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What's Safe and What's Not for Baby's Tummy Sleep

When can babies safely sleep on their stomach?

A sleeping baby is one of the most peaceful sights on earth. And as a parent who works incredibly hard to raise a little one, you relish in these moments because sleep can be so hard to come by. You're willing to do just about anything to help them get good sleep as long as it's safe. Unfortunately, there are a lot of myths that lead parents to make unsafe choices. A friend may assure you that particular sleep practices are fine when they're actually not. An example of this is someone telling you that putting your baby to sleep on their tummy is safe, when it has been proven by the AAP that back sleep is far safer.

At Dreamland Baby safety is a top priority. We strive to help you and your baby get a good night's rest while giving you the tools you need to relax and comfort your little one, in the safest ways possible.

There are a lot of questions around tummy sleep versus back sleep, so today we're making sure you know what's best for your little one at every stage. We're thankful to have Michelle Cormier, Pediatric Sleep Consultant of Sleep Ezzz Consulting to offer her expertise within this post!

Put a Baby Down On Their Back When It's Time for Sleep

Babies sleep a good portion of their day. In fact, we recently went over how many hours of sleep your baby needs depending on their age in this article. Because so much of their lives are spent sleeping, it's important that you're following safe sleep practices.

There is a lot of misinformation spread, and it can be confusing knowing what's best when you may have a friend doing something that you've read is an unsafe sleep practice. Remember that just because you know someone who has had no issues with a particular sleep practice doesn't make it safe. It's important to follow research and recommendations outlined by the experts. In this case, that's the American Academy of Pediatrics.

Here's what you need to know.

Babies should always be put to down to sleep on their backs. Even if they are starting to roll, it's best to continue laying them down on their backs for sleep until the age of 1.

In 1994, the "Back-to-Sleep" campaign was initiated between the AAP and other health and SIDS organizations. After research found that infants placed on their stomachs to sleep had a two-fold risk of dying from SIDS (also referred to as "crib death"), the campaign encouraged all caregivers to only place babies to sleep on their backs.

Since this campaign was initiated, the AAP reported that SIDS' deaths in the U.S. fell from 4,891 yearly down to 2,162. Those are facts you cannot ignore.

The safest way to put your baby to sleep is on their back, which means this is what you should always do even if your baby seems to protest. 

Helpful Tips for Safe Back Sleep

Some parents end up resorting to putting their baby to sleep on their stomach because they notice they seem to sleep better that way. You might have a friend say, "My baby just prefers sleeping on her stomach!"

Unfortunately, this is not a safe practice prior to a baby's first birthday. Don't even give your baby an opportunity to sleep on their stomach so they'll always be accustomed to sleeping on their backs.

Here are some tips to help your baby sleep on their back so you don't have to resort to anything that isn't safe.

Helpful tips for helping your baby sleep their best on their back:

  • Establish a sleep routine that always includes the same steps, as we outlined here. This will help signal to your baby that it's time to sleep. They will thrive off of consistency.
  • Use a weighted swaddle until your baby can roll over, then switch to a weighted wearable blanket. Better yet, use a combination wearable blanket with removable swaddle for an easy transition. The weight of the wearable blanket will increase melatonin and serotonin which relaxes your baby for better sleep.
  • Try using a pacifier. If you're breastfeeding, you'll want to establish this first, so wait a few weeks before introducing the pacifier.

Knowing When It's Safe for Baby to Sleep on Their Tummy

Though it's always safest to place your infant on their back to sleep, it won't be long until your baby can roll over by themselves to their stomach. Many parents see this, worry, and wonder if they should roll their baby back onto their back to sleep. At this point, your baby is completely safe sleeping on their stomach, so definitely don't disturb their peaceful rest!

There isn't an exact age when babies can sleep on their stomachs; it's safe for them to do so when they can roll themselves over to their stomachs independently. This can happen anytime between 3 - 6 months.

With that said, you must follow this important safe sleep rule:

Once your baby can rollover, you cannot swaddle them any longer.

