If there’s only one thing you take away from reading this blog it’s that you should place your baby on their back to sleep. It’s the safest and most hazard-free position for them to be in for several reasons, which we’ll explore further.
The second takeaway is that sometimes it’s not always so easy to do this and if this is the case for you and your child, there are a few strategies and tips that can help you make sure your little one still goes to bed in a safe baby sleep position at night.
Why is Back the Safest Position for Babies?
Babies can sleep in various different positions (and locations) as you’ll probably learn yourself. However, sleeping your baby on their back whenever it’s naptime or bedtime is one of the most sensible protective actions you can take.
This is also known as the supine position and involves your baby, quite simply, sleeping on their back (rather than on their sides or front).
Evidence from around the world suggests that sleeping your baby on their back at the beginning of every sleep or nap can significantly reduce the risk of sudden infant death syndrome (SIDS), which is a common cause of child mortality between the ages 0-4 months.
Despite some confusion around SIDS and what causes it, it is clear that blockage of the airways is one of the major causes of it, which can lead to suffocation. When sleeping on the side or front, it is more likely for children’s breathing to become restricted, increasing the risk of SIDS.
As your baby gets older and their muscles develop, it will gradually become safe to let them sleep on their sides. This is largely because they can maneuver themselves out of positions that are harmful and hard to breathe, just as adults do naturally throughout the night.
Essentially, being on their backs means that you are reducing the chance of your little one encountering breathing difficulties when their lungs and overall cardiovascular system is so delicate and still maturing.
Being on their backs means that you are reducing the chance of your little one encountering breathing difficulties.
About 3,400 babies in the U.S. die suddenly and unexpectedly every year while sleeping, often due to sudden infant death syndrome (SIDS) or accidental deaths from suffocation or strangulation, according to the American Academy of Pediatrics' (AAP).
Many cases of SIDS are linked to children sometimes being placed on their sides or front, in addition to being put down to sleep in a swaddle, which when combined with the wrong sleep position, can trap a baby in a dangerous place where it’s much harder for them to breathe.
Other methods of reducing SIDS include:
- Sleeping in the same room as your baby will help you to discover if they are having trouble breathing when sleeping during the first 6 months.
- Keep the crib clear of any unnecessary items including blankets, pillows, toys, and any crib accessories. A firm flat surface with no gap between the mattress and the crib side is the best option.
- Place your baby in the center of the crib so they do not end up getting pressed up against the side of the crib when they move around at night
- Try to regulate the temperature in the room so that your baby does not overheat or get too cold. It’s also important to give them appropriate clothing that is warm yet breathable.
- Do not allow smoking around your baby. Don’t smoke before or after the birth of your baby, and don’t let others smoke around your baby.
How to Put Your Baby to Sleep On their Backs
The simplest way to implement safe baby sleep positions is to start early and stick to it. You may find at various times that your child sleeps perfectly well on their side or front, but this does not mean they will never encounter difficulties if continuing with this method.
Every time you put your child down for a sleep, make sure they are flat on their backs with their bodies in the center of the bed. Some experts also recommend placing the feet at the foot of the bed to reduce the room for them to slip down under any covers, however, we would say that any loose blankets and covers should be avoided from 0-6 months.
If your child isn't sleeping properly, focus on other strategies for soothing them and getting them to sleep (rather than changing their sleep position). This can include bedtime routines and special soothing methods you know your child responds well to.
If others are looking after your child at any point, advise them that you only want them to sleep on their backs. This can prevent your child from getting used to other positions and making it harder for you to get them to sleep on their backs.
For more tips, check out our popular blog: How to Help Your Newborn Sleep At Night - A Practical Guide
Troubleshooting Safe Baby Sleep Positions
There are many reasons why simply putting your baby on their backs to sleep isn’t always as straightforward as you’d like it to be. Below are a few common concerns and issues you might have when putting your baby to sleep on their back.
What Happens if My Baby Rolls Over?
You’ll find your baby gets more and more active during sleep as they get older. This can include them rolling and flipping over into other positions such as onto their sides or fronts.
While this movement is a sign that their muscles are more developed, making suffocation less likely due to being stuck in a dangerous position, you should still try to be vigilant in the early days. Once your baby can move themselves easily from their back to their front and back again, they will be able to find their own safe baby sleep position.
Just make sure that once you witness more movement in your child, stop swaddling. At this stage, you need to give your child the ability to develop their leg, arm and neck muscles so they become agile enough to avoid danger. Preventing their movement with the swaddle can restrict their growth and cause your baby to be stuck on their sides or face down rolling or flipping.
What If My Baby Sleeps Better on Their Front?
If a baby is given a choice, they may prefer a certain position such as front or side, however, it’s best not to give them the option in the first place. Choosing the back as your go-to safe baby sleep position and sticking to it religiously is the best move to keep SIDS risk to a minimum.
Someone Told me Side Sleeping Prevents Choking
Some parents worry that by sleeping their baby on the back they create a greater risk of choking on their own vomit. However, there is no actual evidence to suggest this and studies by the NIH have shown that back sleep actually has a lower risk of choking, with any vomit being harder to choke on in this position than if babies were on their front.
Sleeping on their backs reduces the chance of choking, according to the NIH
When Does Side Sleeping Become a Safe Baby Sleep Position?
Sleeping on the side is not as dangerous as sleeping on the front, however, once in this position, it is incredibly easy for your baby to fall onto their tummies, which will increase the risk of SIDS and everything you are trying to avoid with a safe baby sleep position.
Remember that when babies are young, their neck muscles are not developed properly so any position you put them in can not be undone by anyone other than yourself. If you put your child to sleep on their side, their heads can easily slump or shift so that their mouths are pressed against the mattress, making it hard to breathe.
It is only when your child is strong enough to support their own heads that you can think about other sleep positions. However, I would always recommend choosing the back position and letting your little one set the pace for when they can sleep in other positions.
For instance, if they are rolling over themselves from back to side and then to front, this is a signal that their muscles are growing stronger allowing them to stabilize and support their necks. Most babies can fully support and lift the head by the age of 4 months but some may take longer, so it’s best to be patient and watch for signs of development.
Also, remember that your child will only be able to roll back into a safe baby sleep position if they are on a baby-safe mattress that is firm and uncluttered with other items that might restrict their movement and stop them from moving back into a safe position when needed.
To strengthen your baby’s neck, remember to get in plenty of “tummy time”. Simply put your baby down on their fronts in a safe environment and let them stretch and wriggle around until they get tired. This should help them to flex their back and neck muscles, building the flexibility and strength needed to be strong independent sleepers.
Choose the Back for Safe Baby Sleep
As mentioned, the major takeaway here is that putting your baby on their back is the safest sleep position for them to be in until they show you they are developed enough to handle sleep on their sides or front. And by combining back sleep with other best practices for safe baby sleep like positioning and clothing, you can significantly reduce the risk of SIDS and help your child enjoy a hazard-free snooze.