A rule that every babysitter probably knows is that it’s safest for babies to sleep on their backs, not their stomachs or sides. On the surface, it sounds simple — back-sleeping is associated with a lower risk of Sudden Infant Death Syndrome (SIDS). But, the rule can also leave parents and guardians with questions. For example, if you have a baby who naturally rolls onto his side or just prefers to sleep on his side, is that OK? When can babies sleep on their sides safely?
The problem with side sleeping is that it “increases the risk of a baby rolling over on their stomach,” explains Dr. Leah Alexander, a pediatrician and consultant for Mom Loves Best. “Although most cases of SIDS are associated with a stomach or prone sleeping position, it has also occurred in side-sleeping infants.”
Although back sleeping is safest for babies, experts agree that there are caveats, and side sleeping may not always be a hard “no”, depending on the circumstances and the age of the baby. Let’s take a look at the issue of side sleeping, including expert tips and advice on when babies can safely sleep on their sides.
Why can’t babies sleep on their side?
The experts we spoke with agreed that babies should never be put to sleep on their sides. The main reason behind this recommendation is the risk of Sudden Unexpected Infant Death (SUID), which results in the tragic deaths of approximately 3,400 infants each year. SUID is an umbrella term that includes infant deaths from SIDS, unknown causes and accidental suffocation or suffocation during sleep.
“Babies should always be put to sleep on their backs. This is the single most important factor in reducing infant mortality.”
—Dr. Jenelle Ferry, board-certified neonatologist
Stomach sleeping is of particular concern and is a leading risk factor for SIDS and SUID. This is because stomach sleeping can increase a baby’s risk of:
- It’s getting too hot.
- Breathing in exhaled air, which can increase carbon dioxide in the baby’s body.
- Experiencing changes in heart and lung function, which can limit oxygen reaching the brain.
Sleeping on the side is also problematic, as it increases the chance that a baby will land on their stomach. There is also evidence that side sleeping in and of itself is a risk factor for SIDS. Research has found that babies who are put to sleep on their sides, who then turn over on their stomachs, face a higher risk of SIDS than babies who are regularly placed on their stomachs to sleep.
“Babies should always be put to sleep on their backs,” says Dr. Jenelle Ferry, board-certified neonatologist at Pediatrix Medical Group in Tampa, Florida. “It’s the single most important factor in reducing infant mortality.” As Ferry noted, in the early 1990s, when physicians discovered that babies who slept on their backs were more likely to die of SIDS, they began recommending that all babies sleep on their backs. Since the “Back to Sleep” campaign began in 1994, the US has seen a massive 50% drop in SIDS cases.
What is the safest way to get babies to sleep?
Getting your baby to sleep on their back is one of the most important ways to keep them healthy and safe during the newborn period, but safe sleep isn’t just about sleep position. It’s also about creating an overall safe sleep environment for your child.
In addition to putting babies to sleep on their backs, the Academy of American Pediatrics (AAP) says you can keep babies safe while sleeping by using the following practices:
- Choosing a stable sleeping surface for the baby.
- Keep baby’s sleeping space clear of loose objects, pillows, toys, blankets and crib bumpers or pads
- Use fitted sheets, instead of loose sheets.
- Always dress babies in breathable clothing to prevent overheating.
Additionally, the AAP warns against co-sleeping with a baby, but recommends sharing a room with the baby for their first six months so you can learn their movements, breathing and needs.
What if a baby rolls onto his side while sleeping?
Obviously you shouldn’t put babies to sleep on their sides, but what if they roll over on their own? This certainly happens to many babies, leaving parents and caregivers to wonder if it’s necessary to move them onto their backs and risk waking them up.
said Dr. Jessica Madden, a pediatrician, neonatologist, certified lactation consultant and medical director of Aeroflow Breastpumps, says it’s usually fine to let babies stay on their side once they’re about 4 months old. According to the AAP, babies younger than four months are at increased risk of sleep-related infant death. In fact, the risk is five to 10 times higher for babies younger than 4 months.
“For the most part, when babies can roll over in their sleep (at 4+ months) they’re past the point where we’re worried about Sudden Unexplained Infant Death (SUID), so it’s OK for them to sleep on their sides if they will naturally end up in this position,” Madden explained.
“If your baby can’t roll over yet but is on his side, it’s OK to leave him sleeping,” adds Ferry. “Just make sure you continue to put them to sleep on their backs, and make sure the rest of their sleep environment is safe.”
Is there a way to prevent side sleeping for babies?
Some products, such as wedges and sleep positioners, claim to prevent rolling or side-sleeping, but Alexander warns that these are not safe. You can’t stop a baby from rolling onto his side once he does, he explains, and “these devices increase the likelihood that the baby will get caught under or suffocate.”
Parents and guardians should no use sleep positioners, nests, wedges, anti-roll products or other devices sold to keep babies in a certain position during sleep.
The AAP also warns that parents and guardians should no use sleep positioners, nests, wedges, anti-roll products or other devices sold to keep babies in a certain position during sleep.
If a baby rolls onto his side frequently, you may wonder if there is anything you can do to prevent this from happening. Madden says you don’t need to overthink it, and focusing on getting the baby down safely — on his back — is the best way to avoid any issues.
When are babies safe to sleep on their sides?
When can you let a baby sleep freely on his side? “After 12 months of age, the risk of SIDs drops significantly, and it’s OK to sleep on a side position,” Alexander says.
This means that once a child is over 12 months old, they should be able to sleep on their side or be put to sleep in this position. This is in line with sleep guidelines from the AAP, which states that babies should be placed to sleep on their backs for both naps and nighttime sleep in the first year (12 months) of life.
Of course, every baby is different. Certain conditions or health factors can make side sleeping unsafe even after 12 months of age. Safe sleep guidance should always be verified with a child’s doctor.
The bottom line
There are many rules and guidelines when it comes to baby sleep. This may seem stressful, but it’s important to remember that they’re all in the name of keeping babies healthy and safe.
Babies who roll onto their sides or prefer to sleep on their sides can stay in that position if they roll over on their own (which happens by age 4 months) or if they are at least 1 year old. old But, it is recommended that babies be put to sleep on their backs, on a firm and clear surface, every time.
Always talk to a doctor before making changes to a baby’s sleep environment. If you have questions about side sleeping or safe sleeping in general, contact your baby’s pediatrician.
