
Newborns should always sleep on their backs, on a flat surface, to reduce the risk of sudden infant death syndrome (SIDS). Sleeping on the back is the safest position for babies, and it is recommended that they sleep in the same room as their parents for the first six months. However, this sleeping position can cause flat spots on the back of the head due to continued pressure on the same area. To prevent flat spots, it is recommended to alternate the baby's position in the crib each day and provide supervised tummy time when they are awake.
Can newborn sleep with head elevated?
| Characteristics | Values |
|---|---|
| Recommended sleeping position for newborns | On their back |
| Sleeping position to avoid | On their front or side |
| Risk associated with sleeping on the front or side | Sudden infant death syndrome (SIDS) |
| Risk associated with sleeping on the back | Flat head syndrome |
| Ways to prevent flat head syndrome | Change the baby's position in the crib each day, supervised "tummy time" when they are awake, use toys to encourage head movement |
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What You'll Learn

Sleeping position and the risk of SIDS
The safest way for a newborn to sleep is on their back on a flat, firm, and waterproof mattress. This is known as the supine position. Sleeping on the back from the very first day helps to make it a routine and placing the baby on their back for every sleep, day or night, lowers the risk of sudden infant death syndrome (SIDS). Sleeping a baby on their front or side increases the risk of SIDS.
Babies who are usually placed on their backs to sleep but are sometimes placed on their front or side are at a high risk of SIDS. Research has shown that infants who were usually placed on their backs to sleep but had last been put down in an unaccustomed prone or side position had a significantly high risk of SIDS. The risk of SIDS was especially high for an unstable side position in which an infant was placed on their side and found prone.
It is recommended that babies are always placed on their backs to sleep unless advised otherwise by a doctor for medical reasons. Babies should be placed on their backs until they are old enough to roll themselves over. Once they can move themselves from their back to their front and back again, they will be able to find their own sleeping position.
To reduce the risk of SIDS, it is also important to keep the baby's cot clear of items such as toys that could cover their face and keep their airways clear. For the first six months, babies should always sleep in the same room as their parents.
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Flat head syndrome
The safest way for a baby to sleep is on their back on a flat, firm, and waterproof mattress. This position is known as the supine position, and it lowers the risk of sudden infant death syndrome (SIDS). However, one of the side effects of the Back to Sleep campaign, which recommends that babies sleep on their backs, is an increase in cases of flat head syndrome.
Premature babies are more likely to develop a flattened head because their skulls are softer when they are born, and they may prefer to rest their head on one side as they are not yet able to move their head. Neck muscle tightness, known as torticollis, can also cause flat head syndrome by preventing a baby from turning their head, resulting in constant pressure on one part of the head. In some cases, flat head syndrome can cause facial differences, practical challenges, psychosocial difficulties, and developmental delays.
To prevent and treat flat head syndrome, it is important to vary the baby's sleep position and provide plenty of "tummy time" during the day while they are awake and being supervised. Changing the position of toys and mobiles in their cot can also encourage the baby to turn their head to the non-flattened side. In some cases, a doctor may prescribe a helmet to help correct the head shape.
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Safe sleeping environment
The safest sleeping position for a newborn is to sleep on their back on a flat, firm, and waterproof mattress. This position is known as the supine position and it is recommended that babies sleep in this position from day one. Keeping the baby's sleep surface clear of items such as toys, loose blankets, pillows, and bumpers is also important, as these items can cover the baby's face and obstruct their airways.
Babies should always sleep in the same room as their parents for the first six months, but not in the same bed. Co-sleeping with a baby can increase the risk of suffocation and strangulation, especially if the adult falls asleep. If you do fall asleep while holding your baby, it is important to put them back in their own sleep area as soon as you wake up.
It is also recommended to alternate the side of the crib that you place your baby's head on to prevent the development of a flat head. This can also help to encourage your baby to sleep on both sides of their head. Allowing your baby to have supervised time on their tummy during the day will also help to prevent the development of a flat head and is good for their development.
Following these safe sleep recommendations can help to reduce the risk of Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS), the leading cause of injury death in infancy.
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Tummy time
It is recommended that newborns sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS). However, this can cause their heads to become misshapen from continued pressure on the same area. To prevent this, it is important to incorporate tummy time into their routine.
To start tummy time, place your newborn on their belly on your chest or lap for a few minutes at a time, two to three times a day. You can also place them on a blanket on the floor for 3-5 minutes, several times a day. As they get used to it, gradually increase the duration and frequency of tummy time. The goal is to reach about 1 hour of tummy time per day by the time they are 3 months old.
During tummy time, encourage your baby to lift their head and turn it from side to side. You can do this by placing toys or a mirror in front of them to grab their attention. Always stay with your baby during tummy time and ensure they are on a safe, low surface, such as a blanket or towel on the floor, or your lap.
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Positional plagiocephaly
The safest way for a baby to sleep is on their back, on a flat, firm, and waterproof mattress. This sleeping position is recommended to reduce the risk of sudden infant death syndrome (SIDS). However, a side effect of this recommendation has been an increase in cases of flat head syndrome, also known as positional plagiocephaly.
Simple practices can help prevent and treat flat head syndrome. Changing a baby's sleep position, holding them, and providing supervised "tummy time" can help flattenings improve or disappear. To encourage active head turning, consider how you lay your baby down in the crib. Most right-handed parents naturally lay their babies down with their heads to the left, so the infant must turn to the right to look out into the room. You can also alternate the side of the crib you place your baby's head on to encourage sleeping on both sides of the head.
If positional therapy is ineffective, helmet or band therapy may be recommended. The original molding helmet surrounds the asymmetrical infant head with a symmetrical mold to guide skull growth back to a normal shape. More advanced techniques, such as Dynamic Orthotic Cranioplasty (DOC Band®), apply gentle pressure to specific areas of the head to manage growth.
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Frequently asked questions
No, newborns should sleep on their backs on a flat, firm, and waterproof mattress. Sleeping on their front or side increases the risk of sudden infant death syndrome (SIDS).
Sleeping with an elevated head can cause a newborn's soft skull to flatten due to the prolonged pressure on the same area of the head. This condition is known as positional plagiocephaly.
To prevent flattening, alternate the side of the crib that you place your baby's head on each day. You can also encourage your baby to look towards the room by placing a mobile on the side of the crib. In addition, provide supervised "tummy time" for your baby when they are awake to help prevent flat spots and promote their development.











































