Back to Sleep and SIDS

Since the topic of back vs tummy sleeping has arisen recently, I thought I'd post an article on this important subject.  Its extremely important to grow beyond the old thinking  that this was always done in the past.  Science and research based recommendations have made it clear that it is safer to put your infant on his/her back to sleep.

Its important to listen to your pediatrician, and to discuss concerns if your infant has other health issues that may make back sleeping less desirable.

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The striking evidence that stomach sleeping might contribute to the incidence of SIDS led the American Academy of Pediatrics (AAP) to recommend in 1992 that all healthy infants younger than 1 year of age be put to sleep on their backs (also known as the supine position).

Since the AAP's recommendation, the rate of SIDS has dropped by OVER 50%. Still, SIDS remains the leading cause of death in young infants, so it's important to keep reminding parents about the necessity of back sleeping.

Many parents fear that babies put to sleep on their backs could choke on spit-up or vomit. According to the AAP, however, there is no increased risk of choking for healthy infants who sleep on their backs. (For infants with chronic gastroesophageal reflux disease [GERD] or certain upper airway malformations, sleeping on the stomach may be the better option. The AAP urges parents to consult with their child's doctor in these cases to determine the best sleeping position for the baby.)

Placing infants on their sides to sleep is not a good idea, either, the AAP said, as there's a risk that infants will roll over onto their bellies while they sleep.

Some parents also may be concerned about positional plagiocephaly, a condition in which babies develop a flat spot on the back of their heads from spending too much time lying on their backs. Since the Back to Sleep campaign, this condition has become quite common — but it is usually easily treatable by changing your baby's position frequently and allowing for more "tummy time" while he or she is awake.

Of course, once babies can roll over consistently — usually around 4 to 7 months — they may choose not to stay on their backs all night long. At this point, it's fine to let babies pick a sleep position on their own.

Tips for Reducing the Risk of SIDS:

-In addition to placing healthy infants on their backs to sleep, the AAP suggests these measures to help reduce the risk of SIDS:
-Place your baby on a firm mattress to sleep, never on a pillow, waterbed, sheepskin, couch, chair, or other soft surface.
-To prevent rebreathing, do not put blankets, comforters, stuffed toys, or pillows near the baby.Make sure your baby does not get too warm while sleeping. Keep the room at a temperature that feels comfortable for an adult in a short-sleeve shirt. Some researchers suggest that a baby who gets too warm could go into a deeper sleep, making it more difficult to awaken.
-Do not smoke, drink, or use drugs while pregnant and do not expose your baby to secondhand smoke. Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS than those whose mothers were smoke-free; exposure to secondhand smoke doubles a baby's risk of SIDS. Researchers speculate that smoking might affect the central nervous system, starting prenatally and continuing after birth, which could place the baby at increased risk.
-Receive early and regular prenatal care.
-Make sure your baby has regular well-baby checkups.
-Breastfeed, if possible. There is some evidence that breastfeeding may help decrease the incidence of SIDS. The reason for this is not clear, though researchers think that breast milk may help protect babies from infections that increase the risk of SIDS.If your baby has GERD, be sure to follow your doctor's guidelines on feeding and sleep positions
-Put your baby to sleep with a pacifier during the first year of life. If your baby rejects the pacifier, don't force it. Pacifiers have been linked with lower risk of SIDS. If you're breastfeeding, try to wait until after the baby is 1 month old so that breastfeeding can be established.
-While infants can be brought into a parent's bed for nursing or comforting, parents should return them to their cribs or bassinets when they're ready to sleep. It's a good idea to keep the cribs and bassinets in the room where parents' sleep. This has been linked with a lower risk of SIDS.

For parents and families who have experienced a SIDS death, many groups, including the Sudden Infant Death Syndrome Alliance, can provide grief counseling, support, and referrals.

[motherof1boy]

how old does a child need to be before given a pillow? My MIL gives my 11 month old son a pillow every time he spends the night. He does not get one at home.

[peekawho]

It should be ok for a child of nearly one to have a small pillow, if he/she seems to sleep better with one.

[rebekah385]

I have an almost 2 year old and I just started giving him a pillow, and it is a small "travel sized" pillow. they are probably safe at 1 year, but I figured why take any chances on something he does'nt need. a small pillow makes less space for billowing around the face or head.

[adgal]

This might be a dumb question, but I'm going to ask anyway.  Should I be using a positioner in infancy?  I have seen them, but wonder if they are necessary.  I read that once he can start rolling over on his own, it is typically safe for him to wind up on his tummy.  Thanks so much.

[jesika1]

It comes down to common sense.. babies don't have the ability or strenght to roll or move that much on their own or to know 'oh help I have my face buries in a pillow that I am haing a hard time rolling out of.' Think before putting something around your child, think about the what ifs, will it be safe? Many parents can be careless and I know a family that are just like that. They're attitude being "oh he'll be fine". I'll be using a positioner  that goes under the mid section of the baby that prevents them from rolling. They are at Walmart where i live. But I will also be doing more research and perhaps finding something even better.

[Helen72]

Amanda,
I was advised not to use a positioner but if you are going to use one you should get a breathable one.

[AndiJ78]

I was told no positioner for my boys. If they are strong enough to roll, they need to be able to.