Why is Sleeping on the Back Considered Best For Babies by Dr. Srikanta J T

10 min read

Written by Dr. Srikanta J T

Dr. Srikanta J T

Sleeping on the Back

Parents leave no stone unturned when it comes to their babies, be it their diet, clothes, diapers, or sleep. Babies are fond of sleeping, and they keep changing their positions, not knowing what is best for them.

In their initial days, they are busy sleeping most of the time. So, if the parent is aware of the right or safe position for them to sleep, the baby can have a sound sleep and be healthy. While most parents don’t give too much priority to their babies’ sleeping positions, the positions make a huge difference to the growing baby’s health and wellness.
In This Article

What are the Good and Bad Positions For a Baby to Sleep?

Your baby is too young to understand what is good for them and what is not. They are completely dependent on you as parents for their needs. If the parents have a thorough know-how of the ways to take care of the baby, the process becomes rather smooth for both parties.

It may sound strange, but the sleeping position of the baby determines health and moods. It is thus important to know the safe and dangerous positions for putting the baby to sleep to avoid any risks.

1. Sleeping on the Back

  • Healthy babies that are born on time and not pre-term should be sleeping on the back while they are taking short naps and even when sleeping throughout the night.
  • This sleeping position is considered to be the best by experts and is known to reduce the potential risk of SIDS in young babies.
  • According to an article published by the National Institute of Child Health and Human Development, sleeping on the back reduces the occurrence of SIDS by 1.7 to 12.9%.
  • Sleeping on the back even helps babies keep the airway open and increases the oxygen supply.

Are There Any Risks For Babies Sleeping on the Back

While sleeping on the back is among the best positions,  if the baby is left in the same position for a longer duration, the head can get flattened. Sometimes the back part of the skull can get flattened too. Having said that, in most cases, however, it resumes to its normal state by the time the baby turns one. As a parent, though, you may want to avoid every risk for your little one.

In such cases, a few precautions can help reduce the threats and the chances of flattening the head. Let us take a look at these measures:

  • Always place your baby on their tummy, especially when they are awake.
  • Help your baby to rest on the opposite side of the flathead.
  • In case of a flat head, prioritise holding your little one in your arms over placing them in baby carriers, baskets, or car seats.
  • Ideally, change your baby’s crib direction so that they keep looking at different angles as well.

2. Sleeping on the Side

baby sleeping on side

  • Sleeping sideways for the baby is not a safe option as it can increase the chances of SIDS.
  • While sleeping on the side, the babies can even end up on their tummy which can suffocate them, thereby increasing chances of SIDS.
  • Sleeping on the side may not aid proper digestion and hence is not recommended.
  • Lying in this position blocks the airways thereby decreasing the oxygen power supply.
  • It even puts excessive pressure on the hand as well as the jaws.
  • It is not a very comfortable position for the baby too.

3. Sleeping on the Stomach

baby sleeping on stomach

  • Making the baby sleep on the stomach is not advisable as it can cause suffocation since the face of the baby is too close to the sheet.
  • If the baby is sleeping on the mattress, there is a danger that the baby can re-breathe the same air which leads to carbon dioxide build-up and lowered oxygen levels, posing threats to the baby.
  • Sleeping on the stomach can also lead to upper airway obstruction, which is again dangerous to the baby.
  • In case the mattress is very soft, it can cause suffocation.
  • The other major hazards of sleeping on the back include vomiting and choking. Choking can happen because little babies are not equipped to turn on their own.
  • Infants who sleep on their stomachs may be less reactive to noise, and experience sudden changes in blood pressure and heart rate control.
  • For these reasons, sleeping on the stomach may not always be safe for the baby. There are however exceptional cases where the baby can be allowed to sleep on their stomachs.

When to Allow Babies to Sleep on Stomach?

  • In case the baby has gastrointestinal issues, doctors often recommend making the baby sleep on their stomach.
  • Doctors also recommend this position for babies who have colic issues.
  • Sleeping on the stomach helps babies get relief from gas, but this should not be done instantly after feeding.
  • Allow enough gap between feeding and making your baby rest, especially on their stomach.

So far we have seen the best and safe positions. At the same time, it is vital for every parent to understand hazardous sleep practices that can cause dangers to the baby. Let us look at some conditions that can cause sudden death in babies due to bad sleep practices.

