Ashwin Lewis
The topic of newborns and infants sleeping face down is a highly debated and often confusing topic for new parents. While some parents swear by the safety and comfort of their newborns sleeping face down, others are concerned about the potential risks involved, such as Sudden Infant Death Syndrome (SIDS) and suffocation. So, what's the verdict? Well, it's a bit of a grey area. While it is generally recommended that babies sleep on their backs, especially up to 12 months of age, some babies will prefer to sleep on their stomachs once they can roll over independently. Let's delve into the pros and cons of this controversial topic and explore the latest research and recommendations to help new parents make informed decisions about their little ones' sleep positions.
| Characteristics | Values |
|---|---|
| Safe sleeping position | On their back |
| Safe sleeping position after 12 months | On their tummy |
| Risk of sleeping face down | Suffocation |
| Risk of sleeping face down | Sudden Infant Death Syndrome (SIDS) |
| Risk of sleeping face down | Rebreathing exhaled air |
| Risk of sleeping in the bed with parents | Suffocation |
| Risk of sleeping in a car seat | Suffocation |
| Crib mattress | Should be breathable |
| Crib mattress | Should be firm |
| Crib mattress | Should be covered with a single sheet |
| Crib | Bumper pads should be avoided |
| Sleep sack | Should not go over the baby's face |
| Sleep environment | Smoke-free |
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What You'll Learn
- Safe sleeping recommendations advise sleeping on the back
- Sleeping face down increases the risk of rebreathing exhaled air
- Crib mattresses are designed to be breathable
- Babies should never sleep directly on their face due to suffocation risks
- Safe sleep environment tips include removing dummies and creating a smoke-free space
Safe sleeping recommendations advise sleeping on the back
Safe sleeping recommendations universally advise that newborns sleep on their backs. This is because sleeping face down increases the risk of sudden infant death syndrome (SIDS) and accidental suffocation or strangulation. According to the Centers for Disease Control and Prevention, there are about 3,400 sudden unexplained infant deaths (SUID) annually—many of which are sleep-related and preventable.
The American Academy of Pediatrics (AAP) recommends that parents follow the ABCs of safe sleep:
- Alone: Put your baby to sleep alone in their crib. Keep soft items like toys, crib bumpers, and blankets out of the crib.
- Back: Place your baby on their back to sleep during naps and at night.
- Crib: The crib, bassinet, or play yard should follow the safety standards of the Consumer Product Safety Commission. Ensure that the space between the crib bars is no more than 2-3/8 inches apart to prevent the baby from getting their head stuck.
It is important to note that the AAP does not provide clear directions for parents on what to do when a baby begins rolling over during sleep. If you find your baby sleeping face down, there is no need to wake them. You can try to gently turn their head to the side, but they will likely return to their preferred position. To help your baby build strength in their neck and upper body muscles, increase the amount of supervised tummy time they get each day. This will help them develop the ability to roll back over or lift their head if needed.
Additionally, it is crucial to maintain a safe sleeping environment for your baby. This includes ensuring the sleeping area is smoke-free, as smoke increases the risk of sleep-related infant death. Keep cigarettes, marijuana, and vaping products away from your baby, and do not share a bed with your baby if you are a smoker or vape user. It is also important to avoid bed-sharing if your baby is very young, small, or premature, or if you have been drinking alcohol, using drugs, or taking medications.
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Sleeping face down increases the risk of rebreathing exhaled air
It is a natural urge for babies to want to sleep on their stomachs, and many do so once they are able to roll onto their fronts independently. However, sleeping face down increases the risk of rebreathing exhaled air, which can be dangerous for newborns.
When a baby sleeps on their side or face down, they are more likely to re-inhale the air they just exhaled. This air contains higher carbon dioxide and lower oxygen levels, which will increase the carbon dioxide concentration in the baby's blood and reduce the oxygen concentration. This can affect the baby's cardiovascular autonomic nerve, which regulates heart rate and blood pressure, and will further reduce the oxygen supply to the baby's brain.
To reduce the risk of rebreathing exhaled air, parents can increase the amount of supervised tummy time their baby gets each day. This will help them to roll back over or lift their head when they need to in their sleep space. It is also important to ensure that the baby's sleep sack cannot go over their face and that they are sleeping on a breathable mattress covered with a single sheet.
While it is generally recommended that babies sleep on their backs, if they are consistently rolling from back to tummy and tummy to back, there is no need to continue trying to get them to sleep on their back. Additionally, once a baby reaches 12 months old, it is considered safe for them to change their sleep position to tummy sleeping, as the risk of Sudden Infant Death Syndrome (SIDS) decreases after this age.
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Crib mattresses are designed to be breathable
It is natural for babies to want to sleep on their stomachs and many parents find their newborns trying to flip to their tummies even when laid on their backs. While it is recommended that babies sleep on their backs, crib mattresses are designed to be breathable to prevent suffocation.
Crib mattresses are made to be super breathable. For example, the SafeSleep® Breathe-Through Crib Mattress is designed by a leading pediatrician to allow babies to breathe normally while sleeping face down. The mattress is tested to show 100% oxygen-rich air while breathing through it. This feature eliminates the risk of suffocation and rebreathing exhaled air, which can increase the carbon dioxide concentration in the baby's blood and reduce the oxygen concentration.
