Evie Summers
The safest sleeping position for a newborn is on their back, which reduces the risk of sudden infant death syndrome (SIDS). However, this sleep position has led to an increase in cases of flat head syndrome, where a baby's soft skull becomes misshapen due to continued pressure on the same areas of the head. To prevent flat head syndrome, parents can alternate the side of the crib they place the baby's head on and provide supervised tummy time when the baby is awake. So, should newborns sleep with a head stabilizer?
Should newborns sleep with a head stabilizer?
| Characteristics | Values |
|---|---|
| Safety | Sleeping on the back is the safest position for newborns to reduce the risk of sudden infant death syndrome (SIDS) |
| Head shape | Sleeping on the back can cause a baby's head to become misshapen due to continued pressure on the same area |
| Prevention | To prevent a misshapen head, alternate the baby's orientation in the crib daily and provide supervised "tummy time" when they are awake |
| Room-sharing | For the first 6 months, it is recommended that newborns sleep in the same room as their caregivers, ideally on a flat, firm, and waterproof mattress |
| Medical advice | Consult a healthcare professional or pediatrician for specific advice, especially for premature babies or those with medical conditions |
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What You'll Learn
- The Back to Sleep campaign has reduced SIDS cases but increased flat head syndrome
- Babies' skulls are malleable and can be affected by sleeping positions
- Babies should sleep on their backs until they can roll over themselves
- Babies should sleep in the same room as their parents for the first six months
- Tummy time when babies are awake can help prevent flat spots on the head
The Back to Sleep campaign has reduced SIDS cases but increased flat head syndrome
The Back to Sleep campaign has been a success in reducing the number of cases of Sudden Infant Death Syndrome (SIDS). The campaign recommends that babies under one year old are placed on their backs to sleep, as this position reduces the risk of SIDS. Since the campaign's launch in 1994, the rate of SIDS has dropped significantly in the USA, the UK, and across the world.
However, an unintended consequence of the campaign has been an increase in cases of flat head syndrome, or positional plagiocephaly. This condition is characterised by a flattening of the back or one side of the head and can be caused by babies sleeping with continued pressure on the same areas of the head. As a baby's skull is very soft, especially in the first year, the weight of the head can result in a misshapen head.
To prevent flat head syndrome, parents can vary their baby's sleeping position in the crib each day. For example, one day the baby's head can be placed towards the head of the crib, and the next day, towards the foot of the crib. This allows the skull to recover and reform into a more normal shape. Supervised "tummy time" when the baby is awake is also recommended, as it gives the baby's head a break from pressure and is important for their development.
If you notice a flat spot on your baby's head, it is important to take measures to prevent it from worsening. In some cases, a flat head helmet may be recommended to gently and permanently correct the shape of the skull.
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Babies' skulls are malleable and can be affected by sleeping positions
The human birth canal is a tight squeeze for babies, so they are born with soft and malleable skulls that can adapt to the space. This skull flexibility also allows a baby’s head to continue growing after birth. A baby's skull remains malleable throughout childhood, gradually hardening as the child grows.
As a result of this malleability, a baby's head shape can be affected by external factors, including sleeping position. Prolonged lying on the same area of the head can cause a baby's head to become misshapen. This is known as positional plagiocephaly, or "flat head syndrome". The Back to Sleep campaign, which recommends placing babies on their backs to sleep, has been successful in reducing the incidence of sudden infant death syndrome (SIDS) but has resulted in an increase in cases of flat head syndrome.
Babies with flat head syndrome tend to have a wider head width, shorter head length, and a larger cephalic index by 6 months of age. A little bit of flattening often goes away on its own, and more serious flattening may not completely go away but will not affect a baby’s brain or development.
To prevent flat head syndrome, parents can alternate the side of the crib that the baby’s head is placed on. This can help to encourage babies to sleep on both sides of their head. If a baby has a tendency to lean on one side of their head when they are on their back, parents can use toys to encourage head movement and a more even pressure to the whole head. Supervised "tummy time" during the day can also help to give a baby's head a break from pressure.
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Babies should sleep on their backs until they can roll over themselves
The safest sleep position for babies is on their back. This recommendation was first made by the American Academy of Pediatrics in 1992 and has been the advised sleep position since. It is recommended that babies sleep on their backs until they can roll over by themselves.
