Miya Pearson
Ensuring that a newborn is safe while sleeping is of utmost importance. The American Academy of Pediatrics does not recommend elevating a baby's head while sleeping as it may compromise respiration and increase the risk of positional asphyxia. The safest way to put a baby to sleep is on their back on a flat, firm, and waterproof mattress. This sleeping position is known as the supine position and is proven to lower the risk of sudden infant death syndrome (SIDS).
| 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 | Greater risk of sudden infant death syndrome (SIDS) |
| Recommended mattress type | Firm, flat, and waterproof |
| Recommended sleeping location | In the same room as the parent or carer |
| Recommended sleeping location for the first few months | Crib or bassinet next to the adult bed |
| Safe sleeping environment | No soft surfaces, crib bumpers, bedding, stuffed animals, pillows, blankets, or unfitted sheets |
| Reflux | Gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) |
| Recommended sleeping position for babies with reflux | On their back on a firm, flat surface |
| Elevating a baby's head while sleeping | Not recommended by the American Academy of Pediatrics (AAP) |
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What You'll Learn
- Babies with reflux should be placed on their back to sleep
- Elevating a baby's crib is not effective in reducing reflux
- Babies should sleep on a firm, flat surface without crib bumpers, bedding or toys
- Babies should sleep in the same room as their parents for the first six months
- Babies should not sleep on adult beds, couches or armchairs
Babies with reflux should be placed on their back to sleep
It is understandable that parents want to do everything they can to keep their baby safe and comfortable, especially if their baby has reflux. Reflux, also known as gastroesophageal reflux (GER) or acid reflux, is a common condition in babies, with symptoms including spitting up, tummy discomfort, and pain. While parents may be desperate for solutions to relieve their baby's reflux symptoms, it is crucial to prioritise their safety, especially during sleep.
Safe Sleep Position for Babies with Reflux
It is recommended that babies with reflux be placed on their back to sleep. This recommendation is supported by the American Academy of Pediatrics (AAP), which advises that the safest position for all babies, including those with reflux, is on their back. Research has shown that sleeping on the back reduces the risk of sudden infant death syndrome (SIDS). Sleeping on the front or side increases the risk of SIDS. Therefore, it is essential to place your baby with reflux on their back for every sleep, day or night, unless advised otherwise by a doctor for specific medical reasons.
Products to Avoid
It is important to note that products claiming to reduce reflux by elevating your baby's head, such as wedges, sleep positioners, swings, reclined bouncy seats, or rocking sleepers, are not recommended by the AAP. There is even evidence that sleeping in a semi-inclined position can worsen reflux symptoms. Instead, it is advised to place your baby on a firm, flat surface without any crib bumpers, bedding, or stuffed animals.
Additional Tips for Managing Reflux
While placing your baby with reflux on their back is crucial for safe sleep, there are also other measures you can take to help manage their reflux and improve their comfort:
- Follow a bedtime routine: A familiar and consistent bedtime routine can help soothe and calm your baby, making it easier for them to fall asleep, even if they are experiencing discomfort from reflux.
- Feed frequently with smaller portions: Pediatricians often recommend offering smaller feeds more frequently to help your baby's digestion and reduce reflux. Increasing the number of feeds ensures your baby receives adequate nutrition.
- Keep your baby upright after feeding: Keeping your baby sitting up for 20-30 minutes after feeding can help reduce reflux. You can use a carrier and take them for a walk, which can also be soothing.
- Try a different bottle: If your baby is bottle-fed, consider trying a different bottle brand. Some bottle nipples allow babies to swallow more air, leading to increased gas and reflux.
- Consult a pediatrician: If your baby has severe reflux or a family history of reflux, consult a pediatrician. They can provide personalised guidance, assess for conditions like gastroesophageal reflux disease (GERD) or food allergies, and recommend treatments such as medication or, in rare cases, surgery.
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Elevating a baby's crib is not effective in reducing reflux
Elevating a baby's crib is often done to help with a baby's reflux or to improve air circulation during sleep. While this practice is recommended for specific infant health issues, it must be done with safety in mind. Firstly, it is important to consult a healthcare professional, such as a pediatrician, before making any changes to your baby's sleep environment. They can provide tailored advice and ensure that elevating the crib is safe and appropriate for your baby's health needs.
However, it is important to note that elevating a baby's crib is not always effective in reducing reflux. The American Academy of Pediatrics (AAP) does not recommend products that promise to reduce reflux by elevating a baby's head, such as wedges or sleep positioners. In fact, there is evidence that sleeping in a semi-inclined position can even worsen reflux symptoms. Instead, the AAP recommends that infants with reflux should always be put to sleep on their backs on a firm, flat surface without any crib bumpers, bedding, or stuffed animals. This is known as the supine position and is the safest sleeping position for babies, reducing the risk of sudden infant death syndrome (SIDS).
Additionally, when elevating a baby's crib, it is crucial to avoid using soft materials such as blankets or pillows for elevation, as they can increase the risk of suffocation. A gentle incline of around 15 to 30 degrees is recommended to provide relief without posing safety risks. Commercial wedges or rolls made specifically for crib mattresses are ideal for achieving this angle. It is also important to regularly check on your baby to ensure they remain safe and comfortable.
