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Our 3 months old baby is very keen on rolling over and being on his stomach. Most of the time he automatically rolls over in a few minutes after we put him on his back, including during bed time. Is this dangerous? We are particularly worried that

  • his nose maybe blocked when facing down
  • it is said that SIDS risk increases when a baby sleeps on his stomach

If it is dangerous, how can we stop this, especially during bed time or other times when we can't watch him continuously?

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By the time they can roll over, SIDS is not considered a high risk any more. –  Rory Alsop Jul 7 '13 at 16:09
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5 Answers 5

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+100

According to the US. Department of Health & Human Services brochure on sleep positioning for infants:

Studies show that, during early infancy, it is unusual for a baby who is placed in the back sleep position to roll onto his or her stomach.20 However, once infants are more developmentally advanced, they often roll over on their own. In this situation, when infants roll over on their own, there is no evidence that they need to be repositioned.

The American Academy of Pediatricians's Task Force on SIDS published the following in Pediatrics in 2011:

Parents and caregivers are frequently concerned about the appropriate strategy for infants who have learned to roll over, which generally occurs at 4 to 6 months of age. As infants mature, it is more likely that they will roll. In 1 study, 6% and 12% of 16- to 23-week-old infants placed on their backs or sides, respectively, were found in the prone position; among infants aged 24 weeks or older, 14% of those placed on their backs and 18% of those placed on their sides were found in the prone position.112 Repositioning the sleeping infant to the supine position can be disruptive and might discourage the use of supine position altogether. Although data to make specific recommendations as to when it is safe for infants to sleep in the prone position are lacking, the AAP recommends that these infants continue to be placed supine until 1 year of age. If the infant can roll from supine to prone and from prone to supine, the infant can then be allowed to remain in the sleep position that he or she assumes.

So the take-away from these expert sources is that you should always place a baby on his or her back to sleep. Once your baby can move allow your baby to sleep in whatever position he or she assumes. Just keep the crib mattress firm, the fitted sheet tight, and keep items other than your baby out of the crib.

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This is not as dangerous as you think. Make sure your child is sleeping on a relatively firm surface, without squishy bumpers on the sides, and the baby will be fine. But still, when you put your child to sleep, start with the the back.

Yes SIDS is a real danger, and there are indeed studies that show the risk increases when the baby sleeps on his stomach. But it's not like putting him in front of a moving train!

You cannot reasonably restrain your child while he is sleeping, nor constantly wake him to change his position.

It may help you to sleep better at night to consider this semi-logic: if the baby can roll onto his stomach, he's clearly got some strength and mobility, which is often 'said' to reduce risk of SIDS.

Focus on bigger risk factors, like the caregiver being under the influence, smoking, or being extremely tired.

Also take all the junk out of the bed, I sometimes see babies sleeping with ten stuffed animals and a giant pillow - stick to a firm mattress and nothing else. Use warmer PJs and avoid all but the lightest, smallest blankets.

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+1 A baby rolling over has significant neck strength to reflexively avoid suffocation when the bed is firm and clear of blankets, toys, or pillows. –  MJ6 Jul 7 '13 at 15:24
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Note that SIDS is not suffocation. But if they're rolling, the SIDS risk drops dramatically as well. –  deworde Jul 7 '13 at 16:04
    
@deworde your link does not state that SIDS is not suffocation. It is an unknown. So we can say 'the cause is not identified as suffocation because it is unknown' but from your reference we cannot say 'the cause is not suffocation'. Of course, I'm not saying it is suffocation. –  Henry Jul 7 '13 at 19:26
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According to my daughter's pediatrician when she started sleeping nose down in the mattress, "Did she get there on her own? Then there's nothing you can do, is there?" If the child is in an empty crib (with the exception of a light blanket or sleep sack) on a firm mattress then you've done what you can. And - bonus - babies usually sleep better on their stomachs. –  justkt Jul 8 '13 at 13:35
    
@deworde This is why SIDS advice always bothers me. If the cause is unknown, you can't claim that any particular condition that's merely correlated with a lower SIDS rate in a population will reduce the chances of a particular child dying. Also, you can't say SIDS is not suffocation; it could be atypical cases of all the ASSB variants they mention in your link that simple aren't identified properly. We simply don't know the cause; that doesn't mean that it's anything exotic. –  William Grobman Jul 13 '13 at 15:41
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My baby rolls on her tummy then on her side then to the other side dancing lol but seems well after reading this is seems normal if they can move their neck and back they are OK

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We also tried a product called a Safe T Sleep which basically velcroes the baby into place in his/her crib. We used it because our 4 month old son ends up spinning himself around in the crib (not rolling over) and kicking the sides of the crib and waking himself up. It works great and I think the fact that it prevents him from moving around so much helps him sleep more soundly.

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Note that I don't think any organization like the CDC or AAP would recommend Safe T Sleep or any of the other similar products because they are basically sleep positioners. Also note that I have known at least one mom who ended up finding that her son started sleeping better without Safe T Sleep once she dropped it because he was fighting so hard to get out of it before (although he was 14 months once she finally dropped it). That said - it might work. –  justkt Jul 23 '13 at 15:06
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My parents told me stories about how I did laps in my crib every night. It's normal for babies to move around at night, at any age, and so I can't condone strapping them down once they're old enough to fight a swaddle. They don't settle down until they're 2 to 3 years old and by then they're learning to sleep in a big kid's (toddler) bed. It's also normal for babies to wake up in the middle of the night, and beyond a certain point (about 5-6mo) the child simply has to learn how to fall back to sleep by himself. –  KeithS Jul 31 '13 at 23:38
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My son is 5 months old and always rolls to his stomach!! After much concern i have realized he is much more content being left in that position than me moving him always. Even though he is on his tummy his head is turned and he can breath quite easily. I have been lucky with him though as he has slept through from 8 weeks old!!!

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Hi Bec - if you look at the top answer here, you'll see they provide some supporting information. This helps provide a better answer to future visitors, as this site is not a discussion forum, but a Q&A site. –  Rory Alsop Dec 16 '13 at 18:46
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