Placing babies on their backs to sleep is the best way to reduce the risk of sudden infant death syndrome (SIDS). Babies who sleep on their backs are much less likely to die of SIDS, which is when a baby (usually under one year old) that seems healthy dies suddenly in their sleep, and the cause of death cannot be explained. Research has shown that even babies with gastroesophageal reflux should be placed on their backs to sleep. Sleeping on the back is also not associated with temporary changes in heart and lung function and control, which could affect the amount of oxygen getting to the brain.
However, a side effect of placing babies on their backs to sleep is an increase in cases of flat head syndrome. With babies' skulls being so soft at a young age, the weight of the head can result in a misshapen head. To prevent this, parents can change the position of the baby's head each day. For instance, one day, place the baby with their head toward the head of the crib, and the next day, place them with their head toward the foot of the crib. Alternating the baby's position every day will help to prevent a flattening from developing. Babies should also have supervised "tummy time" when they are awake, several times a day. This will help prevent a flat spot on the head and is important for the baby's development.
Once babies can roll over by themselves, it is okay for them to sleep on their side or stomach. If they roll over in the middle of the night, there is no need to return them to the back-sleeping position.
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Babies should sleep in the same room as their parents for the first six months
Newborns' skulls are very soft, and their bones can be affected by pressure. They also have weak neck muscles, so they tend to turn their heads to one side when placed on their backs. This can result in a "flat head", or positional plagiocephaly, which may not completely go away as the baby grows. To prevent this, you can change the position of the baby's head each day.
The American Academy of Pediatrics (AAP) recommends that babies sleep in the same room (but not the same bed) as their parents for at least the first six months, with the ideal duration being a year. This is because babies under six months old who sleep in separate rooms are at a higher risk of Sudden Infant Death Syndrome (SIDS). Room-sharing allows parents to monitor their newborns' breathing patterns, quickly attend to their needs, and reinforce feeding practices, especially if breastfeeding.
However, some experts argue that there is little scientific evidence to support the AAP's guidelines. They point to studies that show babies sleeping in separate rooms after four months get to bed earlier and sleep for longer. Additionally, room-sharing beyond four months can lead to sleep deprivation for parents, which can cause them to practice unsafe sleep habits, such as pulling the baby into their bed or having loose bedding, which increases the risk of SIDS.
Ultimately, the decision to room-share should be made by each family, taking into account the needs and preferences of both the baby and the parents.
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Tummy time when babies are awake can help prevent flat spots on the head
Since the launch of the Safe Sleep Campaign (formerly known as the "Back to Sleep" Campaign) in 1994, the rate of SIDS (Sudden Infant Death Syndrome) has decreased by 50%. The campaign recommends that babies always sleep on their backs, which has resulted in an increase in cases of flat head syndrome. This is caused by prolonged lying on the same area of the head, as a baby's skull is very soft and flexible in early infancy.
Tummy time can be started from birth, and it can be done in various positions. For example, you can place your baby on your lap, on your shoulder, or belly-to-belly. Once your baby can hold their head up, they can have tummy time on a mat with some toys. It is important to continue providing tummy time even after your baby can hold their head up well.
In addition to tummy time, parents can encourage "face time" to strengthen the muscles at the front of the neck, enabling the baby to move their head while on their back. Face time can be done by supporting the baby in front of you, face-to-face, and engaging them with direct eye contact, smiles, and talking.
While tummy time is important, it is not the only factor in preventing flat spots on the head. Other recommendations include changing the baby's position in the crib each day and limiting time in "containers" like car seats, strollers, and swings.
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Frequently asked questions
It is recommended that newborns sleep on their backs, as this reduces the risk of sudden infant death syndrome (SIDS). Sleeping on the back can cause pressure to be applied to the same areas of the head, which can lead to a misshapen head, also known as positional plagiocephaly. While some flattening can be permanent, it will not affect a baby's brain or development. To prevent flat spots from developing, it is recommended to change the baby's position in the crib each day. Therefore, it is not advisable for newborns to sleep with a head stabilizer.
To prevent your newborn from developing a misshapen head, you can alternate the side of the crib that you place their head on. You can also encourage head movement by using toys when they are on their back and during supervised tummy time when they are awake.
Newborns should sleep on their backs for every sleep, day or night, for at least the first six months. Once your baby can move themselves from their back to their front and back again, they will be able to find their own sleeping position.
