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Why Newborns Should Sleep on Their Backs

by Sue Hubbard, M.D.

I received another e-mail via our free iPhone App from a listener who was worried about her newborn’s sleep position and she also enclosed photos. (Just like I said last week, what did we all do as parents before we could send emails and attached pictures to ensure an accurate description!?).

She was concerned because her infant son, who is now about four-months-old, is “scooching” around in his bed and likes to get up against his bumpers. She has always put the baby down on his back, as recommended, and he has been comfortable in that position. She also has a ceiling fan in the room, as there was an article last year that showed that there were fewer SIDS (sudden infant death syndrome) deaths among children who had a ceiling fan in their room. Lastly, he uses a pacifier as this was also found to be protective against SIDS in yet another study. In other words, she is doing all of the correct things to try and prevent SIDS.

The current recommendations by the American Academy of Pediatrics (AAP) state that an infant should be placed in the supine position on a firm mattress without soft bedding materials being placed in the crib. The baby should also not be overheated, so again blankets are not routinely recommended, but rather a sleep sack. Placing bumper pads in a crib for a newborn in the first several weeks of age is typically not problematic. The problem with bumper pads is that as an infant starts moving around the bed their heads may become lodged up against the bumper, as her son is doing, or their little head may even become entrapped under the bumper pad. Both of these in theory could obstruct an infant’s airway.

So in the case of her child, I would recommend removing the bumper pads until he is older to eliminate even one variable in the SIDS puzzle. Despite the fact that the baby may prefer snuggling up to bumpers and pillows, the risk of SIDS is greatest in the first six months of an infant’s life. I know it is hard to be a sleep deprived parent, but the risks are just far too great to let your baby sleep on their tummies or with their heads buried in their bumpers or on a favorite large stuffed animal etc. This was a good question by an astute parent.

Since the AAP recommended back sleeping in 1992, about 80% of children are now sleeping on their backs and the SIDS rate has dropped by over 40%. The only issue with back sleeping has been some head flattening that can be mitigated by having a baby get frequent “tummy time” off and on throughout the day (and those nights too when infants are still not sleeping). Many babies like their tummies when they are fussy, but once calmed and ready for sleep need to be turned over and put to sleep on their backs.

Getting your baby into good sleep habits is important, but their sleep position is key!

That’s your daily dose, we’ll chat again tomorrow.

Send your question or comment to Dr. Sue now!

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