Choose the only safe sleeping position: On The Back
Latest update: September 19, 2018
Author: Heidi Holvoet, PhD
is the baby sleeping position that best protects your little one from SIDS
(Sudden Infant Death
Syndrome, also called cot or crib death).
Back to Sleep
to Sleep campaigns in the late 80s-early 90s made
a huge effort to advise parents to put their babies to sleep on their
backs. They were very successful; the
number of SIDS cases has decreased tremendously since then.
Before that, it was believed that putting babies on
their stomach at night was safer as on the back was thought to lead to
aspiration problems. No
evidence was found for this though.
On the contrary, lying on the stomach is when breathing can more
Not all babies have the strength or reflex to lift
their head when necessary which can be life-threatening. Also sleeping
on the side must be avoided.
On The Back is THE single recommended baby sleeping position.
Some situations require extra caution:
- When two or more risk factors are
combined the odds get worse. A
premature or light-weight that does not sleep on her back is at
- When having gotten used to
always lie on
the back and then being put on the stomach gives an extra high risk of
Putting your little one on the side
to sleep is not
recommended either. She can
easily roll onto her stomach. Any wedges or other fixing systems to
keep baby in any one position can be dangerous. Baby can get stuck or
There are specific, medical, conditions that will require baby to be on
her stomach when sleeping. Evidently you will do this only following professional
to keep baby on her back
Until your baby is strong enough to easily roll back and forth from back to tummy, you might want to gently turn your baby back on her back when you notice she's rolled over.
Once your baby rolls back and forth easily, you will still want to put her on the back to sleep whenever first placing her in the crib. Some parents stay near and resolve to keep turning them around. Most experts agree though that this isn't necessary (see external links below).
Following the SIDS
prevention guidelines, you will be near your baby (supervise
closely or sleep in the same room) to monitor carefully. That is
especially advised in the first year, either with baby in her own crib or
cosleeping safely. This way you automatically
monitor your baby and can roll her over when necessary.
But once your baby is
so agile and strong to roll back and forth easily, and you are
confident that she will also be able to do it while asleep, the risk
from being on her tummy decreases, as this comment by Dr Sears and the answer to the rolling over question on Safe to Sleep state.
or wearable blanket can help encourage some babies to remain on their backs when sleeping, especially a slightly heavier one like the Slumbersac
Sleeping Bag 2.5 tog.
It makes it slightly more difficult to
roll over. Of course make sure you get the right (safe) size for your baby and always coordinate with the room
temperature to avoid getting too hot.
A sleeping bag also keeps your little one covered without the risk of
sliding under it with her head.
If you use a blanket
or sheet - something I do not recommend, I always advise sleeping bags - tightly tuck it in and arrange it so that baby is toe to feet: with
her feet at the foot end of the bed. So there is no room to slide under
Do NOT use a sleep
positioner or any type of "holding" wedges. They are not safe.
How to keep baby asleep on her back
Many parents notice that their baby
more easily wakes when she sleeps
on her back. Her sleep seems light most of the time. Many
babies often wave their arms in their sleep and wake themselves up like
This easy arousal
is actually part of why the back position helps with SIDS risk reduction.
They have more ability to wake up when necessary.
It is true that many babies sleep better
when on their stomach.
The reason is that they often go into a deeper sleep (which is
why the SIDS risk increases).
So, as much as we want quiet and long naps and nights, it's safety
As their child grows and becomes stronger (beyond 6 months), parents do
report placing their babies on their stomach for better naps and nights.
To be on the safest side, I don't recommend this. Definitely avoid it
if your baby has any of the higher risk
factors and make sure you are around to check on in on her
very regularly. Always consult your doctor when in doubt.
What about tummy
Tummy time, or
having your baby spend time on her stomach,
is the standard method to
help develop motor skills.
Research has suggested that certain motor skills develop later since
the recommended baby sleeping position became "on the back" ...
The skills do develop, only a bit later. The choice between putting
life at risk or develop motor skills a bit later is easily made.
That said, it is still a good idea to have baby
play on her tummy when she is awake to practice those
Combine sleeping on the back with the other
guidelines to reduce the risk of cot death.
trends in sudden infant death syndrome
Tanabe KO. 2008. Pediatrics 122(3):