Miya Pearson
The safety of newborns and infants is paramount, and one of the most important things to consider is their sleep position. It is a common misconception that babies sleeping on their stomachs are less likely to aspirate or accidentally breathe fluid into their lungs if they spit up. In fact, the opposite is true: back-sleeping infants are much less likely to aspirate. Sleeping on the stomach increases the risk of Sudden Infant Death Syndrome (SIDS) and other hazards, such as rebreathing, suffocation, overheating, and blocked airways. The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs for at least the first 12 months, and ideally until their first birthday. However, if a baby can roll onto their stomach and has the strength to turn back, it is generally considered safe to let them sleep in that position.
| Characteristics | Values |
|---|---|
| Recommended sleep position for newborns | On their back |
| Risks associated with stomach sleeping | Rebreathing, suffocation, overheating, blocked airway, Sudden Infant Death Syndrome (SIDS) |
| Safe age for stomach sleeping | After 1 year, or when the child can roll over by themselves |
| Safe sleep environment for newborns | Crib free from pillows, bumpers, toys, blankets, and bedding |
| Safe sleep practices for newborns | Swaddling, tummy time during the day, co-sleeping with parents |
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What You'll Learn
Stomach sleeping increases the risk of SIDS
The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs for at least the first six months and, ideally, until their first birthday. Sleeping on the stomach increases the risk of sudden infant death syndrome (SIDS). In 2020, approximately 1,389 babies died of SIDS in the United States.
Stomach sleeping can increase the risk of rebreathing, which is when a baby breathes in their own exhaled air. This air has lower oxygen levels and higher carbon dioxide levels, which can cause the oxygen levels in the baby's blood to drop. This is particularly dangerous when the baby is sleeping on a soft mattress or with bedding, stuffed toys, or a pillow near their face.
Research has shown that babies who sleep on their stomachs are more than twice as likely to die from SIDS as babies sleeping in other positions. A study conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) found that 58% of African American infants who died from SIDS were stomach sleeping, compared to 55% for all other ethnic groups.
Babies who sleep on their backs are also better able to avoid conditions that may trigger SIDS. They learn through experience which head movements increase their supply of oxygen-rich air and decrease the discomfort associated with breathing in carbon dioxide.
To reduce the risk of SIDS, it is important to create a safe sleep environment for your baby. This includes using a firm, flat mattress; keeping soft objects and loose bedding away from the sleep area; and room-sharing without bed-sharing.
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Rebreathing exhaled air increases carbon dioxide levels
It is not recommended to let your newborn sleep on their stomach. Sleeping on their back is the best and only position for a baby to sleep in, recommended by the American Academy of Pediatrics (AAP) through the baby's first year. Sleeping on the stomach increases the risk of Sudden Infant Death Syndrome (SIDS) as the baby is breathing in less air, which can increase carbon dioxide levels in the blood. This is known as rebreathing.
Rebreathing is when a baby inhales exhaled air, which is lower in oxygen and higher in carbon dioxide. This can cause the baby's blood oxygen levels to drop. It is primarily thought to occur when an infant is face-down on a mattress or other surface, or when something covers the baby's face, such as a blanket, pillow, toy, another person, or an animal. The AAP also warns that soft, adjustable mattresses, including memory foam ones, can increase the chances of rebreathing.
Physical and geometrical conditions influence carbon dioxide accumulation near the face of a sleeping infant. Mathematical and data-based simulations, as well as an experimental rebreathing model, have shown that with exhaled air at room temperature, the CO2 concentration can increase to about 10% within 5 minutes. The increase is faster in smaller volumes and openings, such as when an infant is placed deep in a cot or pram with the bedding and walls creating a narrow, vertical shaft. This can result in carbon dioxide accumulation around the infant's head.
While some infants sleep face-down for long periods with no ill effects, rebreathing of expired air has been determined by CO2 measurements. Two important factors influencing inspired gas concentrations are a variable seal between bedding and infants' faces and gas gradients in the bedding beneath the infants. The microstructure of the bedding allows airflow with minimal turbulence and, consequently, little air mixing. As a result, the end-expired air, which is high in CO2 content, is trapped closest to the infant's face.
To reduce the risk of rebreathing, it is important to follow safe sleep practices for infants. This includes always placing babies on their backs to sleep, using a firm mattress and tight-fitting sheets, and keeping soft objects, toys, and loose bedding away from the sleep area. Additionally, it is recommended to encourage tummy time when babies are awake to help strengthen their neck and shoulder muscles and promote motor development.
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Suffocation is a risk if bedding covers the baby's face
It is not recommended to let your newborn sleep on their stomach. Sleeping on the stomach increases the risk of Sudden Infant Death Syndrome (SIDS) and other hazards during the first year of their life. The best way to ensure safe sleep for your baby is to place them on their back.