Similarly, the Newton mattress is a breathable mattress that can be covered with a single sheet. The breathability of crib mattresses is important because babies sleeping face down are at a greater risk of Sudden Infant Death Syndrome (SIDS). This is because sleeping on their stomachs can affect a baby's cardiovascular autonomic nerve, which regulates heart rate and blood pressure, and will reduce the oxygen supply to the baby's brain. Additionally, a baby's body may not be able to respond normally to the compromised breathing and their heartbeat will be compromised.
To ensure your baby's safety, it is important to create a safe sleep environment. This includes making sure that their sleep sack cannot go over their face and that the sleeping environment is smoke-free. It is also recommended to increase the amount of supervised tummy time to help build strength in their neck and upper body muscles, allowing them to roll back over or lift their head if needed.
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Babies should never sleep directly on their face due to suffocation risks
It is understandable that parents want to ensure their child is safe and comfortable, especially when sleeping. While it is instinctual for a baby to want to sleep on their stomach, babies should never sleep directly on their face due to the risk of suffocation.
Babies who sleep on their stomach or face-down are at a higher risk of Sudden Infant Death Syndrome (SIDS). This is because sleeping face-down affects the baby's cardiovascular autonomic nerve, which regulates heart rate and blood pressure, and will reduce the oxygen supply to the baby's brain. This effect is most pronounced when the baby is 2-3 months old.
Additionally, babies sleeping face-down are at risk of rebreathing their exhaled air, which contains higher carbon dioxide and lower oxygen levels. This will increase the carbon dioxide concentration in the baby's blood and reduce the oxygen concentration, which can be dangerous.
To reduce the risk of SIDS and ensure your baby's safety, it is recommended that babies sleep on their back until they are 12 months old. After this age, it is generally considered safe for babies to change their sleep position to tummy sleeping, as the risk of SIDS decreases.
If you find your baby sleeping face-down, there is no need to wake them. You can try to gently turn their head to the side, but they may return to their preferred position. Instead, focus on making their sleep environment as safe as possible. Ensure the sleeping area is smoke-free and free of any loose items that could cover the baby's face, such as blankets or toys.
While it is important to follow safe sleep practices, it is also crucial to remember that every baby is unique, and you should consult your healthcare provider for specific advice regarding your child's sleep.
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Safe sleep environment tips include removing dummies and creating a smoke-free space
It is understandable for new parents to be nervous about their baby sleeping face down. While it is true that babies sleeping face down are at a greater risk of sudden infant death syndrome (SIDS) and rebreathing exhaled air, it is okay to let them continue sleeping in that position if they got themselves into it. By seven months, babies should have good control of their necks to prevent suffocation. Crib mattresses are designed to be super breathable, allowing babies to breathe normally even when sleeping face down.
Remove Dummies:
- If your baby is using a dummy, it is not necessary to remove it once they have fallen asleep. However, if the dummy falls out during sleep, there is no need to reinsert it.
- Using a dummy at night can help calm your baby and reduce the risk of SIDS.
Create a Smoke-Free Space:
- Keep your baby's environment smoke and vapour-free, both before and after birth.
- The link between sudden unexpected death in infancy (SUDI) and smoking or vaping is strong, even when parents smoke away from their babies.
In addition to the above, here are some general safe sleep environment tips:
- Ensure your baby sleeps on their back, as the reflexes that keep their airways open work better in this position.
- Keep your baby's sleep space clear of any items that might stop them from breathing easily, such as loose blankets, pillows, toys, and other soft items.
- Make sure your baby's face and head are uncovered, with no pillows, nests, loungers, cot bumpers, mattress padding, or soft toys around them.
- Keep your baby's coverings lightweight and tucked in securely at their chest level, with their feet positioned at the bottom of the cot. Alternatively, use a safe infant sleeping bag or suit instead of coverings.
- Avoid overheating by dressing your baby for the room temperature and not overbundling them.
- Breastfeed your baby if possible, as breastfeeding reduces the risk of SUDI, including SIDS and fatal sleeping accidents.
- Room-sharing with your baby for the first year of life or at least the first six months is recommended, as it makes feeding, comforting, and monitoring them easier. Keep them in a safety-approved crib next to your bed or a bassinet.
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Frequently asked questions
It is not recommended for newborns to sleep face down as it increases the risk of Sudden Infant Death Syndrome (SIDS) and rebreathing exhaled air. The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs until they are 12 months old. After 12 months, it is considered safe for babies to change their sleep position to tummy sleeping.
Sleeping face down can affect a baby's cardiovascular autonomic nerve, which regulates heart rate and blood pressure, and reduce the oxygen supply to their brain. It can also increase the risk of suffocation, especially if the baby's face becomes covered or trapped in bedding or pillows.
While it is not recommended, if your newborn insists on sleeping face down, ensure their sleep environment is safe. Remove any loose bedding, pillows, or toys from the crib to reduce the risk of suffocation. You can also increase supervised tummy time during the day to help strengthen their neck and upper body muscles, making it easier for them to roll over or lift their head during sleep.
