Should babies sleep on their stomachs?

Having a child raises many questions. It just comes with the territory. No matter how many books you read, there is nothing like lived experience. Safe sleep is an important issue, and well-meaning people can advise you on the best way to help your baby sleep. Your suggestions might include when your baby should sleep on his stomach. But is this a safe option?

According to 2020 CDC data, nearly 3,400 babies died as a result of sudden unexpected infant death syndrome (SUID), including 1,389 sudden infant death syndrome (SIDS) and 905 due to accidental strangulation, entrapment and suffocation, often while sleeping.^2.3 In 2022 the The American Academy of Pediatrics (AAP) has released a new policy statement with recommendations for safe infant sleep to reduce the risk of sleep-related deaths in infants.¹

In this article, we discuss safe sleep recommendations and answer parents’ burning questions about children sleeping on their stomachs and the need for stomach sleeping.

For the first year of life, the overwhelming answer is “no.” Babies develop quickly in the first 12 months. The ability to roll over is a milestone that parents can look forward to in about six months. However, some babies start earlier.⁴ Although he may roll over on his own, the American Academy of Pediatrics recommends that “back is best” when it comes to putting your baby to sleep at night and for all naps during the first year.⁵

Some positioning recommendations include the following:¹

• Place your baby on his back every time he sleeps, even if he is taking a nap.
• Use a firm, flat (not sloped) surface when putting your baby to sleep.
• Babies should not sleep on the same surface as their caregivers. For example, sharing a bed, sofa, couch or chair for sleeping is prohibited.
• Babies should sleep in the same room as their parents until they are at least six months old, but should have a separate sleeping surface such as a crib or bassinet.

The AAP developed the “Back is best” initiative in the US to combat SIDS and other sleep-related deaths. SIDS remains one of the leading causes of death in infants.² Although doctors don’t know what causes SIDS, they have found that sleeping on their stomach increases a child’s risk of dying from SIDS.¹

It was previously thought that babies were more likely to suffocate or inhale spit-up milk into their lungs (aspiration) when sleeping on their backs. The AAP says a baby’s normal body responses counter such risks.¹

In the 1990s, experts’ recommendations changed to suggest that babies should sleep on their backs, and guidelines continue to evolve.⁶ However, before the changes, many infants slept on their stomachs. Although the number of annual SIDS deaths has declined after health care providers changed their advice to parents, it remains a significant cause of child mortality.^3.6 As infant sleep recommendations have changed, well-meaning family and friends may advise you to sleep on your stomach simply because they are unaware of this new and important information.

Although SIDS can occur at any time during the first year, the highest risk occurs in months 1 to 4, and 90% of deaths occur within six months. However, to ensure their baby’s safety, parents should continue to place their baby on their back to sleep until their first birthday.^7.8

You may know babies who suffered from gastroesophageal reflux disease (GERD) and slept on their stomachs, perhaps with an inclined pad or wedge. Doctors no longer recommend this because research and data indicate that stomach sleeping and the associated risk of sudden heart attack outweigh the benefits. Parents of babies in a neonatal intensive care unit (NICU) may see their baby lying on their stomach (“prone”) or on their side.

This can be confusing and you may ask healthcare providers if it is safe. Sometimes a hospitalized infant is positioned to sleep on their stomach or side for medical reasons. During this time in the NICU, these infants are monitored in the hospital and cared for by specialized medical staff. However, once stabilized, health care providers will transition these infants to follow “back is best” guidelines.¹

Your baby’s first year is a year full of new things. Before you know it, your newborn will be a fidgety, curious and active baby. Your arms and legs will flail around. They will be able to lift their head, and usually after six months Babies can roll over in both directions.⁴ They will surprise you every day because their development is rapid. Some babies can roll over earlier, so be prepared because one day you’ll look at your little one and wonder how they did it.

So while you’re celebrating your child reaching an exciting milestone, you may be worried about their sleeping position. The AAP recommends placing your baby on their back to sleep. Even if your baby can roll over, you shouldn’t intentionally let him sleep on his stomach. If they roll over in their sleep, they may stay in that position, according to the AAP.¹

However, a rolling baby is at risk of becoming tangled or suffocated in soft bedding, including blankets, pillows, crib bumpers, and stuffed toys. The only thing in your child’s crib should be a fitted sheet. The sleeping surface should be clear and clear. Suppose you put your baby on his back to sleep and roll him onto his stomach. In this case, it is acceptable to leave them in the prone position as long as the sleeping surface meets all other recommendations, including consumer product safety standards.^1.9

Newborns often sleep and theirs Sleep rhythm Usually they are short at first, lasting a few hours between round-the-clock feedings.¹⁰ As a result, newborns may spend a lot of time being held for feeding or comfort and sleeping on their backs. Tummy time helps newborns acquire skills for healthy development and allows them to build on previous developmental milestones. Additionally, Tummy time can help combat the development of a Flat head or “positional plagiocephaly”..” ¹²

Tummy time involves placing the baby on their stomach while they are awake. A caregiver must always look after them. Never leave your baby unattended, even for a short time, while he or she is lying on his or her stomach. By placing your baby on his stomach, you give him time to develop and strengthen his neck, shoulder, arm and chest muscles, preparing him to roll over, crawl and walk.¹¹

The time when you have a newborn on your stomach can begin just a few days after birth. Start by placing your newborn on his stomach for about three to five minutes two to three times a day and slowly increase the duration. The AAP recommends 15 to 30 minutes of tummy time daily through week seven.^1.11

Some tummy time tips include:¹¹

• Lay your baby on the floor on a clean blanket or towel. Make sure the area is free of hazards.
• After a diaper change or after waking up from a nap, try lying on your stomach while your baby is in a calm but alert state.
• Talk and interact with your newborn. You can try to get their attention with a toy.

Perhaps one of the most beautiful sights one can see is a baby sleeping peacefully, and their safety is a top priority. Always contact your doctor if you have any specific questions or concerns about your child. However, sleeping on your baby’s stomach during the first year of life increases the risk of SIDS and other possible sleep-related deaths, including suffocation. But when your child is awake, tummy time is crucial to your child’s development. Tummy time is fun too to interact and bond with your baby as they grow and develop.