Newborn Side Sleeping: Is It Safe for Babys to Sleep on Their Side? A Guide to Baby Sleep

As new parents, ensuring your baby’s safety during sleep is extremely important. One common question is whether it’s safe for newborns to sleep on their side. This comprehensive guide will explore various aspects of baby sleep positions, focusing on side sleeping, and provide you with the information you need to create a safe sleep environment for your little one.

Why do some newborns sleep on their side?

Natural reflexes and positioning

It’s not uncommon for newborns to sleep on their side due to natural reflexes and positioning preferences. Many infants exhibit a strong Moro reflex, which can cause them to startle and possibly roll onto their side. Additionally, some babies may naturally prefer a side-sleeping position reminiscent of their time in the womb. However, it’s crucial to note that while this may feel comfortable for your baby, it’s not considered safe for newborns to sleep on their side during the first 12 months of life.

Comfort preferences in newborns

Some newborns may find side sleeping more comfortable, particularly if they experience reflux or gas. The fetal position, which resembles side sleeping, can help alleviate discomfort for some infants. Despite these comfort preferences, you should always put your baby to sleep on their back, as recommended by the American Academy of Pediatrics. While it might be tempting to let your baby sleep in a position they find comfortable, the risks associated with side sleeping outweigh any perceived benefits.

Influence of pre-birth positioning

The position your baby was in during pregnancy can influence their sleep habits after birth. Some newborns may naturally curl up on their side, mimicking their prenatal position. While this may seem natural, it’s essential to establish safe sleep practices from the start by consistently placing your baby on their back for sleep, regardless of their apparent preferences.

What are the risks of side sleeping for babies under 12 months?

Increased risk of SIDS

One significant concern associated with side sleeping in infants is the heightened risk of Sudden Infant Death Syndrome (SIDS). Research indicates that placing babies to sleep on their back significantly reduces the risk of SIDS. When a baby sleeps on their side, there’s a greater chance they may roll onto their stomach, which is considered the most dangerous sleep position for infants. The American Academy of Pediatrics strongly advises against side or stomach sleeping for babies under 12 months to minimize the risk of SIDS and ensure a safe sleep environment.

Potential breathing difficulties

Side sleeping can also lead to breathing difficulties in newborns. When a baby sleeps on their side, their face may become pressed against the mattress or bedding, potentially obstructing their airway. This position can also make it harder for infants to clear secretions from their mouth and nose, increasing the risk of choking or aspiration. By consistently placing your baby on their back to sleep, you can help keep their airway clear throughout the night.

Risk of rolling onto stomach

Another major concern with side sleeping is the possibility of your baby rolling onto their stomach during sleep. Newborns lack the strength and coordination to roll back onto their back if they find themselves in this position. Stomach sleeping is particularly dangerous for young infants, as it increases the risk of rebreathing exhaled air, leading to a buildup of carbon dioxide and decreased oxygen levels. To prevent this, it’s crucial to always place your baby down on their back and take steps to prevent them from rolling onto their side or stomach during sleep.

How can I prevent my baby from rolling onto their side during sleep?

Proper swaddling techniques

Swaddling can effectively help keep your baby on their back during sleep. When done correctly, swaddling provides security and comfort while limiting your baby’s ability to roll onto their side. However, it’s vital to use proper swaddling techniques to ensure your baby’s safety. Make sure the swaddle is snug but not too tight, allowing for hip movement and chest expansion. Always place a swaddled baby on their back to sleep, and discontinue swaddling once your baby shows signs of rolling over, typically around 2-3 months of age.

Using sleep sacks or wearable blankets

Sleep sacks or wearable blankets are excellent alternatives to traditional swaddling as your baby grows and becomes more mobile. These garments provide warmth and comfort without the risk of loose bedding, which can be hazardous in the crib. Many sleep sacks are designed with wing-like sleeves that allow for arm movement while still discouraging rolling. When using a sleep sack, ensure it fits properly and doesn’t ride up around your baby’s face during sleep.

