Herbie Murray
The safety of babies sleeping on their stomachs has been a topic of concern for parents and caregivers. While some babies may prefer sleeping on their stomachs and seem more comfortable, it is generally recommended that babies are put to sleep on their backs for at least the first 12 months to reduce the risk of sudden infant death syndrome (SIDS), suffocation, choking, and overheating. Babies can be allowed to sleep on their stomachs once they have mastered rolling over and can move freely from tummy to back and back to tummy. This usually happens between 4 and 7 months, and parents can then let the baby sleep in the position they prefer.
| Characteristics | Values |
|---|---|
| Recommended sleeping position for babies | On their back |
| Risks of sleeping on the stomach | Suffocation, choking, overheating, rebreathing, SIDS |
| Safe age to sleep on the stomach | No universal age; once the baby can roll both ways |
| Tricks to help babies sleep on their back | Swaddle, white noise, pacifier |
| Tummy time | Supervised sessions of 3-5 minutes to strengthen neck, shoulder, and arm muscles |
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What You'll Learn
Babies should sleep on their backs for the first 12 months
It is recommended that babies sleep on their backs for the first 12 months to reduce the risk of sudden infant death syndrome (SIDS). Sleeping on their backs also reduces the risk of suffocation, choking, and overheating for babies.
Babies who sleep on their stomachs may be more likely to suffocate. According to Dr. Badgett, when humans breathe out, they release air that has high levels of carbon dioxide. If a baby sleeping on their stomach inhales this air, it can lead to hypoxia (not enough oxygen) and hypercapnia (too much carbon dioxide), both of which are life-threatening and known risk factors for SIDS. On the other hand, when a baby sleeps on their back, the expired air moves away from them, allowing them to breathe in fresh oxygen.
Additionally, when a baby sleeps on their back, the trachea (windpipe) sits above the opening of the esophagus (tube to the stomach), making choking much less likely. However, when they sleep on their stomach, the stomach opening is above the trachea, allowing fluids to collect at the entrance of the windpipe due to gravity, increasing the risk of choking.
To help babies get used to sleeping on their backs, swaddling can be used as it makes them feel more secure and snug, mimicking the womb. White noise can also be used to drown out sudden noises that might startle the baby awake.
Once babies can roll from their back to their stomach and vice versa, it is generally considered safe to let them sleep on their stomach if they roll that way during sleep. Tummy time while they are awake is essential for building the strength needed to roll over and can also help prevent flat head syndrome, which can occur when babies sleep primarily on their backs.
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Rolling over milestone
Rolling over is a significant milestone in a baby's development, and it usually occurs between 4 and 7 months of age. Some babies may show signs of rolling over as early as 3 months, while others may take until they are 7 months old to master this skill. The milestone typically starts with rolling from tummy to back, and then a few weeks later, they learn to roll from back to tummy.
At around 5 months old, your baby will probably be able to lift their head, push up on their arms, arch their back to lift their chest off the ground, rock on their stomach, kick their legs, and "swim" with their arms. These are all signs that they are developing the gross motor skills necessary for rolling over.
You can encourage your baby to roll from back to belly by holding a ball or toy in their line of vision and moving it to the side so they have to roll over to see it. Spending time on their tummy helps build core, neck, shoulder, and arm strength, all of which are needed for rolling, sitting up, crawling, and eventually walking. Tummy time also helps develop your baby's motor skills and can prevent flat spots on their head from sleeping on their back.
Once your baby has mastered rolling over, the risk of Sudden Infant Death Syndrome (SIDS) drops significantly. However, it is still important to follow safe sleep practices, such as always placing your baby on their back to sleep for the first 12 months and keeping their sleeping space free of soft toys, loose blankets, and pillows. If your baby hasn't figured out how to roll by 6 months old and hasn't moved on to sitting, scooting, or crawling, it is recommended to talk to their doctor.
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Safe sleep environment
It is recommended that babies sleep on their backs for every sleep for the first 12 months to reduce the risk of SIDS, suffocation, choking, and overheating. Once a baby can roll both ways, stomach sleeping becomes safer.
- Room sharing without bed sharing is recommended as the safest option. Keep the baby in a safety-approved crib next to the adult bed to make feeding, comforting, and monitoring easier.
- The crib should be empty with no bumper pads, pillows, blankets, stuffed animals, toys, or supplies. Only a tightly fitted sheet is recommended.
- The crib should have spindles no wider than 2-3/8 inches apart and sides that do not drop down.
- The baby's sleep surface should be firm, flat, and level. Sleep surfaces with one end higher than the other are not safe as they can cause positional asphyxia.
- Use a sleep sack or wearable blanket instead of loose blankets to keep the baby warm.
