Colin Snow
There are many schools of thought on whether it is safe for a newborn to sleep on their stomach. While some parents believe that newborns sleep better on their tummies, it is important to note that this position increases their risk of Sudden Infant Death Syndrome (SIDS) and asphyxiation. SIDS is one of the leading causes of death for babies in their first year, with approximately 1,389 cases reported in 2020 in the United States. To reduce the risk of SIDS, the American Academy of Pediatrics (AAP) recommends that babies be placed on their backs to sleep until they are at least 12 months old. However, if a baby can roll onto their belly and back again, it is generally considered safe to let them sleep in the position they are most comfortable in.
| Characteristics | Values |
|---|---|
| Safe sleeping position | On their back |
| Safe sleeping duration | Until the age of 12 months |
| Risks | SIDS, rebreathing, suffocation, overheating, blocked airway, fever, ear infections, stuffy noses |
| Safe sleeping environment | Free of blankets, pillows, and toys |
| Safe sleeping location | Not in bed with parents |
| Safe sleeping age | After 5-6 months of age |
| Safe sleeping practice | Swaddling |
| Safe sleeping alternative | Sleeping on the chest of an awake adult |
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What You'll Learn
- Stomach sleeping increases the risk of Sudden Infant Death Syndrome (SIDS)
- Babies can re-breathe exhaled air, increasing the risk of choking and overheating
- Tummy sleeping can cause a sudden decrease in blood pressure and heart rate control
- Babies should sleep on their backs for the first 12 months
- Tummy time when awake helps build core strength and motor skills
Stomach sleeping increases the risk of Sudden Infant Death Syndrome (SIDS)
Stomach sleeping is not recommended for newborns and infants below the age of one. Sleeping on the stomach increases the risk of Sudden Infant Death Syndrome (SIDS) and other hazards. SIDS is the unexpected death of a healthy infant during sleep, and research has shown that babies who sleep on their stomach are more than twice as likely to die of SIDS. The risk of SIDS is highest for babies between one and four months old.
There are several reasons why stomach sleeping increases the risk of SIDS. One reason is rebreathing, which occurs when babies breathe in the air they have exhaled, leading to high carbon dioxide and low oxygen levels in their bodies. This can happen when babies sleep on soft surfaces or have stuffed animals, bedding, or pillows near their faces. Another risk is suffocation, which can occur if a baby's nose and mouth become blocked, preventing them from breathing. Additionally, sleeping on the stomach can cause a sudden decrease in blood pressure and heart rate control.
To reduce the risk of SIDS, it is recommended that babies sleep on their backs for the first 12 months of life. This recommendation is supported by extensive research and has led to a significant decrease in SIDS-related deaths. If a baby consistently rolls over onto their stomach after being put to sleep on their back, it is generally considered safe to leave them in that position. However, it is important to ensure that the baby can easily roll from their stomach to their back and that the sleep environment is safe, with no obstructions in the cot.
While stomach sleeping is not recommended for newborns, there are some circumstances where it may be appropriate. For example, some parents choose to let their babies nap on their chests while they are awake and alert, as this can provide a sense of security and comfort. However, it is important to ensure that the baby does not become unsupervised during these naps, as the risk of SIDS increases if the baby rolls off or becomes covered by blankets or other objects.
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Babies can re-breathe exhaled air, increasing the risk of choking and overheating
Sleeping on their stomach increases the risk of choking and overheating for babies, who are already vulnerable to infection and have weaker muscles and developing lungs.
Babies can re-breathe exhaled air, which increases the risk of choking and overheating. In the womb, the mother breathes in and out for the baby, with carbon dioxide from the baby exiting through the placenta and oxygen entering through the umbilical cord. After birth, the baby's lungs are filled with fluid and must be inflated by taking a first breath. This first breath is triggered by the newborn's central nervous system reacting to the sudden change in temperature and environment. The baby's lungs inflate and begin working on their own, moving oxygen into the bloodstream and removing carbon dioxide through exhalation.
Newborns are more susceptible to infection, and their weaker muscles and developing lungs can make breathing more difficult. They may breathe irregularly, with long pauses of up to 10 seconds between each breath, and they breathe mostly through their noses. Their lungs are not yet fully developed, and they produce about twice as much heat as adults. This additional heat is removed through the baby's skin, amniotic fluid, and the uterine wall. After birth, the newborn begins to lose heat, and their bodies create heat by burning stores of brown fat.
To reduce the risk of choking and overheating, it is recommended that babies sleep on their backs on a flat and solid surface, with no extra bedding or toys. This sleeping position allows for the best breathing support and reduces the risk of sudden infant death syndrome (SIDS). While it may be challenging to settle a baby on their back, creating a soothing and calming bedtime routine can help. Additionally, it is important to ensure that the room temperature is comfortable for the baby and that their clothing is not causing them to overheat.
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Tummy sleeping can cause a sudden decrease in blood pressure and heart rate control
It is unsafe to let newborns sleep on their stomachs. Sleeping on their stomachs increases the risk of Sudden Infant Death Syndrome (SIDS) and asphyxiation. Tummy sleeping can cause a sudden decrease in blood pressure and heart rate control in newborns.
