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

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