- Swaddling can help the baby feel more secure, but it should be stopped once the baby starts to roll.
- White noise can help to drown out sounds that might startle the baby awake.
- Pacifier use, paired with back sleeping, can help reduce the risk of SIDS.
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Reducing the risk of SIDS
It is recommended that babies sleep on their backs for the first 12 months to reduce the risk of SIDS. Sleeping on their back allows expired air to float away from them, reducing the risk of hypoxia and hypercapnia, which are life-threatening and known risk factors for SIDS. Once a baby can roll both ways, stomach sleeping becomes safer.
Back Sleeping
Placing babies on their backs to sleep for all sleep times is one of the most effective ways to reduce the risk of SIDS. This recommendation is supported by the American Academy of Pediatrics (AAP) Task Force on Sudden Infant Death Syndrome (SIDS). It is important to place babies on their backs for sleep until they are strong enough to roll onto their stomachs on their own.
Safe Sleep Environment
Creating a safe sleep environment is crucial to reducing the risk of SIDS. This includes using a firm mattress with no loose bedding, bumpers, stuffed animals, or extra blankets that could come loose and pose a suffocation risk. The baby's sleep area should be kept clear of any items, except for a fitted sheet.
Avoid Overheating
Overheating is a risk factor for SIDS. Dress the baby in clothing suitable for the room temperature, and avoid overdressing or using too many layers of clothing and bedding. Be cautious about signs of overheating, such as sweating, flushed or hot skin, or a hot chest.
Pacifier Use
Research suggests that pacifier use can reduce the risk of SIDS, especially in formula-fed babies. It is recommended to offer a pacifier after breastfeeding, as it may help prevent babies from getting too deep into sleep and may reduce the risk of rolling over without waking. However, it is important not to attach the pacifier to clothing or other items and not to force the baby to take it if they are uncomfortable.
Breastfeeding
Breastfeeding has been shown to have a protective effect against SIDS. Even a few months of breastfeeding can significantly lower the risk. It helps strengthen the baby's immune system and promotes brain development.
Tummy Time
Encouraging tummy time while the baby is awake can help build their core, neck, shoulder, and arm strength, which are necessary for rolling, sitting up, crawling, and walking. It also helps prevent flat head syndrome, which can develop from spending too much time on their backs.
It is important to note that there is no universal age for safe tummy sleeping, as babies develop at different rates. Always consult with a healthcare professional for personalized advice and to ensure that you are following the most up-to-date safe sleep guidelines.
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Tummy time
It is generally advised that babies should always be placed on their backs to sleep for the first 12 months to lower the risk of SIDS (Sudden Infant Death Syndrome). Babies who sleep on their stomachs may be more likely to suffocate due to inhaling air with too much carbon dioxide and too little oxygen.
However, once your baby can roll both ways (from back to tummy and tummy to back), it is considered safe for them to sleep on their stomach. This typically happens between 4 and 7 months of age, although every baby develops at their own pace. If your baby is strong enough to roll onto their tummy, they are likely strong enough to lift their head and breathe safely in this position.
- Always supervise your baby during tummy time and ensure they are on a safe, low surface where they cannot roll off or suffocate.
- Sing songs, use colourful toys, or get down on the floor to encourage your baby to turn and face you.
- Facilitate baby push-ups by gently placing your hands under their chest and tummy, encouraging them to push up briefly on their hands.
- Be patient and positive, as some babies take time to get used to tummy time.
- Avoid tummy time if your baby is tired or fussy.
- Aim for around 15 to 30 minutes of supervised tummy time per day, in short sessions spread throughout the day.
Remember, even when your baby can roll onto their tummy, it is still recommended to place them on their back for every nap and bedtime until they are 12 months old to reduce the risk of SIDS.
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Frequently asked questions
It is generally recommended that babies sleep on their backs for the first 12 months to reduce the risk of SIDS. However, if your baby can roll both ways (from tummy to back and back to tummy) and chooses to sleep on their stomach, it is typically considered safe to let them do so.
Sleeping on the back is recommended for the first year of a baby's life because it significantly lowers the risk of SIDS, suffocation, choking, and overheating.
Babies who sleep on their stomachs may be at a higher risk of rebreathing expired air, leading to dangerously high carbon dioxide and low oxygen levels, which can cause hypoxia and hypercapnia. This is known as rebreathing and is a risk factor for SIDS.
Babies typically start rolling over and sleeping on their stomachs between 3 and 7 months of age. However, it is important to ensure that they have mastered rolling in both directions before allowing them to sleep on their stomachs.
You can provide supervised tummy time during the day to help strengthen your baby's neck, shoulder, and arm muscles and encourage rolling. Creating a safe sleep environment with a firm, flat surface and no loose bedding can also help your baby sleep comfortably on their back.