Creating a safe sleep environment in the crib

A safe sleep environment is crucial in preventing side sleeping and reducing the risk of SIDS. Start by choosing a firm crib mattress that fits snugly in the crib frame. Keep the crib free of pillows, blankets, stuffed animals, and other soft objects that could pose a suffocation risk. Use a fitted sheet designed for your specific mattress, and avoid crib bumpers, which are not considered safe. By maintaining a clear and uncluttered sleep space, you can help reduce the chances of your baby rolling or shifting into an unsafe position during sleep.

When is it ok for babies to sleep on their side?

Age considerations for side sleeping

The American Academy of Pediatrics recommends that babies sleep on their back for the first year of life. After 12 months, when the risk of SIDS significantly decreases, it becomes safer for babies to sleep in other positions. However, it’s important to note that every child develops at their own pace, and some babies may not be ready for side sleeping even after their first birthday. Always consult with your pediatrician before making any changes to your baby’s sleep position or habits.

Developmental milestones to watch for

Before considering side sleeping as an option, your baby should reach certain developmental milestones. These include the ability to roll from back to side and side to back consistently and easily. Your baby should also have good head and neck control and be able to move freely to adjust their position if necessary. Remember that even if your baby can roll independently, it’s still safest to place them on their back at the start of every sleep period until they are at least 12 months old.

Transitioning from back to side sleeping

If your pediatrician approves side sleeping after your baby’s first birthday, it’s important to make the transition gradually. Start by placing your baby on their back as usual and allowing them to find their preferred sleep position on their own. Continue to keep the sleep environment clear of hazards, and monitor your baby closely during this transition period. Some babies may naturally prefer to continue sleeping on their back, which is perfectly fine and should be encouraged.

What are the safest sleep positions for newborns?

Back sleeping as the recommended position

The safest sleep position for newborns and infants under 12 months is on their back. This position has been shown to significantly reduce the risk of SIDS and other sleep-related infant deaths. Back sleeping keeps your baby’s airway clear and prevents overheating, both of which are crucial for safe sleep. The “Back to Sleep” campaign, now known as “Safe to Sleep,” has been instrumental in educating parents about the importance of back sleeping and has significantly decreased SIDS cases since its introduction.

Why tummy time is important during awake hours

While back sleeping is essential for safety, providing your baby with supervised tummy time during their waking hours is equally important. Tummy time helps strengthen your baby’s neck, shoulder, and arm muscles, which are essential for their motor development. It also prevents flat spots from forming on the back of your baby’s head, a condition known as positional plagiocephaly. Aim for several short sessions of tummy time throughout the day, always under close supervision, to support your baby’s development while maintaining safe sleep practices.

Addressing concerns about flat head syndrome

Some parents worry that exclusive back sleeping may lead to flat head syndrome. While this is a valid concern, there are ways to prevent it without compromising safe sleep practices. Alternate the direction your baby faces in the crib each night, encourage plenty of tummy time during awake periods, and limit time spent in car seats, swings, and bouncy seats when your baby is awake. If you notice any flattening of your baby’s head, consult your pediatrician, who may recommend additional strategies or refer you to a specialist for evaluation.

How can I help my baby sleep safely in a crib?

Choosing the right crib and mattress

Selecting the right crib and mattress is crucial for creating a safe sleep environment for your baby. Choose a crib that meets current safety standards, with slats no more than 2 3/8 inches apart. The mattress should be firm and fit snugly in the crib frame, with no gaps larger than two fingers between the mattress and the crib sides. Avoid using hand-me-down cribs or mattresses, as they may not meet current safety standards. A properly chosen crib and mattress provide a secure foundation for your baby’s sleep, reducing the risk of entrapment or suffocation.

Keeping the sleep area clear of hazards

To ensure your baby’s safety during sleep, keep the crib free of potential hazards. This means avoiding the use of pillows, blankets, stuffed animals, and other soft objects in the crib. These items can pose a suffocation risk, especially for younger infants who may not be able to move away from them. Instead, dress your baby in appropriate sleepwear, such as a sleep sack or wearable blanket, to keep them warm without loose bedding. Regularly inspect the crib for any loose parts, broken slats, or other potential dangers.

