One safe baby sleeping position: on the back
Choose the safest baby sleeping position: on the back On the back is the baby sleeping position that best protects your baby from SIDS (Sudden Infant Death Syndrome, also called cot or crib death).
Worldwide Back to Sleep campaigns in the late 80s-early 90s made a huge effort to advise parents to put their babies to sleep on their backs. They were very successful; the number of SIDS cases has decreased tremendously since then.[1] Before that, it was believed that putting babies to sleep on their stomach was safer as it could lead to aspiration problems. No evidence was found for this though.
When a baby is sleeping on her stomach, her breathing can easily be obstructed.
Not all babies have the strength or reflex to lift their head when necessary which can be life-threatening. Also sleeping on the side must be avoided.
On the back is the one recommended baby sleeping position.
Some situations require extra caution:
- When two or
more risk factors are combined the odds get worse. A premature or light-weight baby that does not sleep on her back is at extra risk.
- A baby that is used to always be on the back and then is put on the stomach have a very high risk of SIDS.
Putting baby on the side to sleep is not recommended either. She can easily roll onto her stomach. Any wedges or other fixing systems to keep her on the side can be dangerous. Baby can get stuck or suffocate.
There are specific, medical, conditions that will require baby to be on her stomach when sleeping. Evidently you will then follow professional medical advice.
How to keep baby on her back Especially in the first months, when you see that your baby has turned over, gently turn her back. However, constantly keeping 
yourself awake at night to check and roll her over, is not necessary.
Once your baby has the strength to roll over and back actively, you can leave her on her stomach even when she rolled over herself.
A sleeping bag or wearable blanket is a great help to keep your baby on her back. It makes it more difficult for her to roll over. A sleeping bag also keeps baby covered without the risk of sliding under it with her head.
When using a blanket or sheet, tightly tuck it in and arrange it so that baby is toe to feet: with her feet at the foot end of the bed. So there is no room to slide under the covers.
How to keep baby asleep when sleeping on her back Many parents notice that their baby is easily awakened when she sleeps on her back. Her sleep seems light most of the time. Many babies often wave their arms in their sleep and wake themselves up like that.
This easy arousal is actually part of why the back position helps with SIDS risk reduction. They have more ability to wake up when necessary.
It is true that babies usually sleep better when on their stomach. The reason is that they often go into a deeper sleep (which again is why the SIDS risk increases).
So, as much as we want quiet and long naps and nights, it’s safety first …
As their baby grows and becomes stronger (beyond 6 months), parents do report placing their babies on their stomach for better sleep.
To be on the safest side, I don’t recommend this. Definitely avoid it if your baby has any of the higher risk factors and make sure you are around to check on your baby very regularly. Always consult your doctor when in doubt.
What about tummy time? Tummy time, or having your baby spend time on her stomach, is the
standard method to help develop motor skills for your baby.
Research has suggested that certain motor skills develop later since the recommended baby sleeping position is on the back.
The skills do develop, only a bit later. The choice between putting baby’s life at risk or develop motor skills earlier is easily made.
It is a good idea to have baby play on her tummy when she is awake to practice those muscles often!
Combine sleeping on the back with the other guidelines to reduce the risk of cot death.
[1]International trends in sudden infant death syndrome Hauck RF, Tanabe KO. 2008. Pediatrics 122(3): 660-666.
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