Many parents have a nighttime routine for preparing their young ones for bed. Parents usually believe that laying them on their back is the best position for them, and they may become worried when their little one squirms in their sleep until they manage to roll over to their side. Additionally, some infants may not fall asleep until they are laid on their side. In this article, we debunk some of the myths associated with side sleeping and equip you with all you need to know about infants and their sleeping positions to help you make informed decisions as you lay your young one to sleep.
Why back sleeping is the best option for infants
Yes, laying your baby to sleep on their back is the safest baby sleeping position. Babies sleeping on their backs are considered safer for infants than sleeping on their stomachs. When babies sleep on their sides or stomachs, they become highly susceptible to sudden infant death syndrome(SIDS), and they are also more likely to suffocate in their sleep. SIDS is considered the leading cause of death in infants between one month and one year old, resulting in the safe to sleep campaign.
Research has shown that letting your baby sleep on their back greatly reduces their chances of dying from SIDS. Additionally, there are additional benefits to babies sleeping on their side; a study carried out in 2003, when the safe to sleep campaign had gained popularity, showed that infants who slept on their backs, be it on baby sleep racks or baby bamboo sleep sacks and baby sleep sacks, were less likely to develop fevers, stuffy noses, or infections in their ears.
Points to note on why back sleep is safer
- There is an increased risk of sudden death when newborn rolls on his side to sleep; this risk is greatly reduced when the babies sleep on their backs
- If you observe that your 8 month old sleeping on side and repeatedly rolls over to their side during sleep for several weeks, you can leave them to find their natural sleeping position
- Once your newborn rolls on his side to sleep and has learned to roll independently, they should not be wrapped anymore
- For babies that are born preterm, they should be laid on their backs to sleep as soon as they are medically stable
Fears about back sleeping
Chance of choking or aspiration
.Health professionals and some parents have expressed concern about back sleeping and the risk of an infant choking when placed in this position. However, careful studies have since been conducted and have shown that healthy infants who sleep on their backs are not likely to choke on their vomit as, say, one month old rolls on side to sleep. In the back position, the respiratory airway is always above the esophagus; therefore, if milk regurgitates up the food pipe, it is immediately swallowed again. Due to this, aspiration into the respiratory system is avoided. When newborn rolls on side, it is easy for regurgitated milk to be inhaled into the airway resulting in micro-aspiration.
Positional plagiocephaly
.This condition results in skull deformity that requires treatment and has been experienced since the advent of the back to sleep campaign. It is important to note that the bones in a baby's skull do not fully fuse until several months after their birth. Flat head syndrome is commonly caused by lying or sleeping in the same position. This can be regarded as a cosmetic problem by many people. Still, it is consequential to the baby's health as it can result in issues such as chronic ear infections because it can reduce the size of the canals making it harder to drain fluid. Back sleeping can also result in this condition as long as the baby is placed in one position for a prolonged period.
Brachycephaly may also occur along with this condition. That being said, the main causes of plagiocephaly are:
- Limited time spent upright by the child
- When the baby spends too little time on their stomach when awake and under supervision
- When the baby spends too much time in car seats and carriers
Positional plagiocephaly and Brachycephaly are usually harmless, and they tend to disappear on their own after a couple of months when the baby gains the ability to sit up. However, the conditions can be avoided altogether by repositioning, as this serves to relieve pressure from the back portion of the baby's head. Some of the ways you can reposition include:
- Alternating the position of the baby's head when they are sleeping to ensure that the baby is not always sleeping on the same side of the head
- Shifting the direction that the baby faces while in their crib every week when baby rolls on side during sleep
- Moving the crib around the room periodically lets the infant turn their head in different directions when something catches their attention
- Reducing the time that the infant spends in car seats, bouncy seats, and carriers and allowing the child to have more time in their stomachs under adult supervision reduces the chances of them getting positional plagiocephaly
The back sleeping position is the best for preterm infants
Preterm babies suffer an increased risk of SUDI compared to babies who are delivered at full term. Therefore, preterm babies are usually placed in the prone position, and it is said that this improves their breathing function and reduces their overall energy requirements. The current recommendation from major health organizations is that preterm children are placed in the supine position as soon as they are out of intensive care.
Is It okay for babies to sleep on their side ?