If a baby is swaddled and rolls over to their stomach, they can suffocate. So if you see during the daytime that your baby is getting close to rolling over, it's time to transition to a wearable blanket.

Read our article, "3 Signs It's Time to Stop Swaddling Your Baby," to find out the two other reasons to stop swaddling.

Our recommendation is to use a wearable blanket with a detachable swaddle from the beginning. The weighted one from Dreamland Baby offers more sleep-inducing and relaxing benefits than typical wearable blankets and is the perfect way to transition a baby from swaddle to wearable blanket when it's time. You can even leave the swaddle portion on if you like, and wrap it around your baby's chest so they still feel the extra security. Just be sure that your baby has full use of their arms by leaving them out.

With your baby's newfound trick of rolling over, you may find that they roll over to their stomach whenever it's time to sleep. Michelle Cormier of Sleep Ezzz Consulting shares that just as adults, some babies prefer to sleep on their stomachs due to personal preferences and comfort. Stomach sleeping may also give extra gassy babies comfort and helps relieve the pressure.

Though many babies will do great with staying on their stomachs, some babies may get frustrated because they're so used to sleeping on their backs. We don't suggest going and flipping your baby to their back, or this may turn into a terrible habit that doesn't stop. It's preferable to stand by their crib and calm them gently by rubbing their back and saying "shhh" until they fall asleep. This way, it won't be long until they enjoy their new way of sleeping.

Keeping Tummy Sleep Safe

Though it's generally regarded that a baby who is able to turn themselves onto their stomach can safely sleep that way, pediatric sleep consultant Michelle Cormier reminds us to not get complacent about other safe sleeping practices. She writes:

1.) To provide the best sleep for your belly sleeper, it’s important to ensure your sleep space is safe with a tight fitted sheet and no blankets until at least 12 months. A sleep sack is a great way to add comfort for both tummy/back sleepers.  

2.)  If a parent chooses to allow stomach sleep, I always advise the parents speak with their child’s doctor and discuss the benefits/risks of tummy sleeping for their child. Always keep yourself up to date on the AAP guidelines and make the informed and safest choice for your family.

Lots of babies become tummy sleepers once they can roll over, and will end up sleeping better this way. At this point, it's a safe way for your little one to sleep when following Cormier's recommendations and the AAP's guidelines.

FAQs About Tummy Sleep

Here we want to succinctly answer some of the most common questions that come up about tummy or back sleep.

My friend said she puts her baby down to sleep on her stomach because she likes it better. Is this safe?

No, we cannot recommend this. We stand by the AAP's guidelines of always putting a baby to sleep on their back. Even if a baby seems to sleep "better" or prefers tummy sleeping, this is not a safe way to lay your baby down for sleeping.

My baby sleeps so much better when swaddled. He doesn't roll over when swaddled, so is it ok to keep swaddling him even though he knows how to roll over when he's awake?

No, a babies should no longer be swaddled once they are rolling over. Even when you see that your baby is close to rolling over, it's time to make the transition from swaddle to wearable blanket.

My baby only sleeps well swaddled, but learned to roll over. What should I do?

We know it can be hard, but it's time to stop swaddling. We recommend using a wearable blanket that has swaddle wings. You can wrap the swaddle wings around the baby's chest but with their arms out. This way, they will still have the secure feeling of the swaddle but full use of their arms to roll themselves over as needed.

How can I be sure that my baby doesn't develop a "flat head" (known as plagiocephaly) from sleeping on their back all the time?

This is a valid concern. With the launch of the "Back to Sleep" campaign by the AAP, an increase was seen in flat head syndrome. This can be avoided through:

  • lots of tummy time play when your baby is awake.
  • positioning your baby in the opposite direction when you lay them down to sleep at night so they're not always looking in the same direction - but still always on their back
  • holding your baby more often

It's important to know that plagiocephaly is mostly a cosmetic concern. Reducing your baby's SIDS risk by placing them on their back to sleep is far more important. 

Are there any other major safe sleep practices that I should know about?

