Colin Snow
There are many schools of thought on whether newborns should sleep on their stomachs. While some sources say it is unsafe for newborns to sleep on their stomachs, others say it is fine as long as they have rolled themselves over and are unswaddled on a firm mattress with no loose bedding. The concern with newborns sleeping on their stomachs is the risk of Sudden Infant Death Syndrome (SIDS) and asphyxiation. According to the CDC, approximately 1,389 babies died of SIDS in 2020. The American Academy of Pediatrics (AAP) recommends that infants sleep on their backs for at least the first year to reduce the risk of SIDS. However, some babies may prefer to sleep on their stomachs, and this position can be beneficial for their development and motor skills. Ultimately, caregivers should discuss any questions or concerns about their child's sleeping position with a pediatrician.
| Characteristics | Values |
|---|---|
| Safe sleep position for newborns | On their back |
| Safe sleep position for babies under 1 year | On their back |
| Safe sleep position for babies over 1 year | On their stomach or another position |
| Safe sleep position for babies who can roll | On their stomach, as long as they are unswaddled on a firm mattress with no loose bedding |
| Safe sleep position for babies who can't roll | On their back |
| Safe sleep position for babies sleeping on a caregiver's chest | On their stomach |
| Risks of sleeping on the stomach | Increased risk of Sudden Infant Death Syndrome (SIDS), rebreathing, decrease in blood pressure, and/or heart rate control |
| Benefits of sleeping on the stomach | Better sleep quality, improved development and motor skills |
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What You'll Learn
Safe sleep positions for newborns
The safest position for newborns to sleep in is on their back. Research shows that placing babies to sleep on their backs reduces the risk of Sudden Infant Death Syndrome (SIDS). SIDS is one of the leading causes of death for babies in their first year, affecting about 3,400 babies in the United States annually. Sleeping on the back is recommended by the American Academy of Pediatrics (AAP) and other pediatricians for the first year of a baby's life.
It is unsafe to put a newborn to sleep on their stomach. Sleeping on the stomach increases the risk of SIDS and other hazards, such as asphyxiation and rebreathing. Rebreathing occurs when a baby inhales exhaled air that is trapped around their face, leading to lower oxygen and higher carbon dioxide levels in the blood. Other risks of tummy sleeping include a sudden decrease in blood pressure and heart rate control.
However, once a baby can roll from back to tummy and tummy to back on their own, it is generally considered safe for them to sleep on their stomach, as long as they are unswaddled and sleeping on a firm infant mattress with no loose bedding. At this stage, babies are usually strong enough to lift their head and turn it if needed. Supervised tummy time during waking hours is important for a baby's development and can help them practice rolling and moving onto their back.
If your newborn struggles to fall asleep on their back, swaddling can provide a sense of security and help prevent their startle reflex from waking them up. It is important to stop swaddling once the baby starts attempting to roll or turn over.
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Reducing the risk of SIDS
It is unsafe for babies to sleep on their stomachs before turning one, as it increases the risk of Sudden Infant Death Syndrome (SIDS). Once a baby can consistently roll from back to tummy and tummy to back, sleeping on their stomach is considered safe, provided they are unswaddled on a firm infant mattress with no loose bedding.
Place babies on their backs to sleep
For at least the first year, it is recommended that babies sleep on their backs. This is true even for babies with reflux. The back sleeping position should be maintained for all sleep times, including daytime naps.
Use a firm, flat sleep surface
The sleep surface should be firm and flat, such as a safety-approved crib or bassinet. A mattress in a crib covered by a fitted sheet is a good option. Avoid soft or plush surfaces, and ensure there are no gaps larger than two fingers wide, as the baby's head could get stuck.
Avoid loose bedding and soft objects
Keep the baby's sleep area free from blankets, pillows, loose bedding, stuffed animals, and other soft or loose objects. These can pose a suffocation hazard.
Breastfeed if possible
Breastfeeding can lower the risk of SIDS by about 50%. It helps the baby's immune system become stronger, and the brain has been shown to develop more maturely in breastfed babies.
Offer a pacifier at naptime and bedtime
Pacifiers may help reduce the risk of SIDS by keeping the baby's airway open and preventing them from sleeping too deeply. However, avoid using pacifiers attached to the baby's clothing or other objects to prevent choking or suffocation.
Keep the baby's room well-ventilated
Avoid overdressing the baby or using too much bedding, as this can cause overheating, which is another risk factor for SIDS. Keep the room well-ventilated, and ensure the baby is comfortable and not sweating.
Vaccinate your baby
Recent evidence suggests that vaccines may have a protective effect against SIDS. Ensure your baby receives recommended vaccines to protect against serious diseases.
Practice tummy time during the day
Supervised tummy time during waking hours is essential for a baby's development and motor skills. It helps babies develop strength and can make them more comfortable with tummy sleeping once they are able to roll both ways.
Remember to always consult with your pediatrician if you have any concerns about your baby's sleep or development.
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The benefits of tummy time
While it is unsafe for babies to sleep on their tummies before turning one, tummy time during waking hours is important for a baby's development and has a wide range of benefits.