Furthermore, there are alternative ways to help a baby with reflux sleep comfortably and safely. For example, a consistent bedtime routine can help babies fall asleep more easily. This routine should be relatively short and start about 30 minutes before the desired bedtime. It is also recommended that babies with reflux be offered lots of comfort when needed. While it might take them a little longer to sleep through the night, many go on to become great sleepers.
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Babies should sleep on a firm, flat surface without crib bumpers, bedding or toys
It is understandable that parents want to do everything they can to keep their baby safe and comfortable, especially when they have reflux. However, the best thing you can do for your baby is to put them down in a safe sleep position.
The safest way for a baby to sleep is on their back on a firm, flat surface without any crib bumpers, bedding, or toys. Research has shown that placing a baby on their back at the beginning of every sleep lowers the risk of sudden infant death syndrome (SIDS). Sleeping a baby on their front or side greatly increases the risk of SIDS. Babies who sleep on soft surfaces or with items such as crib bumpers, bedding, or toys are also at a higher risk of SIDS and other sleep-related deaths. Soft surfaces and items can increase the risk of suffocation, strangulation, and entrapment.
Babies should always sleep on a firm surface that returns to its original shape quickly when pressed on. The surface should be flat, like a table, and level, not at an angle or inclined. Even though a crib with nothing but a fitted sheet covering the mattress may seem bare, it is the safest option for a baby. If a baby is sleeping in an adult bed, all pillows, blankets, and unfitted sheets should be removed from the area to reduce the risk of suffocation and strangulation.
Products that promise to reduce reflux by elevating a baby's head, such as wedges or sleep positioners, are not recommended by the American Academy of Pediatrics (AAP). The AAP reports that elevating a baby's head is ineffective in reducing reflux and may result in the baby sliding down into a position that compromises respiration. Additionally, swings, reclined bouncy seats, rocking sleepers, car seats, and crib wedges are not approved for safe sleep and can make reflux worse by causing pressure on the stomach.
Instead, parents can offer lots of comfort to babies with reflux and give them time to play on their tummies while they are awake, as this helps their development.
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Babies should sleep in the same room as their parents for the first six months
It is recommended that babies sleep in the same room as their parents for the first six months, ideally for up to a year. This is to reduce the risk of Sudden Infant Death Syndrome (SIDS). According to the American Academy of Pediatrics (AAP), room-sharing can halve the risk of SIDS. The proximity allows parents to monitor their newborns' breathing patterns, quickly attend to their needs, and reinforce feeding practices, especially if breastfeeding.
Transitioning a baby to their own room too early could present challenges and risks. The primary concern is the increased risk of SIDS. Being close allows for easier monitoring of potential disturbances or emergencies. Newborns have small stomachs and require frequent feeding. Having them in the same room simplifies night feeds, ensuring they get the nutrition they need while also fostering a bonding experience.
However, some experts say that there is no scientific evidence to back up the guidelines. A study has found that babies get less sleep at night and sleep for shorter stretches when they share a room with their parents after four months. It also found that room-sharing after four months resulted in an increase in unsafe sleep practices. Research shows that babies who room-share beyond four months of age are four times more likely to be pulled into their parents' bed during the night and twice as likely to have pillows, blankets, and other unsafe sleeping materials close by during sleep.
Ultimately, the decision to transition a baby to their own room is unique to every baby and family. It is important to consider the benefits of room-sharing in terms of safety and bonding, as well as the potential challenges and risks of transitioning too early.
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Babies should not sleep on adult beds, couches or armchairs
While it is understandable that parents may sometimes fall asleep with their babies in their bed, it is important to know that this can be extremely dangerous. The safest way for a baby to sleep is on their back on a flat, firm, and waterproof mattress. This sleeping position significantly lowers the risk of sudden infant death syndrome (SIDS).
Babies should not sleep on adult beds, couches, or armchairs. The main risks of co-sleeping are suffocation and strangulation caused by entrapment of the baby's head in various parts of the bed. This includes the baby being overlain by a parent, sibling, or other adult sharing the bed; the baby becoming wedged or trapped between the mattress and another object, such as the wall; and the baby's head becoming entrapped in bed railings. Waterbeds pose a particular risk of suffocation.
A child safety expert has demonstrated that adult mattresses are dangerous for babies because they are too soft. In a video, the expert showed that a baby sleeping on an adult mattress could sink much further down than on a cot mattress, which should be completely flat and firm.
The risks of co-sleeping are even greater on a couch or armchair than in an adult bed. If a parent falls asleep with their baby on a couch or armchair, the risk of suffocation or strangulation is much higher. Therefore, it is recommended that mothers feed their babies in bed and then place them on their own sleep surface afterward.
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Frequently asked questions
Elevating a newborn's head while sleeping is not recommended by the American Academy of Pediatrics (AAP) as it is ineffective in reducing reflux and may compromise their respiration. Instead, it is recommended to place your baby on their back on a flat, firm, and waterproof mattress in the same room as you.
Elevating a newborn's head while sleeping can cause them to slide down to the foot of the crib, compromising their respiration and increasing the risk of suffocation and positional asphyxia.
It is important to ensure that newborns with reflux are placed in a safe sleeping position and offered comfort when needed. You can prop your baby up on your legs with your knees elevated or use a baby jumper or exersaucer (when age-appropriate). Bathtubs can also help maintain the position necessary to decrease reflux concerns.
While most babies spit up, some may experience gastroesophageal reflux (GER), which can be more uncomfortable. If you are concerned about your baby's reflux, it is best to consult a pediatrician for expert advice.
