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The Best Sleeping Position for Infants and Newborns: SIDS Prevention Tips for Keeping Babies Safe

Updated on July 6, 2015
Chris Telden profile image

Chris Telden knows how fortunate she is to be a mom at all, given her high-risk pregnancy and the challenges of extended breastfeeding.

As a mom, I'm very aware of the importance of communicating to new parents the safest sleeping position for newborns and babies under one year of age. Why is sleeping position so important? The risk of SIDS, sudden infant death syndrome, is linked to sleeping position. Yet some parents still do not know this important fact, and just as frightening, it's extremely likely that some caregivers - grandparents, babysitters, even daycare workers--are ignorant of the advice given by the Back to Sleep Campaign, which, through teaching parents and caregivers about the best sleeping position for infants for SIDS prevention, has lowered the incidence of infants dying from SIDS by as much as 50 percent.

Let your caregiver know that he or she must put a baby under one year old to bed in the recommended sleeping position even for a short nap.

It should be stated right off that there is not really any such thing as SIDS prevention - yet. SIDS cannot yet be prevented - according to what researchers know, the risk can only be reduced. While this is disturbing to know for many parents, it's good news that the Back to Sleep campaign has been so successful in reducing the incidence of SIDS.

Also, note that I am a mom, but not a scientific researcher or healthcare professional. Research on SIDS is ongoing and there may come a time when we know even more about the safest way for your baby to sleep. Ask your healthcare providers for the latest updates on our knowledge of SIDS.

What is SIDS?

Crib death, another name for sudden infant death syndrome, is known to be the most common cause of mortality in babies in their first year of life. Most cases occur between the ages of 2 and 4 months. And by six months, 90 percent of SIDS cases occur. After 6 months, the risk decreases, but does not go away, and parents are still strongly advised to put the baby to sleep on her back. SIDS usually happens when babies are asleep.  Generally, the infant cannot be roused even if treated immediately with CPR.  A frightening thought to most parents, SIDS happens across the globe, crossing racial, national, class and socioeconomic boundaries.

Cause Unknown

The cause of SIDS remains a mystery, to the agony of the parents whose babies still die of SIDS, despite the efforts and partial success of the Back to Sleep Campaign. Sudden infant death syndrome has been researched all over the world, and theories abound, but nothing has been conclusively shown. One promising hypothesis is that when they're on their stomachs (in the prone position), if they fall into a deep sleep--the particular kind of sleep infants are known for when the're not in REM - babies' immature respiratory systems can't adjust successfully to pockets of CO2 that build up or other breathing obstructions. Some individuals speculate that toxins in the bedding and mattresses cause SIDS in some cases. There's a good chance that there are multiple causes for multiple cases, all of which are lumped together under the term "SIDS."

Major Risk Factors of SIDS

Despite not knowing what causes SIDS, researchers are aware of certain risk factors that increase an infant's risk of dying of SIDS.

The risk of SIDS happening to a baby is higher in:

  • young mothers under 20 years of age
  • mothers who experienced prenatal care that was substandard
  • mothers who used drugs, smoked or drank alcohol during pregnancy
  • low-birthweight infants
  • babies who were exposed to cigarette smoke after their birth
  • babies of American Indian/Native Alaskan descent
  • babies of African American descent
  • babies who get too hot while sleeping, due to being bundled up or simply hot weather
  • babies who sleep on their stomachs, either during the night or during naps

A Caution About Caregivers

Older individuals, your grandparents, or your parents may have learned that the best sleeping position for a baby is on his stomach--but it's not. If they are in charge of your child, make sure they know that the recommendation has changed and stomach-sleeping is definitely not recommended for infants under one year. The baby must be put to sleep on his back, even for a nap.

Sleeping on Their Backs

The American Academy of Pediatrics has stated definitively that the best sleeping position for infants under one year of age--indeed, the only recommended sleeping position--is on her back. The National Institutes of Health shows what a safe sleep environment for a baby looks like.

  • Always, at naps or at nighttime, put your baby to bed on her back.
  • Furthermore, make sure her feet are at the crib's base.
  • Do not dress your baby in baggy sleepwear. Onesies, footies or other sleepwear should be close-fitting.
  • The crib mattress should be firm and of the type approved for infant safety.
  • One fitted sheet should cover the mattress without folding or bunching.
  • In cold weather, do not put your baby to bed bundled up in clothing or blankets. You can stretch a light baby blanket over the baby--but the blanket should be tucked into the mattress sides and reach no higher than her chest.
  • Keep all toys, pillows, quilts, and other plush objects outside the crib while baby is napping or asleep.
  • Make a list of these rules so caregivers can follow them.

What About Babies Sleeping on Their Sides?

In previous years, doctors recommended the side sleeping position for babies to help reduce the risk of SIDS. They no longer do - or they shouldn't, because the side sleeping position has not been shown to reduce the risk of SIDS. The American Academy of Pediatrics confirmed in 2005 that they only recommend babies be put to sleep on their backs if they are under a year old.

But What About Acid Reflux or GERD?

Gastroesophageal reflux disease, or GERD, afflicts some babies. In some cases, babies experience an uncomfortable degree of reflux - a certain amount actually being normal for infants due to their immature digestive systems. Formerly, some physicians would advise parents to allow babies suffering with severe cases to sleep on their stomachs. Only rarely is this still advised. Doctors prefer to recommend parents elevate an infant's upper body by raising the head of the crib using specially shaped props. The moral of the story? Even in such a case, put your baby to sleep on her back unless advised otherwise by her pediatrician.


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  • melodyandes profile image

    melodyandes 6 years ago

    Thanks for the great information.

  • lorlie6 profile image

    Laurel Rogers 7 years ago from Bishop, Ca

    Hi WryLilt-I'm a brand new grandmother of a little 2 1/2 month old boy. I've been concerned about SIDS and am glad I read your article. This is such a baffling subject-thanks for speaking out about it.