Tummy time is the intentional, supervised playtime that babies spend on their tummies while awake. It is a fundamental aspect of a baby's early development and can have a profound impact on their growth and overall well-being.
Motor Skills Development
Tummy time can strengthen a baby's neck, torso, back, and upper body muscles, leading to improved head control. It encourages the development of crawling and rolling skills as the baby learns to move around and lays the foundation for essential milestones like rolling over, crawling, and eventually walking.
Prevents Flat Head Syndrome
Tummy time reduces the risk of plagiocephaly (flat head syndrome) by allowing the baby to change the position of their head.
Visual and Cognitive Development
Lying in a new position creates a different perspective and allows the baby to explore their surroundings and develop visual tracking skills. This stimulates brain development as the baby interacts with toys and observes their environment.
Bonding and Comfort
Tummy time positions allow newborns to bond with their parents and enable babies to cuddle.
Tummy time can begin as early as a few days after birth, but it is important to consult a pediatrician for specific recommendations. It is recommended to start with short sessions, aiming for just a few minutes several times a day, and gradually increasing the duration. It is important to always closely supervise the baby during tummy time to prevent accidents and provide comfort.
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Safe co-sleeping practices
It is unsafe for newborns to sleep on their stomachs. Research shows that placing babies on their backs to sleep for at least the first year reduces the risk of sudden infant death syndrome (SIDS).
- Always place your baby on their back to sleep. This is true even for babies with reflux.
- Use a firm, flat, and level surface for your baby to sleep on. A safety-approved crib with a firm mattress and a fitted sheet is ideal. Avoid soft mattresses and surfaces such as couches, sofas, waterbeds, memory foam, and adult mattresses.
- Keep the sleep area clear of any items that could pose a suffocation or strangulation hazard, such as pillows, blankets, loose bedding, crib bumpers, stuffed animals, and other soft objects.
- If you choose to co-sleep, ensure that your baby is next to you on a safe surface, such as a safety-approved crib or bassinet. Room-sharing makes feeding, comforting, and monitoring the baby easier.
- If you fall asleep while feeding or comforting your baby in your bed, move them to their own sleep area as soon as you wake up.
- Avoid co-sleeping if you are a smoker, or if you have consumed alcohol or drugs, as these substances can impair your responsiveness.
- Practice supervised "tummy time" during the day to help your baby develop strength and motor skills.
- If your baby starts rolling over onto their stomach while sleeping, you don't need to adjust their position as long as they are unswaddled and sleeping on a firm mattress with no loose bedding.
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Creating a safe sleep environment
For the first year of life, it is recommended that babies sleep on their backs, as this reduces the risk of Sudden Infant Death Syndrome (SIDS). SIDS is one of the leading causes of death for babies in their first year and sleeping on the stomach is a leading risk factor. Therefore, it is important to create a safe sleep environment for newborns.
Firstly, the sleep surface should be firm, flat, and level. A crib with a fitted sheet is the safest option. Sleep surfaces with one end higher than the other, or those that elevate both the head and feet, increase the risk of positional asphyxia. The crib should meet government safety standards and be placed in a quiet, dark, and slightly cool room.
Secondly, loose items in the crib, such as blankets, pillows, stuffed toys, and bumpers, should be avoided as they pose a risk of suffocation. Instead of blankets, consider dressing the baby in a sleeper. If the baby is rolling in their sleep and is comfortable sleeping on their stomach, they should be unswaddled on a firm mattress with no loose bedding.
Thirdly, room-sharing is recommended to facilitate feeding, comforting, and monitoring. A safety-approved crib placed next to the adult bed allows for easy access to the baby and reduces the risk of SIDS. However, it is important to avoid bed-sharing, as this increases the risk of entrapment and suffocation. If the baby is in the adult bed for feeding or comforting, remove all items and bedding from the area to reduce the risk of suffocation.
Lastly, establishing a calming and consistent bedtime routine is important. This may include a gentle bath, a massage with baby oil, and diaper care. A consistent routine can help set the mood for a peaceful night's sleep.
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Frequently asked questions
No, it is not safe for a newborn to sleep on their stomach. Sleeping on their stomach increases the risk of Sudden Infant Death Syndrome (SIDS) and other hazards during the first year of their life.
The recommended sleep position for newborns is on their back on a firm mattress with no loose bedding. This is the safest position for infants as it reduces the risk of SIDS.
If your newborn is able to roll onto their stomach while sleeping, you don't need to adjust their position as long as they are unswaddled and on a firm mattress with no loose bedding. However, you should continue to place them on their back at the beginning of the night.
In addition to the increased risk of SIDS, other risks of newborns sleeping on their stomach include rebreathing (breathing in exhaled air with lower oxygen and higher carbon dioxide), sudden decrease in blood pressure, and heart rate control issues.
Some newborns may sleep better on their stomach and it can provide a sense of security. Sleeping on the stomach can also encourage healthy development and help babies develop strength and motor skills.
