Safe Sleep

Why should I place my baby on his or her back to sleep?

Research shows that the back sleep position is the safest for babies.
The back sleep position carries the lowest risk of SIDS. Research also shows that babies who sleep on their backs are less likely to get fevers, stuffy noses, and ear infections. The back sleep position makes it easier for babies to look around the room and to move their arms and legs.

Will my baby choke if placed on his or her back to sleep?

No. Healthy babies naturally swallow or cough up fluids—it's a reflex all people have to make sure their airway is kept clear. Babies might actually clear such fluids better when on their backs. Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach.

I was placed to sleep on my stomach as a baby. Was that wrong?

We didn't know as much about SIDS or ways to reduce the risk until the early 1990s. Most of us slept on our stomachs—and we survived. But many babies didn't. There is no way to know which babies will die of SIDS, but we do know how to reduce the risk. One of the most effective and easiest ways to reduce the risk of SIDS is to place your baby on his or her back to sleep for naps and at night.

In the early 1990s, when infant stomach sleeping was more common, almost 5,000 babies died of SIDS each year. Today, as more babies sleep on their backs, fewer than half that many babies—about 2,000—die from SIDS every year. These statistics support the recommendation that you should always place your baby on his or her back to sleep.

How old are babies who die from SIDS?

The majority (90%) of SIDS deaths occur before a baby reaches 6 months of age, and the number of SIDS deaths peaks between 1 month and 4 months of age. However SIDS deaths can occur anytime during a baby’s first year, so parents should still follow safe sleep recommendations to reduce the risk of SIDS until their baby's first birthday.

What if my baby can't get used to sleeping on his or her back?

Some babies don't like sleeping on their backs at first, but most get used to it quickly. The earlier you start placing your baby on his or her back to sleep, the more quickly your baby will adjust to the position.

I saw a product that said it could prevent SIDS and keep my baby in the right position during sleep. Can I use it to prevent SIDS?

There is no known way or product to prevent SIDS. The U.S. Food and Drug Administration, the Consumer Product Safety Commission, the American Academy of Pediatrics, and other organizations warn against using these products because of the dangers they pose to babies. You should not use these products for your baby.

What if my baby rolls onto his or her stomach during sleep? Do I need to put my baby in the back sleep position again if this happens?

No. Rolling over is an important and natural part of your baby's growth. Most babies start rolling over on their own around 4 to 6 months of age. If your baby rolls over on his or her own during sleep, you do not need to turn the baby over onto his or her back. The important thing is that your baby starts every sleep time on his or her back to reduce the risk of SIDS, and that there is no soft, loose bedding in the baby's sleep area.

Why shouldn't I use crib bumpers in my baby's sleep area?

Bumper pads and similar products that attach to crib slats or sides are frequently used with the thought of protecting infants from injury. However, evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries or death. Keeping them out of your baby's sleep area is the best way to avoid these dangers.Also keep soft objects, toys, and loose bedding out of your baby's sleep area to reduce the risk of SIDS and other sleep-related causes of infant death. Loose bedding and soft bedding, placed over or under the baby, such as quilts, comforters, and pillows increase the risk of SIDS regardless of sleep position.

It is reported that the majority of other sleep-related infant deaths are due to accidental suffocation involving pillows, quilts, and extra blankets. For these reasons, do not use pillows, blankets, quilts, sheepskins, stuffed animals, or crib bumpers anywhere in your baby's sleep area.

Are there times when my baby should be on his or her stomach?

Yes, your baby should have plenty of Tummy Time when he or she is awake and when someone is watching. Supervised Tummy Time helps strengthen your baby's neck and shoulder muscles, build motor skills, and prevent flat spots on the back of the head.

Will my baby get flat spots on the back of the head from sleeping on his or her back?

When it occurs too often or for too long a time, pressure on the same part of the baby's head can cause flat spots. Such flat spots are usually not dangerous and typically go away on their own once the baby starts sitting up. The flat spots also are not linked to long-term problems with head shape. Making sure your baby gets enough Tummy Time is one way to help prevent these flat spots.

(Adapted from the U.S. Department of Health and Human Service)

Remember: Babies sleep safest on their backs, and every sleep time counts!