Always put your baby to sleep on their back for their first year – sleeping on their stomach can increase your baby’s risk of sudden infant death syndrome (SIDS). The risk of SIDS peaks between 1 and 4 months of age, and the majority of SIDS deaths occur before an infant reaches 6 months old.
But SIDS is still a concern before a baby turns 1, so even once your baby is able to roll over on their own, continue to put them to sleep on their back.
When can babies sleep on their stomach?
Once your baby is strong enough to roll over both ways – from back to tummy and from tummy to back – by themself, you don’t need to be concerned about them rolling onto their stomach during sleep. There’s no need to do anything (such as roll them back onto their back) if they roll onto their tummy.
Preventing SIDS is the most important reason to put your baby to sleep on their back, but research shows there are other benefits, too. Babies who sleep on their back suffer from fewer ear infections, fevers, and stuffy noses than babies who sleep in other positions.
Your baby isn’t more likely to choke or aspirate (if they spit up, for example) while they’re on their back. Studies have shown that there’s no increase in the likelihood of this happening to a baby sleeping on their back.
It is possible for your baby to develop a flat spot on the back of their head from sleeping on their back. But the flat spot usually rounds out as they grow, and there are a few ways you can reduce their risk of developing a flat spot:
- Spend time holding your baby upright in your arms for cuddle time.
- Give your baby plenty of tummy time. (Read our article for tips on how much tummy time your baby needs at their age.)
- Vary your baby’s position when they’re awake. Too much time in swings, bouncy chairs, and car seats puts added pressure on the back of their head.
- Switch the direction of your baby’s feet each time you put them down to sleep. This will lessen the pressure on one particular spot on their head.
- A breastfed baby usually switches sides during a feeding; if you bottle-feed your baby, alternate the side they feed on.
Being on their side or tummy can be very soothing for babies – so soothing that it puts them right to sleep. It’s okay to comfort your baby by holding them in these positions, but always put your baby to sleep on their back.
Is it safe for newborns to sleep on their tummy?
It isn’t safe for newborns to sleep on their stomach. Since newborns aren’t strong enough to hold up their heads on their own, sleeping on their stomach can lead to suffocation.
Simply placing a baby on their back to sleep can reduce their risk of SIDS significantly. Babies who sleep on their stomachs are less reactive to noise and experience sudden decreases in blood pressure and heart rate control. They also move less and have longer periods of deep sleep – all of which may put them at a higher SIDS risk.
Of course, you’ll also want to follow other precautions to reduce the risk of SIDS throughout your baby’s first year. Make sure their mattress is firm, flat, and level (not inclined) with just a fitted sheet over it. Don’t put anything else in the crib – no pillows, blankets, stuffed animals, or crib bumpers. Don’t overheat the room or overdress your baby. (In warmer conditions, check for sweating, flushed skin, or a hot chest, which indicate your baby is too hot.)
Some people say that newborns and older babies sleep better on their stomach – for example, you may hear this from grandparents and older relatives who raised babies before the “Back to Sleep” campaign in the 1990s.
But there are other, safe ways to help your baby sleep better. You can:
- Swaddle your newborn. (Just be sure to stop swaddling as soon as your baby shows signs of rolling over – this is usually around 3 or 4 months, but can be as early as 2 months.)
- Give your baby a pacifier. It can reduce the risk of SIDS and help calm your baby.
- Create a calm, quiet sleeping environment by using a sound machine and blackout curtains in the room where your baby sleeps.
What to do if your baby rolls onto their tummy while sleeping
Babies typically learn to roll from their stomach to their back first, then figure out how to roll from their back to their stomach. Once your baby is strong enough to roll over by themself, you don’t need to keep them sleeping on their back all night or worry if they roll onto their tummy. This is especially true if they’ve been enjoying playtime on their tummy during the day, can hold their head up well, and can roll from their tummy onto their back again by themself.
Keep placing your baby to sleep at night and during naps on their back until they turn 1, and move them to their backs when sleeping until they can roll both ways on their own. Back sleeping is the single most effective way you can lower your baby’s risk of SIDS. Be sure to talk to your pediatrician if you have any questions about safe sleep recommendations.
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