How should a baby sleep? Positions and recommendations to keep him safe

Many moms make the mistake of putting things in their baby’s crib when he goes to sleep: blankets, pillows, bumper pads, quilts, stuffed animals…

But the doctors’ recommendations are contrary to a crib full of items; it is not a good idea to lay them face down, as our grandmothers used to do. What should the place to sleep our little ones be like, what is the safest position for them?

Safest position to sleep a baby

The writer and mother, Emily Oster, with whom we spoke about her book Parenting without myths, explains that when we were children it was common to sleep babies on their stomachs, covered by a thick blanket and surrounded by protectors, “It made sense, babies are so small and the cradles are not comfortable”.

The idea of a tiny baby lying alone in a giant crib is a bit scary

“Until the early 1990s, the most common sleeping position for babies was on their stomachs, most likely because they “don’t wake up much”.

However, since the 1970s there has been evidence that sleeping on the stomach is associated with an increased risk of premature infant death syndrome, also called crib death.

As time has gone by and through very serious research that supported the danger of sleeping on the stomach, pediatric academies around the world issued different recommendations.

The guide, Safe Sleep for Baby, from the National Institute of Child Health and Human Development (NICHD), explains that babies sleep safer on their backs.

“The supine position is the safest position for all babies up to one year of age and they should be placed in this position as soon as possible after birth”.

“Babies who sleep on their backs are much less likely to die from SIDS than those who sleep on their stomachs or sides. It is recommended that they sleep like this during naps and at night”, the document says.

It is even pointed out that babies who are used to sleeping on their backs, when placed on their stomachs for a nap, are at very high risk.

Should the baby be repositioned if he changes position?

According to the guide, “if the sleeping baby rolls by himself from face up to face down or vice versa, there is no need to reposition the baby. Putting him to sleep on his back at bedtime is the most important thing to reduce the risk of SIDS”.

Best place to sleep a baby

American Academy of Pediatrics (AAP) agrees that newborns should sleep alone, in a crib or bassinet, and on their back.

“AAP guidelines say that there should be nothing inside the crib with the baby. Bumpers should not be used, that is, the pads around the crib to prevent their little hands or feet from getting caught”, explains Emily Oster.

Oster recommends that newborns sleep in their parents bedroom, but in their own crib or bassinet, not in bed with them.

“These recommendations are designed to reduce the risk of sudden infant death syndrome”.

On the other hand…

The NICHD guide also refers to not putting things where the baby sleeps, “When putting your baby down to sleep, use a firm and flat surface, such as a mattress in a crib, bassinet, portable crib or playpen, covered with a fitted sheet. Do not include other types of bedding or padded objects in the sleeping area”.

You can read: 6 Books for new fathers

Places that are NOT recommended to sleep your baby

The NICHD also lists certain places we should never sleep our baby. For example:

1. Never place your baby to sleep on soft or cushioned surfaces, such as a couch, sofa, waterbed, pillow, comforter, sheepskin, or blanket. These surfaces can be very dangerous for babies.
2. Don’t put your baby to sleep regularly in a car seat, stroller, swing, baby carrier, cloth carrier such as a wrap, ring sling or similar products.
3. Your baby should not sleep in an adult bed, couch, or chair alone, with you, or with anyone else, including siblings or pets. Sharing a room reduces the risk of sudden infant death syndrome.
4. If you take the baby to an adult bed for feeding or soothing, remove all soft or padded items and blankets or covers. When you’re done, return the baby to where he sleeps alone, such as a crib, playpen, or bassinet, and close to your bed.
5. Armchairs and sofas are very dangerous for babies if adults fall asleep while feeding, soothing or holding the baby on them. Parents and other caregivers need to be aware of how tired they are during these times. There is no evidence for or against devices or products that claim bed-sharing is “safer”.
6. Don’t put any padded objects, toys, bumper pads, or loose blankets or bed covers under the baby, on top of the baby, or anywhere the baby sleeps.
7. Dress your baby in sleepwear, such as a sleeping bag, designed to keep him warm without the need to wrap him in loose blankets. Dress him appropriately for room temperature and not too warm. Parents and caregivers should watch for signs of overheating, such as sweating or the baby’s chest feeling hot to the touch. Keep your baby’s face and head uncovered while he sleeps.

Don’t fall into temptation

For Emily Oster, while the recommendations from the AAP and other institutions are very easy to understand, they can be difficult to follow, particularly amid the exhausting confusion new parents experience.

“Many newborns sleep best on their stomachs and it’s too tempting to let them sleep that way all the time when nothing else works. It can also be tempting to let them sleep in your bed or on the couch, especially while you are breastfeeding, but you have to think carefully about the risks”, concludes the author.

Translated by: Ligia M. Oliver Manrique de Lara

Spanish version: Here

Other interesting topics: 7 ideas to reveal your baby’s gender

My baby moves a little bit, is this normal or should I be concerned?