Safe Tummy Time Sleep For Newborns: Day Or Night?

There are differing opinions on whether newborn babies can sleep on their tummies during the day. Some sources claim that it is unsafe for babies to sleep on their tummies before turning one, while others claim that it is fine as long as they are supervised. The risk of sudden infant death syndrome (SIDS) is higher for babies who sleep on their tummies, and it is recommended that babies sleep on their backs for at least the first year of life.

Safe sleeping positions for newborns

Tummy sleeping is not recommended for newborns as it increases the risk of Sudden Infant Death Syndrome (SIDS). SIDS is the leading cause of death for babies in their first year and affects about 3,400 babies in the United States each year. Babies who sleep on their stomachs may also experience "rebreathing", where they breathe in air they have exhaled, which has lower levels of oxygen and higher levels of carbon dioxide. This can cause oxygen levels in the blood to drop to dangerous levels.

The safest position for a newborn to sleep in is on their back on a flat, firm surface such as a crib or bassinet. This reduces the risk of SIDS and is recommended by experts until the child reaches 1 year of age. Back sleeping also reduces the risk of ear infections, stuffy noses, and fever.

If your newborn rolls onto their tummy while sleeping, you should still place them on their back to sleep. If they are strong enough to roll onto their tummy, they are likely strong enough to lift their head and sleep safely in this position. However, it is important to ensure that there are no loose objects in the crib or bassinet that could cause suffocation, such as blankets, pillows, or toys.

Some newborns may struggle to sleep on their back or prefer sleeping on their tummy. To help them sleep comfortably on their back, you can:

• Swaddle them to provide a sense of security and prevent their startle reflex from waking them up.
• Use white noise to drown out sudden sounds that could startle them awake.
• Give them a pacifier for comfort.
• Spend time holding them in an upright position while they are awake to reduce the risk of flat head syndrome.

In addition to sleeping on their back, here are some other safe sleeping tips for newborns:

• Create a safe sleep space by using a firm, safety-approved sleep surface such as a crib or bassinet. Remove all soft objects from the crib, including toys, pillows, and loose bedding.
• Sleep in the same room as your newborn for the first year, but on a separate sleep surface. This can reduce the risk of SIDS by up to 50%.
• Avoid exposing your newborn to second-hand smoke, as this has been linked to SIDS.
• Keep the room temperature cool to prevent overheating, which is another risk factor for SIDS.
• Offer a pacifier during sleep time, as this has been shown to protect against SIDS.

The risks of tummy sleeping for newborns

Placing a newborn to sleep on their tummy or side is not recommended by healthcare experts. Instead, the American Academy of Pediatrics (AAP) recommends that caregivers place infants on their backs until they are at least one year old. This recommendation applies to all types of sleep, including daytime naps.

Sudden Infant Death Syndrome (SIDS)

The unexplained death of a baby less than a year old is known as SIDS. Research shows that tummy sleeping is linked to SIDS. Once public health experts began promoting the Back to Sleep campaign in the 1990s, SIDS deaths dropped by up to 83%. Babies who sleep on their stomachs may have trouble getting enough oxygen, increasing the risk of suffocation.

Risk of suffocation

When a baby sleeps on their belly, they inhale the air they already breathed out, which can lead to too much carbon dioxide and too little oxygen in their body. On the other hand, a baby sleeping on their back is able to get the oxygen they need without breathing in expired air.

Overheating

A baby sleeping on their belly can get too hot, and they are unable to switch positions to cool off. Research has found that babies who get too hot are at a greater risk of SIDS.

Choking

When a baby sleeps on their stomach, the tube that leads to their stomach sits above the one leading to their lungs. Due to gravity, any fluids that come up from the stomach will gather at the entrance of the lung tube, increasing the likelihood of choking.

Rebreathing

This happens when exhaled air, which can get trapped around the baby's face, is inhaled again. The air is lower in oxygen and higher in carbon dioxide, which can cause the oxygen levels in the blood to drop.

Plagiocephaly

Also known as flat head syndrome, this can occur if babies are laying down in the same position for too long. However, these flat spots typically resolve on their own as babies start to practice more tummy time and sit up.

When can newborns sleep on their tummies?

It is not safe for babies to sleep on their tummies before turning one. This includes allowing little ones to sleep on their sides because it's easy for them to roll onto their stomachs from this position. The risk of sudden infant death syndrome (SIDS) is one of the main reasons why babies should not sleep on their tummies. SIDS is one of the leading causes of death for babies in their first year of life, affecting about 3,400 babies in the United States each year.

The American Academy of Pediatrics (AAP) recommends that infants sleep on a flat and firm sleeping surface, in a bassinet or crib with no soft objects around. Soft objects include pillows, blankets, stuffed animals, and loose bedding. These items are all suffocation hazards for babies.

Other dangers of babies sleeping on their tummies include rebreathing, suffocation, overheating, and blocked airways. Rebreathing occurs when a baby breathes in the air they have exhaled, which is lower in oxygen and higher in carbon dioxide. This can cause oxygen levels in the blood to drop. Suffocation can occur if a baby's nose and mouth get blocked, and they are unable to breathe. When babies lie on their tummies, they can also get too hot, which is linked to SIDS.

Babies should be placed on their backs to sleep for at least the first year. Back sleeping is the safest position for infants because it reduces the risk of SIDS. After a child turns one year old, they can begin sleeping on their stomach or in another position.