During sleep, the body enters a state of recovery, where heart rate, blood pressure, and breathing stabilise and slow down. This is particularly true during the non-rapid eye movement (NREM) sleep stages, which are deep sleep stages. However, when a newborn sleeps on their stomach, they are at risk of restricted airflow, which can lead to sudden decreases in blood oxygen levels. This, in turn, can cause a sudden drop in blood pressure and a slower heart rate, as the body tries to compensate for the lack of oxygen.
Newborns sleeping on their stomachs can also be at risk of sudden infant death syndrome (SIDS). While the exact causes of SIDS are still unknown, it is believed that sleeping on the stomach increases the risk of SIDS by possibly causing respiratory failure. Since 1992, when the American Academy of Pediatrics (AAP) started recommending that babies sleep on their backs, cases of SIDS have drastically reduced.
To ensure a safe sleep environment for your newborn, it is recommended that you always place them on their back to sleep, on a flat and solid surface, with no extra bedding, pillows, or toys. Creating a soothing and calming bedtime routine can also help your baby settle and sleep comfortably on their back. While it can be challenging to follow these recommendations, especially with well-meaning advice from family and friends, it is crucial to prioritise creating a safe sleep environment for your newborn.
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Babies should sleep on their backs for the first 12 months
It is recommended that babies sleep on their backs for the first 12 months. This is because sleeping on their stomach increases the risk of Sudden Infant Death Syndrome (SIDS). SIDS is the term used to describe the unexpected or unexplained death of a healthy infant between newborn and one year of age, usually during sleep. Most SIDS-related incidents occur before the age of six months.
Research has shown that babies who are put down to sleep on their stomachs are more than twice as likely to die of SIDS than infants sleeping in other positions. In addition, sleeping on the stomach can increase the chances of "rebreathing". This is when babies breathe in the air they have exhaled, which can lead to dangerously low oxygen levels and high carbon dioxide levels in their bodies. This can be especially dangerous if the baby is sleeping on a soft surface or has stuffed animals, bedding, or pillows near their faces.
Another risk of tummy sleeping is suffocation. If a baby's nose and mouth get blocked, they will not be able to breathe in the oxygen they need. This can happen if the baby rolls over onto something that blocks their breathing or if bedding covers their face. Tummy sleeping may also lead to a sudden decrease in blood pressure and/or heart rate control.
If your baby consistently rolls onto their tummy while sleeping, it is advised to consult with your GP or pediatrician to find a safe solution. However, if your baby is over the age of one and has good head and trunk control, it is not necessary to turn them back onto their back.
To help your baby sleep comfortably on their back, you can start a soothing and calming bedtime routine. This can include giving them a gentle bath, ensuring the room temperature is between 68° and 72°F, and using a white noise machine to block out outside noises. Additionally, you can swaddle your baby, but only when they are awake and always place them on their back to sleep.
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Tummy time when awake helps build core strength and motor skills
While it is generally advised that babies are put to sleep on their backs, especially until the age of 12 months, tummy time is essential for their physical and cognitive development. Tummy time refers to placing a baby on their stomach while they are awake and supervised.
Tummy time helps build core strength and motor skills, and it is recommended that babies get 15 to 30 minutes of tummy time daily. This can be done in short sessions of 3 to 5 minutes each, gradually increasing the duration as the baby gets older.
During tummy time, babies develop strength and stability in their neck, shoulder, back, and core muscles. This helps them prepare for milestones such as tilting their head to both sides, rolling over, sitting up, crawling, and eventually walking. Tummy time also encourages sensory exploration and enhances visual tracking skills as the baby learns to move their head and look around, getting more familiar with their surroundings.
It is important to never leave a baby unsupervised during tummy time and to ensure that both the caregiver and baby are awake and alert. As the baby develops more muscle strength and stability, new tummy time activities can be introduced to keep things interesting and stimulating for the baby.
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Frequently asked questions
No, it is not recommended for newborns to sleep on their stomachs. Sleeping on their backs is the safest option for newborns and significantly lowers the risk of Sudden Infant Death Syndrome (SIDS) and other hazards.
When a baby sleeps on their stomach, they may re-breathe expired air trapped in the bedding, leading to dangerously high carbon dioxide and low oxygen levels in their bodies. This can cause an imbalance that may harm brain and respiratory function.
You can start a soothing and calming bedtime routine to help your newborn settle and enjoy a good night's rest. This can include giving them a gentle bath and a massage using baby oil. You can also check the room temperature and ensure it is between 68° and 72°F.
If your newborn can consistently roll both ways (back to tummy and tummy to back), it is generally considered okay to let them sleep on their stomach. However, it is still recommended to place them on their back for every nap and bedtime until they are at least one year old.
While it is not recommended for newborns to sleep on their stomachs due to the associated risks, some parents believe that stomach sleeping may have benefits such as reducing the likelihood of aspiration or accidentally breathing fluid into the lungs if they spit up while sleeping.
