Experts agree that putting baby to sleep on her back is the safest sleeping position. This, researchers say, is far safer than putting her to sleep on her stomach or side.
This finding comes after the newly established correlation between sudden infant death syndrome (SIDS) and babies who sleep on their stomachs (or the prone position).
In 1992, the American Academy of Pediatrics (AAP) made the “back-to-sleep” recommendation which calls for parents and caregivers to put babies to sleep on their back. Since then, the SIDS rate has dropped by more than 50 percent.
“Other countries with similar campaigns have had similar success,” says paediatrician Karen Sadler. “Ninety percent of infants who die of SIDS are under six months of age and most are between three and five months old,” Sadler adds. “
What the medical experts say
The exact reason for this finding is not certain, but it may be related to findings that suggest that an infant who sleeps on her stomach gets less oxygen or gets rid of less carbon dioxide because she is “rebreathing” the air. Some researchers suspect that the prone position puts pressure on the baby’s jaw, which ultimately leads to narrowing of the airway. Additionally, newborns have still developing neck muscles and have not yet mastered control over their head movements.
While babies sleep much more deeply and peacefully on their stomachs, this is problematic for babies as they are meant to wake up and breastfeed every couple of hours through the night. According to medical practitioners, some babies may have problems in terms of remembering to wake up and breathe — which is called apnea.
Years ago, nurses would advice mothers to put their babies down on their side and even on their stomach — but studies have found that even by propping them on their sides – babies can still flop over on their stomachs and possibly suffocate.
Medics agree that SIDS is dramatically decreased when babies are put to sleep on their backs because they sleep less deeply. Contrary to popular belief, there is no evidence that suggests that babies are more likely to vomit or spit-up while sleeping on their back. Instead, choking was found to be more likely if a baby was put to sleep in the prone position.
According to John Kattwinkel, MD from the University of Virginia, “babies who sleep in the prone position are about two and a half times more likely to die because of SIDS, if they commonly sleep on their stomachs.”
Back sleeping vital during first six months
Kattwinkel adds that frequently, parents will take care of their baby during the first month or two — and grandparents or day-care centres will then take over after that in the highest age range for SIDS — which is the three to five month range. “This helps to explain why 20% of SIDS cases take place in child care settings.”
For that reason, it is very important that mom respectfully explains which sleeping position is best, before leaving her child with a caregiver.
A 1992 study carried out in South Africa found that different cultures prefer to put their babies to sleep in different positions. The prone position was preferred by coloured moms, followed closely by black moms.
This recommendation of putting the baby down on her back applies to infants throughout the first year of life. However, it is particularly important during the first six months, when the incidence of SIDS is the highest. If however, you put your baby on her back and she rolls over during the course of her sleep (this usually occurs around 5 months) then it is safe for her to sleep on her tummy, say experts. However, always put baby down on her back and refrain from using infant sleep positioners — as they may ultimately increase the chances of baby suffocating.
Recommendations for Infant bedding
The American Academy of Pediatrics (AAP), and the National Institute of Child Health and Human Development (NICHD), offer the following recommendations for infant bedding:
- Keep baby’s crib free of pillows, stuffed animals, comforters, blankets or anything that could potentially interfere with babies breathing.
- A very simple firm mattress with a tight fitting sheet and a standard approved crib is best.
- Consider using a sleeper as an alternative to blankets.
- If using a blanket, put your baby with her feet at the foot of the crib. Tuck a thin blanket around the crib mattress, only as far as the baby’s chest.
- Make sure your baby’s head remains uncovered during sleep.
- Do not place your baby on a waterbed, sofa, soft mattress, pillow, or other soft surface to sleep.
- Offer your baby a clean, dry pacifier at sleep times, but don’t force the baby to take it. Some studies have shown a lower rate of SIDS among babies who use pacifiers. (Breastfeeding mothers however should wait until the baby is 1 month old or is used to breastfeeding before offering a pacifier as this may unintentionally wean baby off the breast).
Although putting baby to sleep on her back goes against what most parents were told previously, this new research has confirmed that placing baby on her back can save her life.