Side Sleeping, Back Sleeping, Or Tummy Sleeping?
Is it safer for baby to sleep on his back or side? New Zealand studies show that SIDS is least likely to occur when babies sleep on their backs, and most likely when sleeping on their tummies. Sleeping on the side falls somewhere in between. This statistical difference is not enough that parents should avoid putting babies to sleep on their sides.
Sleeping on the back, however, is a more stable position than on the side. Many infants do not develop the desire or the motor capability to roll from back to tummy until around five or six months, when the risk of SIDS begins to diminish. Yet even newborns have the capability of rolling from side to back or side to tummy. While most babies less than six months who are put to sleep on their tummies or backs tend to stay there, many infants who are put down to sleep on their sides will change position, most of the time rolling onto their backs rather than onto their tummies. Yet the number of SIDS infants who rolled from their sides to the front position in the Avon study, led experts in England and New Zealand to suggest that the risk of SIDS for side-sleeping may be two times that of back-sleeping. (Once again, parents should be aware that these are purely statistical findings and of questionable meaning for individuals.) At present, most authorities agree that research only supports discouraging the front position, and that both side- and back-sleeping are safe alternatives.
To lessen the chances of a side-sleeping baby rolling onto his tummy, stretch his underneath arm forward. This arm can act as a stabilizer to keep baby from rolling onto his tummy. If the baby’s arm stays closely tucked into his side, it will be easier for him to roll onto his tummy. Wedges to keep baby sleeping on his side are helpful, but never use just a back wedge. Rolling up a towel as a wedge between baby’s back and the bed may encourage baby to roll from side to stomach rather than from side to back. Be sure not to use props that totally restrain the infant’s movement. Freedom of breathing implies freedom to adjust body position as needed. I’m concerned that the multitude of commercial baby wedges may be more restrictive than necessary, and they have not been proven either safe or effective. For these reasons, SIDS organizations and researchers do not endorse these products. If you choose to use a wedge to keep baby on his side, it seems the most sensible to use a front wedge only, which allows baby to roll onto his back if desired.
If your baby is experiencing increased drool associated with teething, or mucous from a respiratory infection, the side position may help him handle it. The excess mucous is likely to collect in the lower cheek pocket or run out of the mouth rather than puddle in the back of the throat, as may occur when baby is sleeping on his back. So, if your back-sleeping teether is having difficulty clearing the mucous (evidenced by coughing, noisy breathing, and night-waking), try the side position.
Don’t over-bundle . Best not to restrain baby’s upper extremities. This allows baby to adjust himself to the safest position for breathing.
It is unlikely that the warning against front sleeping is just a passing fad. In view of what we know at this time, prudent parents should avoid placing their babies in the tummy-sleeping position for at least the first six months.