If your baby is rolling onto their tummy while sleeping, you don't need to adjust their position. Simply begin each night by placing your baby on their back in a safe sleep environment free from blankets and other soft or loose objects. Most doctors agree that if your baby is strong enough to roll onto their tummy, they are strong enough to lift their head and safely sleep in this position.

If your baby is rolling onto their tummy, for safety reasons, they must not be swaddled. Swaddling can be dangerous for mobile babies who can flip from their back to their stomach but are unable to flip back over because they are wrapped in the swaddle. Instead, a sleep sack is a safer option once babies start to roll.

Tips for helping your baby sleep on their back:

• Swaddle your baby, as this can make them feel more secure.
• Use white noise to drown out sounds that could startle your baby awake.
• Give your baby a pacifier, which can be soothing and may further reduce the risk of SIDS.
• Practice tummy time during the day to help your baby develop the strength and motor skills to roll over.
• Limit the amount of time your baby spends in car seats, swings, and bouncy chairs during the day to help prevent plagiocephaly or flat head syndrome.
• Ensure your baby's mattress is firm and designed for infants.
• Keep the crib free of loose bedding, pillows, and toys.
• Stay nearby at bedtime to provide comfort and reassurance as your baby is learning to sleep on their back.

At around one year of age, the risk of SIDS drops dramatically in babies without health problems, so this is an ideal time to start placing your baby on their tummy or side to sleep. By this age, babies have usually developed enough strength to roll themselves back to a safe position if needed.

What to do if your newborn rolls onto their tummy while sleeping

It can be nerve-wracking to find your baby sleeping on their tummy, especially if it's the first time. Here are some steps you can take to ensure your baby's safety and help them adjust to this new sleeping position:

Check their sleeping environment:

• Ensure your baby's crib or bassinet is free of any loose objects such as blankets, pillows, toys, or soft bedding. These items can increase the risk of Sudden Infant Death Syndrome (SIDS) and accidental suffocation.
• Use a firm, safety-approved sleep surface, such as a crib or bassinet, with a tight-fitting sheet.
• Make sure your baby is not swaddled. Once they start rolling, it's important to transition them out of the swaddle to give them the freedom to move and prevent the risk of suffocation.
• Keep the room at a comfortable temperature to avoid overheating, which is another risk factor for SIDS.

Assess your baby's development:

• Most babies start rolling over between 4 and 6 months of age. If your baby has reached this milestone and can roll both ways (from tummy to back and back to tummy), it's generally safe to let them sleep in the position they prefer.
• If your baby is younger than 4 months or hasn't mastered rolling both ways, you may need to take additional steps to ensure their safety.

Adjust their position:

• If your baby is younger than 4 months or cannot roll both ways consistently, gently roll them back onto their back. This is recommended until they are at least one year old, as it significantly reduces the risk of SIDS.
• If your baby is around 6 months old and has good head and trunk control, you don't necessarily need to turn them back onto their back. They likely have the agility to protect themselves and adjust their position if needed.

Encourage tummy time during the day:

• Provide ample opportunities for tummy time when your baby is awake. This will help strengthen their muscles and improve their ability to roll and adjust their sleeping position.
• Tummy time also helps prevent flat spots on the back of your baby's head and encourages the development of other milestones, such as crawling and walking.

Be patient and provide comfort:

• It's normal for your baby to be upset or cry when they roll onto their tummy while sleeping, especially if they are used to sleeping on their back.
• Resist the urge to immediately roll them back onto their back. Instead, rub their back, pat their bottom, and offer comfort to help them adjust to this new sleeping position.
• It usually takes about a week for babies to get used to tummy sleeping or figure out how to roll back onto their back.

Consult your paediatrician:

If you have any concerns about your baby's sleeping patterns or their development, don't hesitate to reach out to your paediatrician for advice and guidance.

How to help newborns sleep on their backs

For the first year of a baby's life, it is recommended that they sleep on their back. This is because sleeping on their tummy increases the risk of sudden infant death syndrome (SIDS).

• Create a safe sleep space: Use a firm, safety-approved sleep surface like a crib or bassinet. The mattress should be covered by a fitted sheet, with no toys, pillows, blankets, bumper pads or other soft objects in the crib.
• Room-share: The American Academy of Pediatrics recommends that infants sleep in the same room as the caregiver, on a separate surface, for the first year after birth. Research has found that a child sleeping in the same room as parents can reduce the risk of SIDS by up to 50%.
• Avoid second-hand smoke: Smoking during and after pregnancy is associated with various infant health issues, including premature births, birth defects and SIDS.
• Offer a pacifier: Research has shown that offering an infant a pacifier before sleep can protect against SIDS.
• Keep the room at a comfortable temperature: Overheating due to clothing, blankets or room temperature increases the risk of SIDS. Infants should wear light clothing or a wearable blanket designed for sleep.
• Practice tummy time: During the day, practice tummy time to help your baby develop the strength and motor skills needed for rolling and crawling.
• Be patient: It can take time for a baby to adjust to sleeping on their back.

Remember, once your baby can roll from their back to their tummy and back again, it is generally considered safe for them to sleep on their stomach, as long as they are unswaddled on a firm mattress with no loose bedding. However, it is still recommended that you place your baby on their back to sleep, even after they have learned to roll over.

Frequently asked questions