Side sleeping is a common practice, especially for adults, and however, it comes with a lot of concern with a newborn sleeping on side around their health, and one should ask themselves, can infants sleep on their side? We tell you all you need to know about side sleeping in this segment.
As with adults, babies are not the same, and it may be that your newborn rolls onto side while sleeping or sleep on their stomach, but the evidence still supports back sleeping as the safest option for your infant.
The advent of the back to sleep campaign
In the 1970s and 80s, sleeping on your stomach was highly touted by doctors as they held the view that this would reduce the chances of babies choking on their vomit as they slept, and as such, it was common for baby sleeps on side. As a result of this, a rise in cases of cot death, also known as SIDS, soon followed. New recommendations have since been given based on numerous studies, and in contemporary times, the number of SIDS cases has reduced significantly. Unfortunately, SIDS is the highest cause of death in infants, especially when the baby sleeps on side, making it important for parents to understand sleep recommendations from medical sources and blogs such as ours to avoid a situation where the baby sleeps on side.
Why babies should not sleep on their sides
.While putting baby sleeps on side may seem less dangerous than putting them on their stomachs, it still carries great health risks, and many ask, What age can babies sleep on their side?. If your infant has not yet developed motor skills, they could easily roll over onto their stomachs as the side sleeping position is not stable.
Is it ok for newborns to sleep on their side?
Research has proven that it is not likely for a child placed in the back sleep position to roll over to their stomachs. However, infants develop over time, and they begin to roll over without any assistance. To answer the question, can newborns sleep on their side? It is important to know that once baby sleeps on side on their own, there is medically no reason to reposition them to reduce the risk of SIDS. However, when you are placing your baby to sleep, it is recommended that you place them in the back position. The area the baby sleeps on side should not contain loose clothing or bedding as this makes it safer for the child if they roll over during their sleep. By the time the baby sleeps on side at six or seven months old, it is safe for them to sleep in whatever position they get themselves into as long as their environment is safe and free from anything that can obstruct their airway.
Will my baby choke on their back?
There is no evidence that aspiration is more prevalent in infants who sleep in the supine position compared to healthy children who sleep in the prone position. In addition to this, countries such as the USA that have changed their position on infant sleep from advocating baby sleeps on side to now advocating back sleeping has not seen an increase in cases of aspiration. It has been shown that babies have a better chance of clearing build-ups in the back position as the trachea will naturally lie above the esophagus. Ant food or fluid refluxed from the food pipe has to contend with gravity before it is aspirated into the windpipe. When a baby is in the stomach position while they sleep, anything regurgitated will collect at the trachea, making it easier for the baby to choke.
When do babies roll over naturally?
Falling asleep in one position can be very disorienting in adults, which applies to babies. Unlike adults, your side sleeping newborn does not have the same levels of muscle paralysis as they sleep, so they usually act up on their dreams or make movements in their sleep as baby sleeps on side. The more you intervene when your side sleeping newborn rolls over, the longer it will take your newborn only wants to sleep on side to realize that rolling over is not such a bad thing. You should let your baby sleeps on side to figure out their most preferred sleeping position if the baby wants to sleep on side, and once the newborn rolling to side in bassinet on their own, usually between 4-7 months. To help your baby as they begin this phase of rolling, there are a few tips you can follow.
Do I need a positioner to keep my baby on their back?
Not really; anything that inhibits the infant's movement is unsafe for use. Contraptions such as positioners, wedges, and others that claim to be able to prevent SIDS are not recommended at all. Additionally, some of these products have led to accidental suffocation in babies. Most of these accidental deaths occurred when the babies were placed in the prone position with these devices. The infant can struggle and roll onto their stomach and suffocate between the side of the crib and the device.
Health Conditions Associated with Side Sleeping and Possible Remedies
Harlequin colour change
In the medical field, this condition is usually referred to as erythema, affecting about 10% of newly born children. It usually makes itself visible in the first week after birth, and the sleeping side of the baby can be seen to turn pink or reddish. The body will also have a boundary running through its central axis, meaning half the baby's body will be normal-colored. This condition, however, does not result in lasting health effects on the child; switching the sleeping position of the child makes the reddish color fade away after some time. Medical experts have been unable to pinpoint the exact cause of this condition, but many in the field agree that immature blood vessels in the skin may be the culprit. As a result, red blood cells could accumulate on one side of the body.
