Babies should always be put to sleep on their backs to reduce the risk of sudden infant death syndrome.
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Claire Chamberlain
When you’re a new parent, it can seem like there’s an overwhelming amount of information and advice to remember in order to keep your new baby healthy, safe and happy. But if there’s one piece of information you should always follow, it’s that for every single nap and sleep that you put your baby down for, they should always be placed on their back.
Why? Recent research from numerous worldwide studies has shown there is a connection between the sleeping positions of babies and sudden infant death syndrome (SIDS), and the risk is greatly reduced if your baby sleeps on their back.
From cot placement to perfect room temperature, we speak to Liz Halliday, Deputy Head of Midwifery at Privatemidwives.com, about the safest way to put your baby to sleep:
Why is it safer for baby to sleep on its back?
Nobody yet knows exactly why it’s safer for your baby to sleep on their back rather than their stomach, although there are several well-respected theories:
• Oxygen levels
A baby sleeping on its stomach may be lying with its face so close to the sheets that it keeps breathing the same air in and out, which can reduce oxygen levels.
• To avoid suffocation
Another possibility is that a baby can suffocate when sleeping on his or her stomach on a mattress that’s too soft and yielding.
• Mattress microbes
Finally, it may be dangerous for a baby to lie with its face against the mattress, which could contain microbes that can interfere with the baby’s breathing.
While SIDS is yet to be fully understood, one thing we do know is that cases have reduced dramatically, ever since doctors started recommending babies sleep on their backs, in the early 1990s.
Should all babies sleep on their backs?
Your baby should always sleep on its back, unless you have been given medical advice to the contrary. In rare cases, your baby may suffer from a condition that means a doctor will advise you which position your baby should sleep in.
What if your baby is sick on its back?
Parents sometimes worry that if their baby is asleep on its back, it might be dangerous if they vomit. But don’t be concerned – babies sleeping on their backs have no difficulty turning their heads if they’re sick. Your baby is safest sleeping on their back.
Can baby sleep on its side?
All recent studies show that the safest position for your baby to sleep in is on its back. Babies sleeping on their side often end up on their tummy, which increases the risk of SIDS significantly.
Can baby occasionally sleep on their side?
Routine is very important when it comes to safety in infant sleep – research has shown that babies who are normally placed to sleep on their backs but are occasionally placed to sleep on their tummies are at a greater risk from SIDS. It’s therefore important to place your baby on their back for every sleep – even daytime naps.
What if baby rolls onto his/her tummy…
When your baby is old enough to be able to turn over in bed by themselves, don’t worry – at this stage, the risk of SIDS is significantly lower anyway. It’s still best to tuck your baby into bed at night on their back, but don’t worry if they turn themselves over later.
You might feel more comfortable gently rolling them onto their back when you notice they have shifted positions, but there’s no need to get up all night to check and reposition them.
⚠️ It’s been proven that the risk of SIDS is increased if parents smoke. Smoking is one of the main factors associated with SIDS, with scientists believing that the number of cases of SIDS could be reduced by 66 per cent if parents stop smoking.
Sleep and baby skull development
Sleeping on their backs can cause babies’ skulls to temporarily grow out of shape, known as plagiocephaly (flat head syndrome). You can avoid this by lying your baby’s head on the opposite side every time you place them down to sleep. The shape of your baby’s head will gradually become normal with time and almost never requires treatment.
To help avoid this happening, you can try ‘tummy time’ with your baby each day, by placing them on their tummy while awake, so they can play and explore. This is also a good way of training your baby’s stomach, back and neck muscles.
How to make your baby’s sleep safe
To ensure your baby is as safe as possible come bedtime, Liz Halliday has the following advice:
✔️ A cot that complies with British standards is considered a safe place for your baby to sleep. However, accidents can still happen. Make sure your cot has been properly assembled, so that baby can’t fall or get caught up in the bedding (pillows, toys and cot bumpers are not recommended), and hanging objects, such as curtains or blind pulls, are well away from the cot so the baby won’t become entangled.
✔️ The cot should be placed in the same room as an adult, as research suggests 75 per cent of daytime SIDS deaths occur when the baby is in a room away from adults, and 36 per cent of night time SIDS deaths might have been prevented if baby had been sharing a room with their parents.
✔️ If co-sleeping is being undertaken safely following the recommended guidelines, it is not currently considered to pose a significant SIDS risk. Do check the guidelines for situations when it is unsafe to co-sleep such as if you smoke or have taken drugs or drunk alcohol.
✔️ Babies should sleep on their back, to ensure they are unable to roll onto their tummy and subsequently smother themselves in blankets, or breathe in any vomit that they may bring up.
✔️ When placing baby in their cot, follow the ‘feet to foot’ rule. When baby’s feet are to the foot of the cot, they are unable to wriggle down the bed and therefore cannot end up under blankets and smother themselves. Blankets should be tucked under their arms, to further avoid them riding up over the baby’s face.
✔️ Ideal room temperature is 16–20C. I’d advise the baby wear a nappy, vest and sleep suit, plus a lightweight sleeping bag OR two to four layers of well-fitting cellular blankets. If your room is colder, an extra layer of blankets should suffice, but babies should not sleep with hats or gloves on. If your room is too hot, reduce the bedding and clothing of your baby accordingly.