One of the lessons drummed into new mothers and fathers is the importance of sleeping position for babies during the first year of life. Knowing that sleeping position has been linked to occurrences of SIDS—sudden infant death syndrome—today’s parents are understandably eager to know the best way to put their babies to sleep. Although medical researchers have not yet come to a consensus on how to prevent all cases of SIDS, amazing strides have been made since the introduction of the Back to Sleep Campaign in the 1980s, which has reduced the number of babies who die from SIDS by as much as 50 percent. The best thing you can do to lower your baby’s risk of SIDS is to put your baby to sleep in the recommended sleeping position.
Sudden infant death syndrome, also known as crib death, is the most common cause of infant death in the first year of life, with the majority of cases occurring between the ages of two and four months and 90 percent of cases occurring by six months. It commonly, but not always, occurs in babies who are asleep, and the babies usually cannot be roused, even with early medical intervention. SIDS occurs all over the world, in developed and less developed countries, and crosses racial, socioeconomic and class boundaries.
No Sure Answer
Despite the success of the Back to Sleep Campaign, about 2,500 cases of SIDS still occur annually in the United States. What causes SIDS remains one of the biggest and most tragic mysteries of the day, even after decades of worldwide research. One promising line of research suggests that the deep sleep of babies sleeping in the prone (tummy down) position inhibits their immature breathing response. Although there are many hypotheses, so far, there are no simple answers.
What We Do Know About SIDS
Even though they don’t know exactly why SIDS occurs, researchers do know that certain factors increase a baby’s risk of dying of SIDS. The risk is higher in babies of young mothers (under 20), mothers who had substandard prenatal care, and mothers who smoked, drank, or used drugs during pregnancy. Babies exposed to tobacco smoke after birth and babies born prematurely or at a low birth weight are also at a higher risk of SIDS. Compared with white babies, infants of American Indian or Alaskan Native descent have three times the risk of dying of SIDS, and those of African American descent have twice the risk. And babies who sleep on their stomachs or who are overheated while sleeping are more likely to die of SIDS.
According to the American Academy of Pediatrics, the best sleeping position for a baby is supine—on his back. Whether it’s for a short nap or for the night, always put your baby to sleep on his back with his feet at the base of the crib. Use a firm crib mattress that has been approved for infant safety, covered tightly by a fitted sheet. If the temperature is cool, you may tuck a light blanket into the sides of the mattress, placing the blanket no higher than the baby’s chest. Dress your baby comfortably in close-fitting sleepwear—not baggy. Avoid dressing her too warmly or using excessive blankets that can overheat he. Do not put any pillows, toys, stuffed animals, cushions, quilts, comforters or other soft, plush objects inside the baby’s crib.
Take special care to make sure all your baby’s caregivers know the best way to put your baby to sleep. Keep in mind that your own parents and grandparents might have been taught to put their babies to sleep on their stomachs and might need re-educating. Don’t assume daycare workers already know the best sleeping position for a baby.
Although previously recommended along with back sleeping to help reduce the risk of SIDS, the side sleeping position has not shown to be an effective protection against SIDS. In 2005, the American Academy of Pediatrics affirmed that the only recommended sleeping position for babies under one year of age is on their backs. If your baby rolls during sleep onto his side or tummy, you may want to contact your pediatrician for advice.
GERD and Infant Acid Reflux
GERD is gastroesophageal reflux disease. Most babies experience some infant acid reflux, particularly in the first few months. Sometimes that reflux can be uncomfortable during sleep. In the past, some doctors would occasionally recommend that babies who suffer from severe reflux sleep on their stomachs. Because the efficacy of this treatment has come into question, only in rare cases is this still recommended; instead, doctors might recommend raising the head of the crib to elevate the baby’s upper body. Don’t put your baby to sleep on her tummy unless under the advice of your baby’s pediatrician.