Yes! Other than always placing your baby to sleep on their back and making sure to stop swaddling when your baby can roll over, here are a few other important safe sleep guidelines:

  1. Make sure your baby's crib is completely bare (other than a fitted sheet) until the age of one. This means it should be free of loose bedding, pillows, bumpers, etc. We recommend using a wearable blanket to keep your baby cozy and warm!
  2. Don't let your baby sleep in a carrier, sling, car seat or stroller unsupervised.
  3. It is recommended by the AAP that babies sleep in the same room as their parents until 6 months of age (but in a separate crib or bassinet.)
  4. Don't use sleep positioners such as nests, anti-roll pillows, mats or wedges. These are a suffocation risk.

Why is it bad for a baby to sleep on their stomach?

When it comes to tummy sleeping, Sudden Infant Death Syndrome (SIDS) is a major risk factor. Some research shows that tummy sleeping may cause an upper airway problem as it can cause your infant to “recycle” their own inhale/exhaled breath. This can cause carbon dioxide to build and oxygen to drop – which can also create overheating, another known risk of SIDS.

 

This is why way back in the ‘90’s, the American Academy of Pediatrics (AAP) created their “Back to Sleep” Campaign which encouraged parents and caregivers to always place baby to sleep on their backs – always! -  in an effort to reduce the risk of SIDS. This resulted in a decrease of cases by 50% - hooray!

 

The “Back to Sleep” campaign has since been re-branded as “Safe to Sleep” as a way to further expand and encourage safe sleep practices.  This now includes:

  • Babies should always sleep on their backs for naps and at night
  • Keep soft bedding such as blankets, pillows and soft toys out of the baby's sleep space (to avoid accidental suffocation)
  • Sleep surface (crib, co-sleeper, bassinet, etc.) should always be firm with a tight-fitting top sheet
  • When possible, share a room, but not a bed, with your baby

Why do some babies sleep better on their tummies?

With all the important reasons for placing baby to sleep on their backs, some babies do seem to get better quality sleep when sleeping on their stomachs. They seem to startle less and sometimes seem less bothered by their environment. Of course, you should always put baby to sleep on her back – always! - for naps and nighttime, to reduce the risk of SIDS.  Should baby roll onto her tummy after starting on her back, this may be okay if she’s had her first birthday. Otherwise, turn her onto her back to ensure her safety.

Why do babies like sleeping on their tummy?

Tummy time is important for babies to develop strong neck and arm muscles and to boost their motor skills. But when it comes to sleep, always put baby to sleep on her back. Always! At around 5 months, baby may start to roll from tummy to back, but until she can do so unassisted, always start her on her back for sleep time! In fact, until she passes the 1-year milestone, always start her on her back to sleep.

Can I let my baby sleep on his stomach if I watch him?

Nope! According to the AAP, the safest way for your baby to sleep is on their back. Always!  Even when you think that stomach sleeping is the only way your little one will doze off, chances are, “watching” her sleep can be exhausting and the risks are just too high. That said, once your baby reaches around 12 months, the risk of SIDS decreases. This may seem like an arbitrary number but ideally, you should put baby to bed on their back for as long as they’re in the crib.  Not until baby can roll onto her tummy, and roll back to her back on her own, is stomach sleep generally considered to be okay. If this is an ongoing concern or proving to be difficult, please talk to your pediatrician.

Should a baby under a year-old sleep on their stomach?

Your baby should always be put to sleep on her back for as long as she’s in the crib. This will reduce the risk of SIDS and adheres to the American Academy of Pediatric “Safe to Sleep” guidelines. The chances of SIDS appear to be greatest between 1-4 months, and greatly seem to decline by the 1-year mark. So until then, please put baby to sleep on her back for all sleep.

How do I stop my baby from rolling over if they shouldn't sleep on their tummy yet?

Let’s face it, we all have a favorite sleep position, and that includes baby. But when it comes to sleep safety, baby must always start out on her back. If she is starting to roll onto her tummy after being placed on her back, that may be okay, especially once she hits the 12 month mark. If it’s in the earlier months, however, roll her onto her back again.  This will help to greatly reduce the risks of SIDS.

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