When is it okay for a baby not to sleep on their back?

Since 1994, new parents have been told that one of the best ways to protect their children from Sudden Infant Death Syndrome was to put them down to sleep on their backs. In the time since then, the rate of SIDS deaths in the United States has fallen to almost one-third of what it was before the recommendation was put in place. Many parents still have trouble convincing their babies that back-sleeping is better for them, though, and when babies start to move around in their sleep, keeping them sleeping on their backs really starts to get tricky. Fortunately, once this greater mobility happens, there’s not nearly as much to worry about.

The American Academy of Pediatrics recommends continuing to put Baby to sleep on their back until they are a year old, but when they start rolling onto their front or sides during the night, they can generally be allowed to stay in that position. This is because being able to move into it shows that they have been building enough muscle to control their movements well enough to sleep safely in whatever position they turn to.

When Baby starts to turn over on their own though, it’s a sign that it’s a good time to stop swaddling, since limited use of their arms could keep them from turning back over if they need to, and just generally limit their movements. In addition to the increased muscle control, part of the reason back sleeping becomes less of a concern when babies start rolling over from their backs on their own is that they generally don’t start turning from their backs onto their stomach or sides on their own until around the fifth or sixth month, while the risk of SIDS death is highest between the second and third month.

If Baby objects…

If you’re having trouble coaxing Baby into sleeping on their back, and they isn’t quite mobile enough to maneuver themself into a better position on their own, there are a couple of different culprits that could be robbing you and Baby both of your sleep. The first is Baby’s own reflexes which can, when they are asleep, cause them to flail and even hit themself, startling them awake. Many parents successfully counter this problem by swaddling, which pins their limbs in place so they won’t disrupt their sleep.

Another reason babies often have trouble sleeping on their backs is that the position can increase the effects of reflux. So if your child has been experiencing reflux symptoms, be sure to talk to your healthcare provider about solutions that can help Baby feel better and sleep better.

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