New parents get lots of information thrown at them when it comes to baby sleep, but among the most important pieces of advice is about baby sleep positions. Is putting baby to sleep on her back really best, or can she sleep on her tummy? And what happens, despite your best efforts, if you wake up in the middle of the night to find baby sleeping on her stomach? Here’s what you need to know so you and baby can rest peacefully.
Is It Okay for Babies to Sleep on Their Stomach?
The short answer is no. Baby sleeping on stomach equals baby breathing in less air. This increases her chance of Sudden Infant Death Syndrome SIDS. About 1,600 babies died of SIDS in 2015, the last year statistics were available. That’s why baby shouldn’t sleep on her side either: She can easily roll onto her stomach.
The best and only position for baby to sleep is the back—which the American Academy of Pediatrics recommends through baby’s first year. Sleeping on the back improves airflow. While some parents are concerned that this might increase the risk of choking, they shouldn’t be, says Deborah Campbell, MD, FAAP, chief of the division of neonatology at Children’s Hospital at Montefiore in the Bronx, New York. “The baby’s airway anatomy and gag reflex will keep that from happening,” she says. Even babies with gastroesophageal reflux (GERD) should sleep on their back. This goes for naps and bedtime, and it’s important to be consistent.
When, in 1994, the National Institutes of Health launched the “Back to Sleep” campaign (now known as “Safe to Sleep”)—which educated parents and caregivers about why infants should be put to sleep on their backs—the number of SIDS-related deaths dropped within six years by 50 percent, to current levels.
At What Age Can Babies Sleep on Their Stomach?
So when is it safe to have a stomach sleeping baby? Pediatricians recommend not until after his first birthday. Typically at this stage, babies are able to sit without support and can roll from back to front. “This requires good head and trunk control,” says Campbell, and it suggests that baby is strong enough to roll back to safety if he needs to.
What to Do If Baby Rolls onto Stomach While Sleeping
You’ve done your part and put baby to sleep on her back. But as every new mom knows—no matter how exhausted you are—you can’t help but wake up in the middle of the night to make adjustments should you find baby sleeping on her stomach.
The good news is, depending on baby’s age, you might not need to do that. If your child is around 6 months old and has good head and trunk control (which he probably does, if he rolls over a lot), then “it’s not necessary to turn baby over onto his back,” Campbell says. (Of course, if you happen to be up, sure, go ahead and adjust him.)
But not all babies wait until the six-month mark to roll over; some as young as 3 or 4 months can turn onto their stomachs while they’re sleeping. If this is the case, Campbell advises gently turning baby onto her back. The following tips can also help keep baby safe throughout the night:
• Encourage lots of tummy playtime when he’s awake, so he has plenty of practice moving onto his back by himself while you’re able to supervise him.
• Keep the crib clear of toys and blankets (unless you’re swaddling) and keep the bedding tight. Loose blankets can increase the risks of SIDS.
• Use a firm crib mattress and make sure it meets safety standards.
• Stay away from wedges or pillows, Campbell says, unless your pediatrician recommends them (in which case, she’ll advise placing them under the mattress).
• Remember, once a baby attempts to roll or turn over, it’s important to stop swaddling the baby,” Campbell says.
Updated September 2017