One of the most common topics I discuss with parents is sleep safety. Above all else, your child’s sleep safety is THE MOST IMPORTANT aspect of sleep.
There is a lot of misinformation about sleep positions for infants, and some of it can be concerning for parents trying to make the best choices for their babies. One topic that often comes up is the idea of putting babies on their bellies to sleep. I want to set the record straight about this, and explain why it's absolutely essential to follow current sleep guidelines to protect your baby’s health (even if your baby seems to prefer sleeping on their belly, like most babies do).
The Current Safe Sleep Guidelines
First, let’s start with the basic, evidence-backed recommendation: babies should always be put to sleep on their backs. This is the guideline that pediatricians and sleep experts around the world endorse for the first year of life, and it has been proven to significantly reduce the risk of Sudden Infant Death Syndrome (SIDS), the leading cause of death in infants under one year old.
In fact, research and years of studies have shown that babies who sleep on their bellies are at much higher risk of SIDS. The American Academy of Pediatrics (AAP) recommends that babies be placed on their backs for all sleep times — both naps and overnight sleep — until their first birthday.
Why Belly Sleeping is Dangerous
When babies sleep on their bellies, several things happen that can be harmful:
Breathing Difficulties: Babies have very limited neck control in the early months. When placed on their belly, they may have difficulty turning their head to clear their airway if they spit up or if their breathing becomes restricted. The risk of suffocation or rebreathing carbon dioxide increases in the belly position. It should also be noted that it is recommended that babies under 8-12 weeks are swaddled with arms in. They therefor will not have their arms (and nor do they have the arm strength) to change their position.
Overheating: Babies sleeping on their stomachs are more prone to overheating. When their face is pressed into the bedding, it can restrict airflow and lead to a rise in body temperature — a known risk factor for SIDS.
Increased Risk of SIDS: As I mentioned, babies placed on their bellies are at a significantly higher risk for SIDS. The back-sleeping position has been shown to decrease this risk by up to 50% since it allows for better airway management, improved breathing, and greater comfort.
Tummy Time: The Key to Healthy Development
While placing babies on their bellies to sleep is dangerous, it’s important to note that tummy time is crucial for a baby’s development. Tummy time refers to the practice of placing your baby on their stomach while they are awake and supervised. This helps to strengthen the neck, shoulder, and arm muscles, which are vital for rolling over, sitting up, crawling, and other motor milestones.
Start tummy time as early as possible (from the first week of life) and aim for short, frequent sessions throughout the day. Your child will likely not like this! That is ok. Many/most babies protest tummy time especially in the first few months when it is difficult. The key is supervision — tummy time should always be done when your baby is awake and alert. If you’re looking for a way to integrate tummy time into your baby’s routine, consider doing it during playtime or while they’re interacting with you on the floor. Over time, your baby will build the necessary muscles to support their movement, and tummy time will become a fun and engaging activity for them.
What Parents Can Do to Ensure Safe Sleep
Ensuring your baby’s sleep environment is safe is critical to their well-being. Here are some key recommendations to follow:
Always place your baby on their back to sleep: This is the single most important thing you can do to reduce the risk of SIDS.
Use a firm, flat sleep surface: Avoid soft bedding, pillows, blankets, and stuffed animals in the crib, as these can pose suffocation risks.
Sleep in the same room, but not in the same bed: The AAP recommends room-sharing (keeping your baby’s crib or bassinet in your room) for the first six to twelve months to reduce the risk of SIDS. However, babies should sleep in their own safe sleep space and not in an adult bed, as co-sleeping increases the risk of suffocation and accidental injury.
Dress your baby appropriately for sleep: Keep your baby’s room at a comfortable temperature (68-72 F/19-22 C) and dress them in light layers to prevent overheating. Avoid using heavy blankets or quilts.
Avoid exposing your baby to secondhand smoke: Smoking during pregnancy and after birth increases the risk of SIDS. Creating a smoke-free environment is essential for your baby’s health.
Understanding the 'Back to Sleep' Campaign
The “Back to Sleep” campaign, launched in 1994, significantly reduced the rate of SIDS in the United States by educating parents about the importance of back sleeping. Since then, the number of SIDS-related deaths has decreased by more than 50%. This campaign has been incredibly successful, and we know that following these guidelines has a real and positive impact on babies' health.
Will it ever be safe for my baby to sleep on their belly?
Yes. While it is imperative that babies always be put on their back to sleep, your baby may eventually choose to sleep on their belly. This is safe when they are able to roll independently both directions (back to front and front to back), typically around 6-8 months (but can be as early as 4-5 months). The general consensus here is that if a baby gets themself onto the bellies on their own, they are safe to stay there. Note: babies this age (over the age of 8-12 weeks) should be fully unsaddled and arms out to allow them to mobilize and clear their airway by turning their head and pushing up with their arms.
Conclusion
As a pediatric sleep consultant, my primary concern is the safety and well-being of infants. The recommendation to place babies on their backs to sleep is not just a guideline — it’s a life-saving measure. While tummy time is a crucial part of infant development, putting babies on their bellies to sleep is simply not safe and significantly increases the risk of SIDS. By following current sleep recommendations, you can ensure that your baby’s sleep is as safe and healthy as possible.
If you're ever in doubt about your baby's sleep habits or have concerns about their sleep environment, don’t hesitate to consult your pediatrician for personalized guidance. Your baby's health and safety is always worth it!
Commentaires