Miya Pearson
Should newborns sleep on their bellies? This is a question that many new parents ask, and for good reason. The short answer is no—infants should sleep on their backs for the first year of their lives. Sleeping on their bellies increases the risk of sudden infant death syndrome (SIDS) and other dangers such as rebreathing, suffocation, overheating, and blocked airways. However, once babies can roll both ways, stomach sleeping becomes safer, and parents can encourage tummy time and rolling practice to help them build strength and get used to sleeping on their bellies.
| Characteristics | Values |
|---|---|
| Recommended sleep position for newborns | On their back |
| Age to start sleeping on the belly | After turning 1 year old |
| Risk of sleeping on the belly | Sudden Infant Death Syndrome (SIDS) |
| Risk of sleeping on the back | Flat head syndrome |
| Tips to sleep on the back | Practice tummy time during the day |
| Hold the infant upright when they are awake | |
| Limit the use of seats that put pressure on the back of the baby's head |
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What You'll Learn
The risks of sleeping on their stomach
It is recommended that newborns sleep on their backs for at least the first year of their life. Sleeping on their stomach increases the risk of sudden infant death syndrome (SIDS). Babies who sleep on their stomachs are more than twice as likely to die of SIDS than infants sleeping in other positions. SIDS is the term used to describe the unexpected or unexplained death of a healthy infant, usually during sleep. In 2020, approximately 1,389 babies died of SIDS in the United States.
When a baby sleeps on their stomach, they breathe in less air, increasing their risk of SIDS. They are also more likely to overheat, breathe in too much carbon dioxide, and suffocate, which are all events linked to SIDS. Research suggests that stomach sleeping may inhibit the ability of low-birthweight babies to release heat and regulate body temperature, leading to overheating, another risk factor for SIDS.
Sleeping on the back improves airflow and reduces the risk of choking. According to Deborah Campbell, MD, chief of neonatology at the Children's Hospital in New York, "Baby's airway anatomy and gag reflex will keep [choking] from happening.". Additionally, back sleepers are at a reduced risk of ear infections, stuffy noses, and fever.
If your newborn baby struggles to fall asleep on their back, you can try swaddling them to provide a sense of security and help prevent their startle reflex from waking them up. Swaddling can give your baby the secure feeling they seek on their tummy without the same risks. However, once they start to roll, it is important to stop swaddling to allow them to move freely and prevent the risk of suffocation.
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Benefits of sleeping on their stomach
While it is recommended that newborns sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS), there are some benefits to letting them sleep on their stomachs.
One benefit of letting newborns sleep on their stomachs is that it can help them sleep more deeply and comfortably. Newborns may also feel more secure sleeping on their stomachs, as it can provide a sense of comfort similar to what they felt in the womb. Additionally, sleeping on their stomachs can help newborns avoid flat head syndrome, which can develop when they spend too much time on their backs.
Another benefit of letting newborns sleep on their stomachs is that it can help reduce the risk of aspirating or accidentally breathing in fluid if they spit up while sleeping. This is a common concern for parents, and sleeping on the stomach can provide some peace of mind in this regard.
Furthermore, letting newborns sleep on their stomachs can help them develop physically. Tummy time is essential for building the strength needed to roll over and move around independently. It is recommended that newborns be given plenty of tummy time while they are awake to promote this development.
It is important to note that the benefits of stomach sleeping for newborns should be weighed against the risks. While stomach sleeping can be beneficial in some aspects, it is essential to prioritize the safety and well-being of the newborn above all else.
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Safe sleeping environments
The first year of a child's life is full of new developments and milestones, and one of the most important milestones is when an infant can safely begin sleeping on their stomach.
Safe Sleeping Positions
Experts recommend that infants sleep only on their backs until they are 1 year old. Sleeping on the back can decrease the risk of Sudden Infant Death Syndrome (SIDS) and improves airflow. Sleeping on the stomach is not advised for most infants as it is a considerable risk factor for SIDS. Babies sleeping on their stomachs are breathing in less air, which can increase their risk of SIDS.
Safe Sleeping Environment
- Use a firm, safety-approved sleep surface like a crib or bassinet to ensure that an infant gets the appropriate support.
- The sleep surface should be flat and level, not at an angle or inclined.
- Remove all loose bedding, pillows, blankets, and soft items from the area to reduce the risk of suffocation and strangulation.
- Avoid sleeping on a couch or armchair, or in a seating device like a swing or car safety seat (except while riding in the car).
