Placing a baby "back to sleep" became a routine recommendation beginning in 1994 after evidence showed that babies who slept on their backs had a much lower risk for sudden infant death syndrome. SIDS is the leading cause of death for children under the age of one year.
In this study out of Yale University, researchers found that the number of babies who were put on their backs to sleep increased from 25 percent to 70 percent since the recommendations changed in 1994. But in this study, the number of caregivers heading this advice has not changed since 2001.
The researchers looked at how different caregivers positioned their babies for sleep to see if there were any factors affecting a caregiver's choice of an infant's sleeping position.
Interestingly, one of the factors was whether or not the caregiver was ever told to place the baby on their back to sleep. One-third of those surveyed said that their doctor did recommend that their child sleep on their backs, but many did not receive any recommendation. How is a parent to know how to position their baby for sleep if their doctor does not discuss sleep positioning?
Another factor, which influenced a caregiver's choice of infant sleep position, was comfort. Again, more than one-third of those surveyed felt like the baby was more comfortable on their tummy. Another 10 percent were worried that an infant might choke if they were lying on their back.
It is imperative that physicians discuss infant sleep position with parents and the need to reiterate this is evident in my own practice. Just today I saw a two-month-old baby with her mother and babysitter. The mother and I had discussed "back to sleep" (this is her third child), but the babysitter happened to mention that she "puts the baby on her tummy to sleep if she is in the room watching her". It doesn't matter if you are in the room, sleeping next to the baby, or watching on one of those new video monitors.
Placing babies on their backs to sleep remains the most effective means to reduce the risk of SIDS, and there are few exceptions. The risk of a baby sleeping on their tummy "because they seem more comfortable" is just too great. The evidence is compelling.
So.... until your child is old enough to role all over their crib, put them "back to sleep" and know that you are doing the very best thing to protect your baby.
Tummy time is only for awake time. Don't cheat!
I'm Dr Sue with The Kid's Doctor helping parents take charge.