Treatment: This harmless condition disappears without medical assistance with time.
Flatheads
As discussed earlier, flatheads are only cosmetic as they can permanently affect the shape of the head. As discussed, the bones in a newborn's skull are not fused to allow the brain to expand. Developing a flathead can cause the baby to have stunted brain growth as the cranial space that would be required will not be present. It can reduce the cognitive abilities of the child later in life. An accompanying neck condition called torticollis may develop.
Treatment: Suppose the condition is identified in its initial stages. It can be corrected by using head braces that are usually referred to as 'baby helmets' since the bones are still malleable enough to reposition themselves. The medical professional can also recommend switching your baby's sleeping side to correct the flathead.
Torticollis
This condition results in the abnormal tilting of the neck towards one direction caused by the severe shrinking of the sternocleidomastoid muscle that joins the lateral side of the head to the clavicle. Torticollis can develop for several reasons, one of them being poor baby placement while sleeping. Since the neck muscles are still in their development stages, they may shorten due to repeated sleeping on one side or turning the head to one side when sleeping on the back.
Treatment: Physical therapy will effectively ease the stiffness in the neck. The doctor can also recommend that the child wear a recovery harness, and it is usually wrapped around the baby with a soft pad being placed near the neck. This soft pad applies pressure in the opposite direction and gradually brings the neck to a more normal position.
Safe Sleep Tips for Infants
Make use of a firm crib mattress
A cozy mattress is the most logical option for adults, but this is different in the case of children. It is not the safest option for them, and it is recommended that you use a firm crib mattress that fits nicely into the crib. Although this may seem uncomfortable to the side sleeper child, it prevents the likelihood of the crib having loose beddings, which can impede the breathing of your young one.
Keep the crib clear
.This is another important sleep recommendation, and you should keep your young ones' crib free from anything this can impede their sleep. This can include pillows and crib bumpers which create an unnecessary safety hazard.
Use a swaddle instead of a blanket
.You can wrap your baby in bamboo swaddling blankets or sleep sacks to help them stay warm as they sleep. You can dress your young one in cute baby boy clothes if they are male and swaddle them, making them feel secure and safe. If swaddled newborn sleeps on side, it is better to use a sleep wrack instead.
How to prevent your infant from side sleeping
.Since we have established that side-sleeping is unsafe for babies, there are some simple steps you can take as a parent or caregiver how to stop newborn from sleeping on side.
- Place your baby on their back when it is time to sleep
You can take this simple step when placing the baby in their cradle or crib. According to research, the back sleeping position is the most effective way of preventing fatal medical emergencies such as SIDS. Putting your young one in this position also reduces their risk of developing upper respiratory infections.
- Do not make use of unnecessary support structures on the bed
Support structures on the bed or crib of the baby are not recommended, as outlined earlier. These structures could range from home pillows to custom-made bumpers, which are ineffective in providing any additional benefits to the baby. Structures like pillows may even cause the young ones to roll over to the side if they move in their sleep.
- Refrain from positioners
They are a suffocation hazard and should be avoided by all parents as they are not necessary.
- Remember that swaddling can increase your baby's risk of rolling over
When you swaddle your baby, you inadvertently increase the chance that they will roll over to their side. This is because swaddling creates a smooth cylindrical surface that surrounds the baby, making it easy for them to roll over, thus increasing the risk of SIDS.
- Always remember to alternate your baby's sleeping position
For example, if they sleep on their back with the head tilting towards the left, you should gently tilt their head to the right the next night. It is also helpful to place your baby in a separate cradle or crib in the same room you are sleeping in.
Myths on Safe Sleeping Positions for Newborns
In the United States of America, more than 2300 otherwise healthy infants die from Sudden Infant Death Syndrome. These untimely deaths can negatively impact families and communities at large. The cause of SIDS is yet to be pinpointed, but it has been shown that the risk of SIDS in infants peaks at three months of age and decreases after that. Even though the information regarding safe sleeping practices for infants is out there, there are still some common misconceptions held by people, and we debunk some of them in this section.
