Is It Safe for a Baby to Sleep on His Back?

Mother comforting baby.
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If your baby is a healthy baby (for instance, not born very prematurely or with special needs), the best position for sleep is on his back. It's been more than 10 years since the Academy of Pediatrics and other health organizations have been recommending this and since that time, they've seen deaths from SIDS decrease by 50 percent.

No Evidence of Babies Choking in Their Sleep

It can be tempting to put a baby on his stomach, especially if he seems to sleep better that way or if he spits up a lot and you still 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.

According to the United States Department of Health and Human Services, "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."

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. It has been proven that this contributes to SIDS. It is known that more infants die who sleep on their stomachs than those who sleep on their backs. Studies have 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 can pose a suffocation risk (just like stuffed animals, pillows, thick blankets, and bumpers) and should not be in your baby's crib.

My son was just a baby when the "Back to Sleep" campaign was getting its start, and I had the same concerns that you have. I also had my doubts about all the expert advice over something as simple as a sleep position. My mother and mother-in-law advised me to let my son sleep in whatever position he preferred. None of their babies had died and they'd all slept on their stomachs. It occurred to me, though, that it's like saying that nobody dies in car wrecks just because you don't know anyone who ever has. Lots of babies have died and many studies have been conducted over the years to get to the bottom of these deaths.

I know that my mother and mother-in-law meant well, and of course, nobody likes to hear that the way they parented their kids back in the day was somehow wrong. But just like not using car seats and letting your toddlers eat whole hot dogs, new information, and better parenting practices are preventing deaths every day. Put your baby on his back to sleep and don't worry about him choking. The risks are just too high for SIDS.

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  • American Academy of Pediatric's Caring for Your Baby and Young Child 
  • National Institute of Child Health and Human Development