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For our first baby, we were told by various midwives in no uncertain terms, that babies must always be placed on their backs to sleep (no explanation ever given- just instructions!). This was all very well, but our little boy just wouldn't stay asleep for more than a few minutes on his back before waking himself up crying.

It was only when his Grandmother came to stay after a few weeks and placed him on his front that he actually had any kind of lengthy sleep at all. She says that the advice used to be to always do the exact opposite, and place babies on their front to sleep.

We are now expecting a second child, and would like advice as to whether we should try our best again to place him on his back as before.

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    Quick update- our second child is now over a year old. And he slept soundly on his back throughout his first year.
    – Urbycoz
    Jul 11, 2013 at 9:50

6 Answers 6

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When I was baby, my the official recommendation was to sleep babies on their stomach. I don't know the scientific/medical reason for that decade (1980's).

According to research, sleeping babies on their back greatly reduces SIDS probability, and that is the main reason for recommending sleeping on back.

According to this article,

Since "Back to Sleep" was launched in 1994, the incidence of SIDS has declined by more than 50%.

Many older children and adults also sleep better on their stomach, or on the side. Once the baby is old enough to turn around (and back again), you can't really influence it anymore anyway, so don't worry about SIDS then. Until then, placing the baby face-up is safer.

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    Its worth adding that no one actually knows why this makes a difference, just that it does.
    – Mongus Pong
    Jan 13, 2012 at 9:54
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    I heard that babies used to be placed on their stomachs to supposedly stop them choking on vomit.
    – Urbycoz
    Jan 13, 2012 at 10:30
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    @urbycoz that was definitely one of the main rationales for having infants sleep prone. However, research has since then shown that this is actually unfounded.
    – user420
    Jan 13, 2012 at 16:31
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    I ABHOR STATISTICAL QUOTES LIKE THIS. What region, USA? California? Orlando? Who's study was it? How the hell do you have a control group for something like this? Even the wikipedia article is light on clarification of parameters. i had a Dr. throw this exact stat at me in 2003 and I asked her all those questions that she couldn't answer. Baseless or undefined stats can be dangerous.
    – monsto
    Jan 16, 2012 at 9:28
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    @monsto The American Academy of Pediatrics cites the CDC's compressed mortality file:Mortality for 1979 –1998 with ICD 9 codes; Mortality for 1999 –2001 with ICD 10 codes. Available at: wonder.cdc.gov/mortSQL.html. Control groups are irrelevant for identifying correlation trends in large populations.
    – user420
    Jan 19, 2012 at 19:24
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As a former nurse and mother of 5 I have to say that when my daughter brought home a leaflet on how to reduce the risk of SIDS I tore it up and threw it away. She was a young first time mother and the last thing she needed if, God forbid, anything had happened to her daughter was to be given the impression that something she did or did not do was the cause. There is no known reason for SIDS and that being the case it baffles me, as a former health professional, how they can possibly advise how to avoid it - in simple medical terms if you do not know what causes it then you cannot give health advice on how to prevent it and that would apply to any medical condition. You can ask your OBGYN or midwife about it as suggested and they can tell you the statistics but what they cannot tell you a definitive cause and there is no practical advantage to knowing how many babies die of SIDS. There is also a strong 'association' between breast feeding and lowered incidence of SIDS - does that mean the bottle feeding mothers are putting their baby's health at risk and should feel guilty if their child is a victim of SIDS ? Of course not .

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    While it doesn't precisely answer the question, I think this is a valuable perspective. You are precisely right: there is no known cause of SIDS... that's part of the definition of SIDS. However, there are large volumes of studies that demonstrate a statistically valid correlation between SIDS and certain things (such as prone sleeping). The distinction between "correlation" and "causation" is one that is not clear to many people. I've upvoted your answer because it is useful, but I'd love to see you edit this and expand upon it a bit to add some detail about the perceived risks.
    – user420
    Jul 10, 2013 at 13:08
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    Sorry, but this seems dangerously wrong. The statement "if you do not know what causes it then you cannot give health advice on how to prevent it" is a fallacy: If you know/have reason to suspect something is dangerous, it is sensible to avoid it, even if you do not know what exactly causes the danger.
    – sleske
    Apr 23, 2014 at 21:21
  • @sleske Yes, but there are other factors. Like in the original question - the baby is getting poor sleep due to these SIDS prevention measures, which for all we know, may only be trying to prevent drowning by abstaining from ice cream. I think the idea in this answer is, sleeping prone certainly solves a concrete problem, but sleeping supine may solve a poorly defined problem (SIDS being literally defined as unexplained infant death).
    – wberry
    Oct 5, 2014 at 15:45
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Your Grandmother is correct - during their times, it was always recommended to place the baby to sleep on their tummys (because of risk of choking on their own vomit). Babies LOVE sleeping on their tummy - they have a longer, more sound sleep. Has the baby ever fallen asleep on you (on its belly)? They fall into a very deep sleep.

But THAT is the problem with kids sleeping on their belly. The babies are so soundly asleep that they don't wake up to get out of danger.

Researchers don't know what exactly causes SIDS. They really don't. All they know is that the risk of death is greater when the infant is sleeping on their belly versus when sleeping on their backs. At the same time, studies have shown that an infant has the same likelihood of choking and dying regardless of the sleeping position it is in.

