When it comes to putting your baby to sleep, safe sleep practices are crucial to ensure their well-being and prevent the risk of sudden infant death syndrome (SIDS). One of the safest sleeping positions for babies is sleeping on their back, also known as the supine position, for infants who are less than a year old. In this article, we will delve into why sleeping on the back is considered the best sleeping position for babies, along with tips on sleep safety.
Sleeping on the back has been found to significantly reduce the risk of SIDS in babies. In fact, the US National Institute of Child Health and Human Development (NICHD) has labeled sleeping on the back as the best sleeping position for babies (1). Since the American Academy of Pediatrics first recommended the “back-to-sleep” position in 1992, the rate of SIDS has dropped by more than 50%. This recommendation has since been campaigned as “safe to sleep” (4).
Sleeping on the back helps keep the baby’s airways open, reducing the risk of breathing difficulties or obstructions during sleep. It allows the baby to breathe easily and comfortably, decreasing the chances of SIDS. However, it’s important to note that babies should be placed on their backs for naps, short periods of rest, and sleep at night, as prolonged time on the back can lead to positional plagiocephaly and brachycephaly, conditions where the head may become flattened or misshapen (1).
To prevent positional plagiocephaly and brachycephaly, parents can employ simple repositioning techniques. These include increasing the baby’s “tummy time” when they are awake, allowing the baby to rest on the other side of the head rather than the flat side, reducing the time spent by babies in carriers or car-seats, and providing more “cuddle time” (1). Additionally, changing the direction of the baby in the crib so that they do not always view the same things in one direction can also help.
On the other hand, sleeping on the stomach, also known as the prone position, is discouraged for babies as it can increase the risk of SIDS. Sleeping on the stomach can put pressure on the baby’s jaw, reducing the airway and restricting breath. It can also lead to suffocation if the mattress is too soft or if the baby breathes in microbes present on the mattress (2). However, in rare cases, due to medical conditions, doctors may advise parents to make the baby sleep on their stomach rather than their back. But this should only be done after considering the potential benefits and risks, and under the guidance of a healthcare provider (2).
Some physicians believe that sleeping on the stomach could be beneficial for babies with severe gastroesophageal reflux or certain upper-airway malformations like Pierre Robin Syndrome, which lead to acute airway obstruction episodes. However, no recent study has supported or refuted these benefits (2). It’s essential to discuss any concerns or medical conditions with a healthcare provider before deciding on a sleeping position for your baby.
Sleeping on the side is also discouraged for babies, as they may end up on their stomach, increasing the risk of SIDS. It is unsafe for babies to sleep on their side, but if they roll to the side during sleep, it is safe to keep them in that position. However, it is always best to place the baby on their back to sleep, as recommended by Dr. Nilong Vyas, a board-certified pediatrician and sleep consultant (3).
In addition to choosing the right sleeping position for your baby, it’s also important to be aware of other sleeping practices that could lead to sudden unexpected death in infancy. It is crucial to understand the potential risks and take necessary precautions to create a safe sleep environment for your little one.
Tips for Safe Sleep
To ensure safe sleep for your baby, follow these tips:
- Always place your baby on their back to sleep: The supine position, or sleeping on the back, is the safest sleep position for babies. It helps keep their airways open and reduces the risk of SIDS. According to the US National Institute of Child Health and Human Development (NICHD), placing babies on their back to sleep has resulted in a significant decrease in SIDS rates by over 50% since the ‘back-to-sleep’ recommendation was introduced in 1992 (4). Remember to place your baby on their back for naps, short periods of rest, and during the night.
- Avoid stomach and side sleeping: Sleeping on the stomach or side increases the risk of SIDS. Babies who sleep on their stomach may experience reduced airflow and may be more likely to rebreathe their own exhaled air, leading to a higher risk of SIDS. Similarly, sleeping on the side may cause babies to roll onto their stomach, posing a potential risk. It is best to avoid these positions and always place your baby on their back to sleep.
- Use a firm sleep surface: It is essential to provide your baby with a firm sleep surface, such as a crib mattress that meets safety standards. Avoid soft surfaces like mattresses, sofas, waterbeds, pillows, or lamb’s wool, as they can pose a suffocation risk for infants. Make sure the crib mattress fits snugly in the crib without any gaps, and do not use any additional padding or soft bedding, including crib bumpers, blankets, or pillows.
- Keep the crib or sleep area free from hazards: Make sure the baby’s sleep area is clear of any objects that can pose a suffocation or choking hazard. Avoid placing toys, pillows, blankets, or other loose items in the crib. Use a fitted sheet to cover the mattress, and dress your baby in a sleeper or a sleep sack instead of using loose blankets.
- Avoid overheating: Overheating can increase the risk of SIDS. Dress your baby in light, breathable clothing and keep the room at a comfortable temperature. Avoid using too many layers of clothing or heavy blankets, and do not cover your baby’s head or face while sleeping.
- Breastfeed if possible: Breastfeeding has been shown to have a protective effect against SIDS. If possible, try to breastfeed your baby, as it has many other health benefits as well.
- Avoid smoking during pregnancy and after childbirth: Smoking during pregnancy and exposure to secondhand smoke after childbirth are significant risk factors for SIDS. It is crucial to avoid smoking during pregnancy and keep your baby’s environment smoke-free.
Creating a safe sleep environment for your baby is essential in reducing the risk of SIDS and other sleep-related accidents. Always remember to place your baby on their back to sleep, use a firm sleep surface, keep the crib or sleep area free from hazards, avoid overheating, and avoid smoking during pregnancy and after childbirth. By following these safe sleep practices, you can provide your baby with a safe and healthy sleep environment, promoting their overall well-being. If you have any questions or concerns about safe sleep for your baby, consult with your pediatrician for expert advice. Sweet dreams for your little one!