About SIDS – Causes and Prevention

What is SIDS?

SIDS refers to “Sudden Infant Death Syndrome” or “crib death”. It is very common and mostly happens when babies are sleeping. It is very tough to determine the main reason for the death of the baby. But by taking proper measures SIDS can be prevented. Additionally, using the correct and safe positions while sleeping also helps to reduce the chance of SIDS.

3 Important Causes For SIDS

SIDS can happen for many reasons. Ignorance on the part of the parents or being overprotective is one of the major contributing factors. We discuss some important causes that can lead to SIDS.

1. Sleeping on the Side or Tummy

Doctors often advise parents to prevent the baby from sleeping on their tummy, as it can hinder digestion, block the airways, and reduce the oxygen supply. Sleeping on the side can exert too much pressure on the hands and the jaw as well. Sleeping on the side and tummy can increase the risk of SIDS in the baby.

2. Exposure to Smoking or Intake of Tobacco

Babies are very small and cannot express if they are getting disturbed or uncomfortable by someone smoking in the room where they are. They can inhale the smoke of tobacco which can fill their lungs and sometimes lead to suffocation or SIDS.

3. Overprotection or Heating

Many mothers have the habit of overdressing their babies in order to protect them from cold and keep them warm. While this is an overprotective behavior from the mother and is quite understandable, it can cause discomfort and choking in babies, leading to SIDS.

Different Ways to Prevent SIDS

baby swaddled prevent SIDS

It may be difficult to prevent SIDS but a few measures can help you avoid the condition altogether. Here are the measures you can follow:

  • One should be careful not to cover the head of the baby with blankets.
  • No toys that can lead to suffocation should be in the baby’s bed or crib.
  • Try to keep the baby in the crib and not on the same bed as parents.
  • Babies are delicate and need soft blankets and clothes but not too soft mattresses.
  • Always regulate the temperature in the baby’s room.
  • Keep the baby in light and breathable clothes, never overdress the baby.
  • The crib should be bumper-free for the baby.
  • Swaddling the newborn baby is an excellent practice to keep your baby safe.
  • In addition to the above, it is extremely crucial that you monitor the sleeping position of your baby in the initial months.

Sleeping Practices That Could Lead to Sudden Unexpected Death in Infancy (SUDI)

SUDI comprises both Sudden Infant Death Syndrome as well as other threatening sleeping hazards. Some causes of SUDI are as follows:

  • Baby sleeping on the side or on their tummies
  • Smoking by the mother-to-be
  • Secondary smoke exposure.

6 Tips to Ensure Safe Baby Sleep Positions

The safety of the baby is of the utmost importance and so is the right sleeping position. Most doctors advise that sleeping on their backs is the safest position for babies.

Few additional measures ensure total safety and keep your baby healthy and happy.

1. Avoid Covering the Baby’s Head

  • Always keep your baby covered till the chest and not till the head.
  • Leave the arms of the baby open to prevent suffocation.
  • Medical experts also advise using sleeping bags with armholes and fitted necks as the safest option to cover the baby.
  • Using a baby sleep sack is also advisable.
  • You can wrap the baby in muslin or any cotton cloth. This method offers safety to the baby to not roll to the tummy side when they are asleep.

2. Good Sleep Environment

  • Never take the help of rolled blankets or sleep positioners to keep the baby on their back.
  • Infant carriers or car seats should not be used as a replacement for the crib.
  • Smoking should be a big no in the proximity of the baby.
  • If the crib cannot be accommodated in a room, replace it with a bassinet or a cradle.
  • Maintain the right temperature for the baby to sleep. It shouldn’t be too hot or cold.

3. Avoid Using Loose Bedding

  • Always make the baby sleep on a firm mattress as opposed to the soft ones, sofas, or even a waterbed.
  • Avoid using pillows, fluffy and soft bedding, bumper pads, or soft toys around the baby.
  • Anything that covers the face or the head of the baby should not be used at all.
  • These measures ensure that the baby does not get suffocated, the airways are not blocked, and the supply of oxygen is not hampered.