Proper room temperature and clothing

Maintaining a comfortable room temperature and dressing your baby appropriately for sleep are important aspects of safe sleep practices. The ideal room temperature for infant sleep is between 68-72°F (20-22°C). Dress your baby in light layers, adding or removing clothing as needed to maintain comfort without overheating. A good rule of thumb is to dress your baby in one more layer than you would wear to feel comfortable in the same room. Avoid covering your baby’s head or face during sleep, as this can lead to overheating and an increased risk of SIDS.

Are there any safe alternatives to side sleeping for newborns?

Using sleep positioners or wedges

While sleep positioners or wedges may seem like a solution to prevent side sleeping, they are not recommended by the American Academy of Pediatrics. These devices, often marketed as ways to keep babies in a specific position or reduce the risk of reflux, can actually increase the risk of suffocation if a baby rolls against or onto them. The safest approach is to place your baby on a firm, flat surface without any additional positioning devices.

Elevated head of crib for reflux

For babies with reflux, some parents may consider elevating the head of the crib. However, this practice is generally not recommended, as it can cause a baby to slide to the foot of the crib into a position that may compromise breathing. Instead of altering the sleep surface, discuss other reflux management strategies with your pediatrician, such as smaller, more frequent feedings or holding your baby upright for 30 minutes after feeding.

Consulting with a pediatrician for sleep concerns

If you have concerns about your baby’s sleep position or habits, it’s best to consult with your pediatrician. They can offer personalized advice based on your baby’s individual needs and medical history. Your pediatrician can also address any specific concerns you may have about reflux, flat head syndrome, or other issues that might make you consider alternatives to back sleeping. Remember, while it may be tempting to try different sleep positions or products to soothe your baby or address specific concerns, the safest approach is always to follow established guidelines for safe infant sleep.

More information about when to start sleep training can be found in my other blog article here.

FAQ

Q: Is it safe for newborns to sleep on their side?

A: No, it’s not safe for newborns to sleep on their side. The safest position for babies to sleep is on their back, especially during the first 12 months of life. Side sleeping increases the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related dangers.

Q: When is it safe for a baby to sleep on their side?

A: It’s generally safe for your baby to sleep on their side once they are able to roll over independently, which usually happens around 4-6 months of age. However, you should still place your baby on their back to sleep until they reach 1 year old, even if they roll to the side or onto their tummy during sleep.

Q: How can I prevent side sleeping in my newborn?

A: To prevent side sleeping in your newborn, always place them on their back to sleep in a crib or bassinet. Avoid using positioning devices or wedges, as these can be dangerous. Keep the sleep surface firm and free of loose bedding, pillows, or toys that could cause the baby to roll to the side.

Q: What should I do if my baby rolls onto their side while sleeping?

A: If your baby is under 4 months and rolls to their side, gently reposition them onto their back. For older babies who can roll over independently, it’s safe to let them sleep this way. However, always start by placing them on their back, and ensure their sleep environment is safe.

Q: Can I use a sleeper or positioning device to keep my baby on their back?

A: No, it’s not recommended to use sleepers, positioning devices, or any products that claim to prevent side sleeping. These items can actually increase the risk of suffocation and are not considered safe for your baby. The best approach is to always place your baby on their back on a firm, flat surface.

Q: Is it okay to let my baby sleep on their side if they fall asleep that way while feeding?

A: If your baby falls asleep while feeding, it’s important to move them to their crib or bassinet and place them on their back. Even if they’ve fallen asleep on their side, always reposition them onto their back for safe sleep, especially during the first six months.

Q: How can I help my baby get used to sleeping on their back?

A: To help your baby get used to sleeping on their back, start this practice from day one. Provide plenty of tummy time during awake hours to strengthen their muscles. Use a firm mattress and avoid soft bedding. If your baby fusses, try swaddling (until they can roll over) or using a pacifier, which can help soothe them to sleep on their back.

Q: Are there any exceptions to the back-sleeping rule for newborns?

A: In general, there are no exceptions to the back-sleeping rule for newborns. However, if your baby has certain medical conditions, your pediatrician might recommend a different sleep position. Always consult with your healthcare provider before changing your baby’s sleep position from the recommended back-sleeping.