Baby Tummy Sleeping

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I received a question this week and it came at the perfect time. And, it was a good question. The gist of the question is whether it’s OK to put a 9-month old on his tummy to sleep.


First, Back to Sleep

It is highly recommended to place your baby on his back to sleep to reduce the risk of SIDS. If you haven’t already, please review the ten ways to reduce SIDS risk, one of which is to make sure baby sleeps on his back to sleep. Some parents are worried baby will choke on spit-up, but babies will automatically swallow fluids or turn to the side. The #1 way to reduce the risk of SIDS is to put baby “back to sleep”.


When can baby sleep on his tummy?

So, when can we put our babies on their tummy to sleep? Please note you should check with your pediatrician, first and foremost. I am not a doctor, but it is my understanding that once your baby can roll onto her tummy, it is OK to allow her to sleep that way and you do not need to worry about continuously flipping her back over. Dr. Sears’ website states “It does not mean that if your baby sleeps on her tummy she’s going to die of SIDS. Current SIDS rates are around one in a thousand babies; meaning that there’s a 99.9 percent chance your child will remain a healthy little girl regardless of her sleep position.” HOWEVER, the AAP recommends that you place baby on her back each time you lay her down for the first year, even if she changes position later.

Some babies start to roll and don’t like it and wake you up numerous times per night. That is never fun. I was lucky that once my son learned to roll that way, he actually slept better! If your baby is rolling uncontrollably and doesn’t like it, this is usually a “short” (not when you’re going through it) 2-3 week phase and she will likely stop.

But, what about older babies?

Even though SIDS can happen anytime in the first year, the peak risk for SIDS is between 2 and 4 months old and 95% of all cases have occurred before 6 months, so that is probably less of a concern in a baby as old as 9 months old (the question at hand I mentioned at the beginning of this post). Many babies are rolling by 9 months old and likely would roll in their sleep, too.


Should you “force” tummy sleeping to get better sleep?

While encouraging your baby to sleep on his tummy when he hasn’t done it himself can work, it may be difficult to implement and not what the AAP recommends. It is best to develop a plan that you can 100% commit to and the #1 question to ask yourself when you consider a plan such as this, is whether you can stand at the crib and rub/pat his back for 2 hours. Of course, most babies probably will not take that long, but in most cases, if you had to visit this site, you do not have an “easy” sleeper and thus, certain methods may take a little longer than with other babies (especially in this case if he isn’t used to sleeping on his tummy). While some may drift off to sleep in 5-10 minutes, yours might take 30, 60 or 90 minutes. The #1 key is to be consistent with your plan, so make sure whatever you choose to do, you feel 100% committed you can stick with it for as long as it takes and then hope he doesn’t take that long. ;) Of course, you will never know unless you try, either.

However, as with any method, you should be very careful not to create yet another sleep association that you will need to break. Don’t break one sleep association in exchange for another. That’s very important!


When did your baby start to sleep on his tummy?

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22 Responses to Baby Tummy Sleeping

  1. Pam says:

    Love your article! I’d like to offer one clarification. Parents should always place their baby to sleep on his or her back, then allow the baby to adopt whatever position her or she feels most comfortable. We also want to make a distinction between “flippers” and “rollers” . A “flipper” is an infant that can only roll to one position. A “Roller” is a baby that can freely move from back to tummy and tummy to back at will. Once the baby is freely rolling, we let them adopt whatever position they are comfortable with in a safe crib (no bumpers, pillows, quilts, stuffed animals etc.)

    “Flippers” are inexperineced rollers. They can get into trouble and not be able to get out. You MIGHT consider repositioning that child if you happen to find him or her on the tummy. Most important, tummy time play during the day. That assists babies of all ages with their upper body strength, torso rotation and development. Enjoy your baby!

  2. Nicole says:

    @Pam Thank you so much for commenting! Reducing SIDS risks is very important, so I’m so glad you added this valuable information from SIDS of Illinois.

    Nicoles last blog post..Is Your Kid Cute?

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  4. Kite says:

    Thanks for the posting.

  5. Jesica says:

    I confess my husband and I allowed our baby to sleep on her front right from the beginning. We fought getting her to sleep in the crib for two weeks, but she wouldn’t. I was exhausted because she would only sleep if I held her. Finally, a friend came over, put her on her stomach in the crib, and Emma slept for 2 hours!!!!!

    So now, I have the opposite problem… she flips over on to her back and then can’t stay asleep. How do I help her?

    BTW, part of the reason she couldn’t/can’t sleep on her back is because her hands move so much she wakes herself up. I know Swaddling was supposed to help that. But if we swaddle her with both arms inside the blanket, she screams, kicks and twists until she gets her hand free. (She was ok with being swaddled, as long as at least one hand was free.)

  6. Pam says:

    Jesica,
    The great thing about being a parent is that you get to make the decisions. You weighed the information available to you then decided that for your child, belly sleeping worked best. That’s your right as a parent.

    You don’t say how old your daughter is, but I’d say that your answer is tummy time while she is awake and observed. Tummy time will allow her to develop the skill of rolling completely around so that she can assume any position that she likes rather than getting stuck on her back.

    Once a baby has begun to roll, swaddling is no longer recommended.

    Good luck!

  7. Jesica says:

    Thanks!

