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 her back until she is a year old, but when she starts rolling onto her back or sides during the night, she can generally be allowed to stay in that position. This is because being able to move into it shows that she has been building enough muscle to control her movements well enough to sleep safely in whatever position she turns to.

When Baby starts to turn over on her own though, it’s a sign that it’s a good time to stop swaddling, since limited use of her arms could keep her from turning back over if she needs to, and just generally limit her 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 her back, and she isn’t quite mobile enough to maneuver themselves into a better position on her 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 she is asleep, cause her to flail and even hit themselves, startling her awake. Many parents successfully counter this problem by swaddling, which pins her limbs in place so they won’t disrupt her 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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