Side sleeping is the safest option for babies.This is a myth held by many people, with the majority of them believing that a baby sleeping on their stomach is the only unsafe position for them. However, through reading this article, you have already discovered that sleeping on the side in newborns is associated with elevated risks of SIDS.Side positioning sleep position is unsafe in babies; some parents usually attempt to stop their children from rolling in this position using pillows, pieces of cloth, or other objects. It adds fuel to the fire as the objects increase the risk of the baby suffocating and can even end up helping them to roll.
The baby can choke if I let them sleep on their back or spit up. The myth that babies will choke in their sleep if laid in the back position is not grounded on any scientific fact but rather the parents' fear passed down from generation to generation. Babies usually spit up during the initial months of their lives, leading parents to fear them choking. Studies have, however, shown that there is fundamentally no difference in the rate of aspiration when the sleeping position is changed due to these fears.
The baby sleeping on their back in a car swing is safe. This is a contemporary myth that does not consider that when babies are sleeping in these positions, they usually recline into a position that may compromise their airway. There is also a risk of them overturning or falling from the car's seat using these devices.
Since many cultures share beds, it is safe. Some cultures have normalized bed-sharing while still maintaining relatively low levels of SIDS. However, it should be noted that these cultures have very different sleeping practices compared to the United States; for example, they may have firm mats on the floor, no soft bedding, and a separate sleeping mat for the young ones. Credible studies have shown that bed-sharing significantly increases the risks of SIDS by more than double. The risk can even be higher in special conditions such as if the parents are smokers, when the infant is below three months of age and when the parents are intoxicated from alcohol consumption. In the market, there are many options of so-called 'co-sleeper' products, which are marketed to improve the safety when bed-sharing; you should note that they have not been shown to prevent SIDS.
Frequently Asked Questions on Safe Infant Sleep and SIDS
Before delving into this section, it is important to consult your doctor or health care provider if you are experiencing any difficulties with your baby's safety as they sleep.
What is the best way to reduce a baby's risk for SIDS?
SIDS is a condition that can prematurely end a baby's life, especially if they are below the age of three months. The best way to protect your young one from this is always to lay them on their back when you put them to sleep. It would also help if their designated sleep area were designed for the baby with no toys or loose clothing.
Why should I place my baby on their back as they sleep?
This is because it has been proven that laying your baby on their back as they sleep carries the lowest risks of SIDS. Additionally, babies who sleep on their backs are less likely to develop fevers, ear infections, and stuffy noses. This position also makes it easier for the baby to scan the room and move their limbs.
What if I fall asleep while feeding my baby?
According to research, it is more dangerous to fall asleep with an infant on a sofa or chair. Before you feed your baby, consider how sleepy you are, and if there is a chance that you might doze off, you should avoid armchairs and sofas. This is because these surfaces can be dangerous to your young ones. If you are feeding them in bed, remove toys and unwanted pieces of clothing to reduce the likelihood of suffocation and SIDS.
Will my baby choke if I lay them on their back to sleep?
No, this is the safest way to place them and protects them from choking as the trachea will be above the esophagus, and this can help them clear any fluids they cough up.
Can swaddling my baby reduce the risk of SIDS?
Currently, no evidence supports this theory. Swaddling can raise the chances of SIDS and other causes of infant death when babies are left on their stomachs for sleep.
What if my one month old rolls on side to sleep comfortably?
If the baby's comfort is a priority, you should also remember that safety is even more important. You should place babies on their backs during sleep even if it feels uncomfortable to them, and most of them will quickly get used to it. It is normal for babies to wake up during the night frequently, and this should not be a cause for concern.
If my baby rolls over onto their stomach while sleeping, should I put them back in the back sleeping position?
Not necessarily; babies sleep on their sides, which is a natural part of the baby's development. If the toddler rolls over on their own once they are four to six months of age, you should not be worried. The important thing is that you should initially place them in the back position when they begin to sleep.
What are the other sleep-related causes of infant mortality?
Other causes of infant deaths that occur during sleep include accidental suffocation, caused by objects such as the mattress, or strangulation, which happens when the baby's airway is blocked.
Takeaway
Until your swaddled newborn sleeps on side or gets the natural ability to place themselves into other sleeping positions, you should place them on their back during bedtime to safeguard their well-being. Additionally, once they begin to roll on their own, you should unswaddle them for their safety.
