they can consistently roll from tummy-to-back on their own.

Your doctor may very rarely recommend tummy or side sleeping if your baby suffers from a medical condition. However, if this is the case, they should also educate you on how to safely place your baby in their crib.

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Help Your Little One Learn To Fall Asleep Lying Still

Once she’s used to falling asleep being rocked or walked instead of eating, the next phase is to get her to fall asleep without rocking. So you begin with rocking, but then, before she is actually asleep, you stop rocking, and just sit, holding her calmly. If she protests, begin rocking again. Keep repeating this. It may take 25 attempts, but eventually she will begin falling asleep even though you have stopped rocking. Thats a real victory.

Do this for a week or so until she’s used to it as your new routine: getting sleepy while rocking and then falling asleep in your arms while not rocking.

Sleep Habits To Reduce The Risk Of Sids

In addition to following the AAP’s recommendation for baby sleeping positions, you can protect your infant from SIDS by following these simple sleep safety tips:

  • Opt for a firm sleep surface. Purchase a safety-approved crib mattress, covered by a fitted sheet, and never place your baby down for sleep on soft surfaces, like pillows, quilts, and sheepskins.
  • Keep the sleeping area clean and clear. This means no soft objects, toys, pillows, blankets, quilts, sheepskins or crib bumpers.
  • Keep your babys sleep area near but separate. While your infant can sleep in the same room as you, he should not sleep in a bed or on a couch or armchair with adults or other children. Instead, your baby should sleep in a bassinet, crib, cradle or a bedside co-sleeper.
  • Monitor the temperature in your babys room. In other words, not too hot or too cold. And never place your infant near air-conditioning or heating vents, open windows or other sources of drafts.
  • Skip the blankets. Instead, invest in a one-piece sleeper or sleep sack as an alternative to blankets.
  • Consider a pacifier.Pacifiers have been shown to reduce the risk of SIDS, but don’t force it if your baby doesn’t want it.

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