One of the most concerning aspects of a baby sleeping on their stomach is rebreathing. This happens when exhaled air, which can get trapped around a baby's face, is inhaled again. This air is lower in oxygen and higher in carbon dioxide, which can cause the oxygen levels in the blood to drop. This can lead to dangerously high carbon dioxide and low oxygen levels in their bodies, which can harm brain and respiratory function. Rebreathing is primarily thought to occur when an infant is face-down on a mattress or another surface, or when something covers the baby's face, such as a blanket, pillow, toy, another person, or an animal.
To reduce the risk of rebreathing, it is important to keep the baby's head and face uncovered and to avoid soft, adjustable mattresses, including those made of memory foam. It is also recommended to keep the crib clear of toys and blankets and to keep the bedding tight. Loose blankets can increase the risks of SIDS.
Additionally, if a baby without sufficient head control rolls onto their stomach with their face buried in the crib mattress or bedding, it could pose a suffocation risk. To help protect a young baby from suffocation, it is important to keep the crib free from pillows or bumpers and avoid sleeping wedges or weighted sleep sacks that could inhibit their movement.
If your baby is consistently rolling onto their stomach to sleep, consult with your GP or pediatrician to find a safe solution.
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Overheating can occur if babies sleep on their stomachs
Sleeping on their stomach increases a baby's chances of rebreathing. This happens when a baby breathes in exhaled air that is trapped around their face, leading to lower oxygen and higher carbon dioxide levels in the blood. This can be dangerous for newborns who are already at risk of sudden infant death syndrome (SIDS).
Overheating is a common risk factor for SIDS. Babies are not very good at regulating their body temperature, and their body temperature rises much faster than that of an adult. They also sweat less, which reduces their ability to cool down. Overheating can cause lethargy and discomfort in babies, and in some cases, it can lead to heat rash and other heat-related illnesses.
To prevent overheating, it is important to maintain a comfortable room temperature for your baby. Keep the room temperature between 68 and 72 degrees Fahrenheit (20 to 22.2 degrees Celsius) and no higher than 75 degrees Fahrenheit (23.8 degrees Celsius). Avoid bundling your baby in too many layers of clothing or bedding, especially during the winter months when parents often worry about their babies getting cold. Instead, dress your baby as you would dress yourself for the temperature of the room.
Additionally, keep your baby's sleep space away from heat sources such as heaters, radiators, and fireplaces. Use lightweight and breathable materials for bedding and clothing, and avoid synthetic fabrics like fleece that can trap heat. It is also important to monitor your baby's temperature and watch for signs of overheating, such as warm ears, flushed skin, and sweating.
By taking these precautions, you can help reduce the risk of overheating and create a safer sleep environment for your newborn.
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Tummy time is encouraged when babies are awake
While it is recommended that babies sleep on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS), there are benefits to letting your baby spend time on their tummy when they are awake. This is often referred to as "tummy time".
Tummy time is important for your baby's development and has many benefits. It helps to strengthen your baby's neck, shoulder, and arm muscles, allowing them to start to sit up, crawl, and eventually walk. It also improves your baby's ability to move and control their muscles, also known as motor skills. Tummy time gives your baby a new perspective and encourages them to look around, which can help to prevent flat spots on the back of their head.
You can start tummy time a day or two after your baby is born. Start with short sessions of 3-5 minutes, two to three times a day. Place your baby belly-down on your chest or across your lap. As your baby gets used to it, you can gradually increase the duration and frequency of tummy time. By the time your baby is 3 months old, they should be getting about an hour of tummy time each day.
To make tummy time more enjoyable for your baby, you can sing songs, shake a rattle, or place colorful toys nearby to encourage them to look up and reach. Always stay with your baby during tummy time and choose a low, safe surface to place them on to avoid the risk of rolling off or suffocation.
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Frequently asked questions
No, it is not considered safe for newborns to sleep on their stomach. Sleeping on their back is recommended by experts until the baby reaches 1 year of age. Sleeping on the stomach increases the risk of Sudden Infant Death Syndrome (SIDS) and other hazards such as rebreathing, suffocation, overheating, and blocked airways.
SIDS stands for Sudden Infant Death Syndrome. It is the unexpected or unexplained death of a healthy infant between newborn and 1 year of age, usually during sleep.
Rebreathing is when a baby breathes in their exhaled breath, which is lower in oxygen and higher in carbon dioxide. This can lead to dangerously high carbon dioxide and low oxygen levels in the baby's body, harming brain and respiratory function.
To reduce the risk of SIDS, it is recommended to always put your baby to sleep on their back. You can also take measures such as keeping the crib clear of toys, blankets, and pillows, and ensuring your baby's head and face are uncovered. Additionally, encouraging tummy time while they are awake can help with their muscular development and head shape.
If your baby rolls onto their stomach while sleeping, it is generally considered fine as long as they are able to roll both ways (from tummy to back and back to tummy) consistently. This usually happens around 6 months of age, but some babies may start rolling earlier, between 3 to 5 months.
