If you're a parent of a newborn, you may have heard the phrase “back is best” from your doctor, baby books, friends, or the Internet.
The widely adopted “Back to Sleep” campaign was launched in the early 1990s when research showed that putting babies under the age of 12 months to sleep on their backs instead of putting them to sleep on their stomach reduced the risk of Sudden Infant Death Syndrome (SIDS).
Read on for more about why putting your little one to sleep on their back is safer than stomach sleeping, when your infant can start sleeping on their tummy, and what to do to promote safe sleep habits in your baby.
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Can Newborns Sleep on Their Stomach?
For the first 12 months of their life, babies should be put to sleep on their backs, including during daytime naps and at night. Research shows that putting babies under one-year-old to sleep on their back decreases the risk of SIDS, which is the sudden unexplained death of a baby under one during sleep. Putting a baby who typically sleeps on their back to sleep on their stomach or side can increase their risk for SIDS as much as 7 to 8 times.
If your newborn rolls onto their stomach while sleeping, you should gently roll them back. If your baby rolls onto their stomach while sleeping but can roll back on their own, you no longer need to return them to the back sleeping position.
Can newborns sleep on their tummy during naps?
Newborns should never sleep on their tummy, including during naps.
Why Shouldn’t Babies Sleep on Their Stomach
Stomach sleeping is a known cause of SIDS. Putting a baby to sleep on their stomach significantly increases the risk for SIDS. Since experts began recommending that babies be put to sleep on the back, the incidence of SIDS has decreased by more than 50%.
There are many reasons for why stomach sleeping may increase the risk for SIDS. Reasons include:
- Breathing Obstruction: When a baby sleeps on their stomach, they may press their face into the mattress, which can obstruct their breathing. If a young baby is not able to move themselves out of that position, they may struggle to breath which could lead to suffocation.
- Overheating: Overheating is a potential risk factor for SIDS. Babies who sleep on their stomachs may become overheated more easily because their faces are more likely to be covered and their breath stays near their facing making them warm.
- Rebreathing: When a baby sleeps on their stomach, they may inhale their own exhaled breath, which is high in carbon dioxide. Rebreathing could decrease the levels of oxygen in their blood and potentially increase the risk of SIDS.
- Autonomic Nervous System: Sleeping on the stomach can potentially affect the baby's autonomic nervous system, which controls vital functions like heart rate and breathing. This could potentially make them less responsive to factors that might otherwise wake them up from a deep sleep.
Is side sleeping safe for babies?
Just like with stomach sleeping, side sleeping is unsafe for babies and can increase their risk for SIDS. A baby sleeping on their side is more likely to roll onto their tummy.
If your baby rolls to their side while asleep and they won’t be able to roll back on their own, gently return them to their back.
When Can Babies Sleep on Their Stomach
It is widely recommended by major health authorities around the world that all babies under the age of 12-months-old are put to sleep on their back for all daytime and nighttime sleeps.
Approximately 90% of deaths from SIDS happen in the first six months of a baby’s life, with a peak of between one and four months old, and two-thirds of SIDS deaths happen at night.
When a little baby sleeps on their stomach, they could struggle to breathe, give they aren’t as strong as an older baby to move into a more comfortable position.
If your baby can roll back and forth on their own, they can choose their sleeping position. However, they should still be put down in their crib or cot on their back.
What to Do if Your Baby Rolls on Their Stomach When Sleeping
Studies show that it’s rare for newborns who are put down on their back to roll onto their stomach.
If your baby rolls onto their stomach or side when sleeping and is not yet able to roll back and forth independently, it’s recommended you gently move your baby back to their back. Sometimes if a baby rolls onto their stomach and gets stuck, they will get upset or cry.
If your baby is developmentally able to roll back and forth unassisted, you do not need to move them back to their back if they roll in their sleep.
Babies typically start to show signs of starting to roll over around 3 or 4 months old, but every child is different.
Tips for helping your baby sleep comfortably on their back:
- Start From Day 1: Put your baby to sleep on their back starting right when they’re born to help them get used to sleeping on their back.
- Swaddling: Swaddling helps keep a newborn baby feeling warm, safe, and comfy, and keeps their natural, involuntary newborn reflexes from startling them awake. Once your baby shows signs that they may roll over, stop swaddling immediately.
- Firm Mattress: A firm mattress, along with a fitted sheet, is known to reduce the risk of sleep-related accidents associated with loose bedding or soft surfaces. Firm mattresses also reduce the risk of SIDS.
- Comfortable Environment: The right temperature and a dark room can do wonders for a newborns sleep – both during the night and at naptimes.
- Consistent Routine: Cueing sleep is a great way to get your baby ready for shut eye. The same set of steps before bed every night helps soothe your little one and signals that it's time to fall asleep.
- Room Sharing: The American Academy of Pediatrics recommend you share a room with your baby for the first six months of life as it can cut the risk of SIDS in half and is a safer alternative to sharing a bed. It also helps you keep an eye on your baby in case they start to roll.
If you’re looking for support around how to ensure safe, restorative sleep for your little one, download the Smart Sleep Coach by PampersTM app. The app is a parent’s partner in everything baby sleep – from how to create the perfect sleep environment to how to remain consistent with a bedtime routine. It also personalizes a sleep schedule for your baby to maximize their wake windows and sleep cues to make bedtimes a breeze.
Can babies sleep on stomach if supervised?
Babies should always be put to sleep on their back. Unless your baby can roll back and forth on their own, they should never sleep on their stomach, even if supervised.
However, experts recommend lots of tummy time for babies when your baby is awake. Tummy time, or spending time on their stomach, strengthens important muscle, supports development, and can even help with digestion and gas. If you’re worried about your baby developing a flat head because of sleeping on their back, tummy time helps prevent that, too.
How to Prevent a Baby from Rolling on Their Tummy
- Swaddling: Swaddling can help keep a baby snugly wrapped and reduces their ability to roll over onto their stomach. Make sure to use a swaddle that allows for proper hip movement and doesn't restrict breathing and stop swaddling the second they show signs of being able to roll onto their stomach.
- Repositioning: If you notice the baby starting to roll onto their stomach during sleep, or rolling onto their side, gently reposition them back on their back.
Experts recommend you keep your baby’s crib free of any blankets, stuffies, or other soft objects for the first 12 months of life. If you’re concerned your baby is going to roll onto their stomach, it is not recommended or safe to use products such as an anti-roll pillow, rolled-up blanket, or sleep positioner for a newborn.
If you have questions about what to do if your baby rolls onto their stomach, speak with your pediatirican.
Final Thoughts
“When can my baby sleep on their stomach” is a common question asked by parents. The answer is they should never be put to sleep on their stomach before their first birthday, and you should make sure they stay sleeping on their back until they can roll back and forth on their own. This is the safest way for a baby to sleep and decreases their risk of SIDS.
While swaddling can help stop your baby from rolling onto their stomach, ensuring the proper sleep environment, consistent bedtime routine, and optimal sleep schedule can also help your baby fall asleep faster and stay asleep longer – and sleep like a dream. If you have more questions about how to keep your baby safe while sleeping, speak to your pediatrician.
