Is It Safe for Babies to Sleep on Their Backs?

Baby in crib sleeping on back
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Every baby should sleep on their back. It is the only safe sleeping position for babies, whether they are napping during the day or sleeping at night. Since 1992, the Academy of Pediatrics and other health organizations have been making this and other safe sleep recommendations. In that time, deaths from SIDS have decreased by two-thirds, from 120 per 1000 births in 1992 to 40 per 1000 births in 2016.

No Evidence of Babies Choking in Their Sleep

It can be tempting to put a baby on their stomach while sleeping, especially if they seem to sleep better that way or if they spit up a lot and you worry about choking. Family members and friends can also be a source of pressure in this area.

Since parenting is such an open-ended experience with many different paths, it can be easy to brush off lots of what experts say. Don't give in to this temptation when it comes to your baby's safety. (Babies do need "tummy time" while they are awake and supervised.)

"Healthy babies automatically swallow or cough up fluids. There has been no increase in choking or other problems for babies who sleep on their backs," notes the National Institutes of Health Safe to Sleep campaign.

The American Academy of Pediatrics states, "Despite common beliefs, there is no evidence that choking is more frequent among infants lying on their backs (the supine position) when compared to other positions, nor is there evidence that sleeping on the back is harmful to healthy babies."

Babies on their stomachs tend to rebreathe their own air. This can lead to increased carbon dioxide levels and decreased oxygen. Babies also stay warmer and sleep more deeply on their belly, These are all risk factors for SIDS. Being in a deeper sleep state can make it harder for a vulnerable infant to rouse themselves.

Research has also revealed that babies who are used to sleeping on their backs are at even higher risk of SIDS if put to sleep on their stomach at other times (like during a nap or by an unknowing relative or caregiver).

Babies put to sleep on their sides don't stay in that position for very long and are likely to roll over onto their stomachs. Wedges and other items used to prop babies on their sides don't prevent babies from rolling onto their bellies, and can pose a suffocation risk (just like stuffed animals, pillows, thick blankets, and bumpers) and should not be in your baby's crib.

Nobody likes to hear that the way they parented their kids back in the day was somehow wrong. But just like using car seats and not letting toddlers eat whole hot dogs, new information and better parenting practices are preventing deaths every day.

Put your baby on their back to sleep and don't worry about choking. The risk of SIDS is just too high. Sleep is literally the biggest risk to a baby's life. Following the "safe to sleep" guidelines are a parent's best chance at ensuring that their child wakes up after each sleep.

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  1. National Institutes of Health. Fast facts about SIDS. Updated August 19, 2019.

  2. National Institutes of Health. Myths and facts about SIDS and safe infant sleep.

  3. American Academy of Pediatrics. Where we stand: Back to sleep. Updated July 11, 2014.

  4. American Academy of Pediatrics. Sleep position: Why back is best. Updated February 28, 2012.

  5. Li DK, Petitti DB, Willinger M, et al. Infant sleeping position and the risk of sudden infant death syndrome in California, 1997-2000. Am J Epidemiol. 2003;157(5):446-55. doi:10.1093/aje/kwf226