- Breastfeed if possible and avoid smoking.
- The American Academy of Pediatrics (AAP) recommends that infants sleep in the same room as the caregiver, on a separate surface, for the first year after birth.
- If you fall asleep while feeding or comforting your baby in bed, put them back into their own sleep area, like a bassinet, next to your bed as soon as you wake up.
- Each week, switch the direction your child lies on their mattress.
- Limit the use of seats that put pressure on the back of your baby's head, such as carriers and bouncy seats.
- Hold your baby upright while they are awake.
Remember, it is important to understand the proper sleep position for your baby and other measures you can take to create a safe and comfortable sleep environment.
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Rolling over
If your newborn has rolled over onto their stomach during sleep, you should gently return them to their back. It is important to resist the urge to immediately roll them back onto their back each time they roll over. Instead, you can try to get them comfortable on their back by rubbing their back or patting their bottom. It is normal for newborns to be upset when they roll onto their tummies, and it may take time for them to adjust to this new sleeping position.
To help your newborn build the strength to roll over, you can give them plenty of tummy time during the day. This will help them build core, neck, shoulder, and arm strength, all of which they need to roll, sit up, crawl, and eventually walk. Tummy time also helps to prevent flat head syndrome, which can develop when babies spend too much time on their backs. It is recommended that babies get around 15 to 30 minutes of supervised tummy time each day from the age of two months.
It is also important to include some back-lying time during your baby's active, awake hours. This will help them get used to being on their back and create a positive association with this position. You can do this by having them lie on their back while playing with a toy or listening to a story.
Risks of Tummy Sleeping
The main risk associated with tummy sleeping is sudden infant death syndrome (SIDS). Sleeping on the stomach can also increase the risk of rebreathing, suffocation, overheating, and blocked airways. Research has shown that babies who sleep on their stomachs inhale air they have already exhaled, leading to increased carbon dioxide and decreased oxygen levels in the body.
Safe Sleep Environment
To create a safe sleep environment for your newborn, it is recommended that they sleep on a firm, flat surface with only a fitted sheet. Their crib or bassinet should be empty, with no soft toys, bedding, or pillows that could pose a risk of suffocation. It is also important to ensure that your baby's clothing is not causing them to overheat and that the room temperature is between 68° and 72°F.
Additionally, the American Academy of Pediatrics (AAP) recommends that infants sleep in the same room as their caregiver, on a separate surface, for the first year after birth. This has been shown to reduce the risk of SIDS by up to 50%.
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Safe sleeping positions
It is recommended that newborns and infants up to one year old sleep on their backs, as this is the safest position to reduce the risk of sudden infant death syndrome (SIDS). Sleeping on the back, also known as the supine position, improves a baby's airflow, reducing the risk of choking.
However, some babies may have difficulty adjusting to sleeping on their backs, especially if they have spent time in a neonatal unit and are used to sleeping on their fronts for medical reasons. In such cases, it is important to consult a paediatrician for advice. Additionally, babies with gastroesophageal reflux (GERD) should still sleep on their backs, as advised by the Safe to Sleep campaign.
To help your baby get used to sleeping on their back, you can practice tummy time during the day. This involves placing your baby on their tummy while they are awake, which helps with their development and can also prevent flat spots on their head. You can also work on rolling from back to belly and belly to back. When your baby is sleeping on their back, it is important to ensure they are on a firm, flat, and smooth mattress, with no loose bedding or stuffed animals that could obstruct their breathing.
For the first six months, it is recommended that babies sleep in the same room as their caregiver, on a separate sleep surface such as a bassinet or crib. This arrangement can reduce the risk of SIDS by up to 50%. It is important to ensure that the crib or bassinet meets current safety standards, with slats no farther apart than 2 3/8 inches to prevent the baby from getting trapped.
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Frequently asked questions
No, newborns should not sleep on their belly. The only safe position for newborns to sleep in is on their back.
Sleeping on their belly increases the risk of sudden infant death syndrome (SIDS) and can also cause rebreathing, suffocation, overheating, and a blocked airway.
Babies can start sleeping on their belly when they turn 1 year old and are able to roll both from back to belly and belly to back.
You can help your baby get used to sleeping on their back by including back lying during their active, awake hours. They can lie on their back while playing with a toy or listening to you read a story.
You can help your baby build the strength they need to roll over by giving them plenty of tummy time while they're awake.