[Read : Pros And Cons Of Using A Pacifier]

4. Use a Pacifier (at Sleep Times)

infant sleeping with pacifier

  • SIDS or Sudden Infant Death Syndrome can be reduced using a pacifier as the baby does not go deep into sleep while sucking it.
  • As indicative of the name, the pacifier is meant to pacify the baby and if anything goes wrong, they can cry or scream, preventing them from SIDS.
  • Sucking a pacifier increases the air space since the tongue comes forward while sucking thereby increasing the oxygen as well.
  • Babies move less or are less restless while sleeping with a pacifier.
  • Using a pacifier helps in minimizing the chances of covering the face with blankets by accident
  • One very important reason behind SIDS is that the baby’s face gets buried in the overly soft blanket accidentally. The use of a pacifier prevents it as the bulky handle of the pacifier in the arms of the baby is exposed. Additionally, there are minimal chances of the baby getting buried fully into the blanket.

5. Avoid the Use of Products That Claim to Prevent or Reduce SIDS

  • There are many over-the-counter products that claim to reduce or even prevent SIDS. Products such as baby mattresses, pillows, crib tents, baby monitors, sleep positioners, crib bedding, etc come under this category.
  • Parents must remember that these products are more often a  threat to babies as they can lead to suffocation.
  • Avoid the use of breathing monitors or heart monitors at home to prevent or reduce SIDS.
  • When awake, the baby should be given a lot of tummy time.
  • It is best to breastfeed the baby to reduce the potential risk of SIDS.

6. Keep the Crib Simple

infant sleeping on crib

  • Do not use comforters, wedges, or quilts under the baby in their bed or crib to make them feel comfortable as it can create more discomfort.
  • Allow the baby to sleep on a firm and clean mattress that fits well in the cot.
  • Let the feet of the baby touch the bottom portion of the crib. This prevents them from wriggling under the bedding.
  • The ends or the sides of the crib should be sufficiently high to prevent the baby from crawling out or climbing.

[Read : Baby Safety- Crib and Baby Bed Safety Tips]

Raising babies is not an easy prospect and comes with many responsibilities and challenges. It is not easy to take care of them without the proper know-how. Parents want the best for the baby, so will keep the surroundings and their outside world as safe as possible. Sleeping is one of the major things a baby does in their initial days and putting the baby to sleep peacefully is a challenge. So, it is always advisable to have a thorough knowledge and then work accordingly. After all, a safe and sound sleep keeps the baby healthy and happy and even keeps the parents at ease. Given above are some of the measures that can be adapted for the baby to have a sound sleep and that even keeps him secure from SIDS.


1. What if the Baby Rolls Onto the Stomach While Sleeping?

It is normal for a baby to roll to the tummy from the back when they are near five months of age. This is also the time when the chances of SIDS are low. Once the baby is in a comfortable position, they can keep turning towards the side. Ensure that their nose and mouth are free so that they breathe well even though they are sleeping on their tummy. Always let your baby sleep on their back when they are put to sleep. Chances of SIDS are at a maximum when the baby is anywhere between one and four months. It is a major threat till the baby is a year old though. So, it is best to take all precautionary measures to prevent SIDS in the first year of the baby.

2. What to do if My Baby Has Difficulty Sleeping on the Back?

Many infants do not go into a deep sleep even when they are lying on their backs. Infants at times are too stubborn and do not feel comfortable, especially if they have a blocked nose. In these cases, a humidifier can be kept in the room of the baby for moistening the air and to loosen the congestion in the baby. You can even elevate the head of the baby to reduce any discomfort that can arise from a stuffy nose.

3. What if Babies Throw Up When Sleeping on the Back?

Even healthy babies can choke on their own vomit when sleeping on their back rather than sideways or on their tummy. This happens because the baby does not have enough strength to turn back from the front to back or sideways. So, in case the vomit gets inside the nose, it can choke the baby. The choking risk is minimal with babies who have gastric issues even when they are lying on their back. It is never advisable to leave the baby with a milk bottle without any supervision. If the baby is not attended to properly, there are high chances of choking and of ear infections as well.

Read Also: Natural Sleep Remedies for Babies

Dr. Srikanta J T, MBBS, Diploma in Child Health (DCH), Diplomate of National Board(DNB), Fellowship in Pediatric Pulmonology and Sleep Medicine(NUH, Singapore), Training in Interventional Pulmonology
Consultant - Paediatric Interventional Pulmonology, Allergy and Sleep Medicine, ASTER CMI Hospital
10 years of experience

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