SIDS is a very real thing. Even today, 3000 babies die from it every year in the US. Before the "Back to Sleep" (sleep on back) campaign was launched, more than twice as many infants use to die. Just because none of your Grandmother's children lost their lives to SIDS, doesn't mean that it won't happen. It can happen. It does happen. I would highly recommend reading more about SIDS (just ask your ob, midwife, pediatrician, doctor) and the risks of putting your child to sleep on their tummy. The highest risk of SIDS is between the 2-4 months of age; the risk disappears after 1 year of age.

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Adding to the answers already here, it is true that the incidence of SIDS fell at around the same time that health care professionals started telling parents to not let babies sleep on their front.

The problem is, around that time parents were also told not to smoke around their babies, and a number of other sensible things like having proper air circulation, proper bedding that won't smother the baby, etc.

So it is not clear that the sleeping position is a causation, though it is an association.

Babies do seem to sleep better on their fronts. They also tend to be better crawlers, with better upper body strength - babies who sleep exclusively on their back often skip crawling and go straight to walking.

Because of this, I let my babies sleep on their front, tried to monitor it when I could, and hoped for the best.

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    It is true that there is no known causation between prone sleeping and SIDS, but there is very strong correlation. Proper bedding that won't smother the baby wouldn't impact SIDS rates, as infant suffocation is different than SIDS (the cause of SIDS is unknown). The general advice is to encourage "tummy time" with prone sleeping, which offsets the idea that supine sleepers crawl better.
    – user420
    Jan 19, 2012 at 19:01
  • Both of my kids were exclusive back sleepers until they could flip themselves over and they were both champion crawlers. I don't know a single kid who slept on their back and didn't crawl.
    – Meg Coates
    Feb 20, 2012 at 15:16
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    @Beofett - I was under the impression (via an NPR story) that also around the same time that the Back-To-Sleep campaign began in the US and elsewhere the ability to separate asphyixation deaths from SIDS deaths rose. So before the back-to-sleep campaign deaths that would today be considered asphyxiation may have been considered SIDS.
    – justkt
    Jul 11, 2013 at 14:09
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    As a mother who suffered many sleepless nights due to back-sleeping I wish that there would be a way to ethically re-study stomach sleeping (maybe via volunteers from the 10-25% of families who self-reportedly do stomach sleep despite the recommendations) now that all the other changes have happened and see if the correlation is still there since causation is not proved. Either that or I hope the cause of SIDS is discovered so that it can be determined if a portion of babies can safely stomach sleep while those with a SIDS risk cannot.
    – justkt
    Jul 11, 2013 at 14:11
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    Don't forget the incidence of babies with malformed (flattened) skulls. That has increased greatly since doctors began recommending having your baby sleep on their back. As a sidenote, I feel quite sorry for new, well-meaning parents who actually try act on all the advice given by their doctors, medical organizations, and books.
    – Ask About Monica
    Jul 11, 2013 at 18:11
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The most important thing is to make sure there is nothing obstructing the baby's breathing. Use light cotton bedding, and ensure the sheet the baby is sleeping on is tight, and cannot become crumpled up near his/her face, and never use a pillow for young babies. Make sure blankets and sheets covering the baby are not pulled up too high.

We relented early on, and let our babies sleep on their front, as it became very obvious they really did not want to sleep on their backs.

It's not good for anyone if the baby can't sleep.

Severely sleep deprived parents are a big risk for babies. Parents have to have enough sleep to be able to function safely. Driving children to school, carrying babies around in arms etc.

I remember when our first was very young, I would sometimes be so utterly exhausted that I when I was walking the halls trying to put her to sleep, I was terrified I would fall asleep while walking and accidentally drop her. Thankfully it never happened.

There comes a point where virtually nothing can prevent you from falling asleep. I read about an incident where a mother fell asleep while breast feeding her newborn on a plane, in doing so she slouched forward in her seat and accidentally smothered the baby.

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So here's the deal:

Sleep infants on their back. It can reduce SIDS.

Vs.

Sleep infants on their stomach and eveyrone gets a full nights sleep.

Really, tho, what is SIDS anyway? I read an article about a woman that had a couple babies die of SIDS. Come to find out, the babies were sleeping in her bed. And since she was a large woman she was actually suffocating the babies unintentionally. Is that SIDS?

Basically what it comes down to is this: It's a choice between the risk and the quality-of-life.

Personally, we always kept all the potential breathing problems out of the crib, and put the baby on their stomach. I always felt that the risk was ridiculously lower than the potential benefit of being able to sleep 4hr+ at a crack. When baby sleeps, we all sleep. When we all sleep, we can drive to work without wrapping up around a light pole.

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  • No, babies dying of suffocation is not SIDS. Many supposed SIDS cases are later found out to be from other sources. Any sources to support the claim that babies sleeping prone will sleep longer, and those sleeping supine less?
    – user420
    Jan 19, 2012 at 19:04
  • @Beofett I'm not sure if there's sources for this, but personal experience certainly bears this out. Babies/Toddlers just like being on their tummies. For toddlers their favourite sleeping position is usually on their tummies, knees tucked up and bottoms in the air.
    – user1751825
    Feb 25, 2016 at 4:21

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