    She’s almost 5 months now. She can roll back over, but I am not sure she knows it yet. As a matter of fact, I think it’s only been a week or two that she realizes she can (intentionally) roll to her back. I will continue to encourage her to roll back to her front. Thanks for your help!

  8. Nicole says:

    @Jesica Thank you for sharing your story. I agree with Pam.
    @Pam Thank you for chiming in! :)

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  10. roxie says:

    ummm this whole thing with SIDS is bullsh*t as u r born with SIDS it has nothing to do with sleeping… SIDS is caused from a chemical in the brain stem which if your body does not produce enough of u die… if ur baby dies from anything else then its called suffocation…. NOT SIDS! this is not like a personal attack on u or anything… my mhn still craps on about safe sleeping and SIDS, but i no it bullsh*t

  11. Pam says:

    Roxie,
    Our researchers have not proven that you are “born with SIDS”. We do believe that our SIDS babies have a vulnerability that other babies don’t have and it may very well be a lower level of serotonin but we don’t believe that a baby is doomed because of these lower levels.

    We have proven successfully over the last 15 years that placing a baby on his or her back does work. Otherwise, the number of deaths due to SIDS would not have fallen more than 50%. Research shows that about 97% of the babies that die have a least one known risk factor and over 80% have at least two risk factors.

    Something as simple as placing baby on his or her back could save a life. Isn’t it worth it?

  12. Nicole says:

    @Roxie I understand you feel strongly that SIDS is not real or that babies are born with it, but it is real and it is not the same as suffocation. They rule that out and a baby who dies from SIDS can’t be explained. They are still researching all of the causes of SIDS, but they have studied ways to limit your baby’s risk. Some babies may still die, even if you follow all of the advice and some babies won’t even if you break all of the “rules”, but to limit your risk, it’s best to use what years and years of research has told us: Babies sleeping on their backs have lower risk. If that one decision is all a parent makes and it saves their baby’s life, isn’t it a good thing to pass on? I think that’s why the person you are referring to is trying to share with you safe sleeping tips, so you don’t have to go through what 2,500 moms will go through this year in the U.S. Read more here: http://www.sids.org/

  13. Tracy says:

    Hmmm Roxie

    Wish you’d have been at the coroner’s office and performed my daughter’s autopsy, perhaps her death certificate wouldn’t be blank. You clearly have found the reason for this awful syndrome, or perhaps it isn’t a syndrome anymore since you know why babies die.

    All babies should be placed on their backs to sleep regardless of age or ability to roll. They can in fact become stuck in the tummy position, especially when the covers get caught over their heads.

    When a baby dies of suffocation, there is haemoraging behind the eyes, that’s how an autopsy can rule out suffocation as SIDS babies don’t have this haemoraging.

    Just my two cents worth.

  14. Nicole says:

    @Tracy I am so sorry for your loss! :( I will add that you should not use covers with a baby and instead use a sleep sack. We don’t want anything going over their faces and tiny airways, so it is recommended to keep the crib free of anything “free” that can cover a baby like a stuffed animal, blankets, etc. Thank you for sharing your story and I’m sorry about the other reader’s insensitivity.

  15. Lindie says:

    Hi,
    I don’t know if it’s too late to comment on this story, but I hope I can get a little feedback/advice. I apologise in advance for the length of this post.

    My son is 8 months old and has been rolling both ways since 4 months and has been crawling for the last 4 weeks. He has never, not even once, slept on his belly. From day 0 to 6 months he was a back sleeper, and since then he’s been sleeping on his side as he started waking frequently and I have been patting back to sleep on his side. Now he settles very easily in that position.

    Just in the last two days he’s discovered that he can roll over in his cot and crawl around (previously he’s always been pretty immobile, waking up in more or less the same position he fell asleep).

    Okay, now here’s the problem. Every time he wakes (during every nap and through the night) he immediately rolls over and starts crying, trying to crawl around, and rubbing his eyes. I think he’s half awake / half asleep and rolls almost out of habit and without meaning to. He won’t lay down or flip back over and settle. He just props himself up on his arms and cries.

    I have to go in and put him back on his side, which results in a struggle trying to get him to lie still and settle all the while fighting him from flipping back onto his stomach.

    I’ts 9:30pm and he’s been asleep 90 mins and has woken 4 times and rolled onto his stomach. Help! How can I get him to settle on his stomach and sleep, he’s been resisting all my attempts (he doesn’t know how to relax in that position). Or is it possible for me to get him to sleep on his back again?

    I can see lots of wakeful nights in my future! Any advice would be appreciated, although I am not willing to try CIO.

  16. Jesica says:

    Lindie,

    Emma, now 14 months, also wakes and cries in the middle of the night. At about 9 months, we decided to resist the temptation to go in. The first few nights were hard, esp the night she cried for over an hour! I know some people aren’t comfortable with the CIO, but after a month of running in to help her and not getting any sleep ourselves, we realized it was time for her to learn to get back to sleep herself.

    For a long time, when she would wake she’d cry, but max of 2 min and usually more of a yelp. Occasionally, this still happens. Then she goes back to sleep. I guess that means she learned to settle herself back to sleep.

    She started waking up earlier and earlier in the morning around 12 months. But she was tired and grumpy until her first nap… usually 1.5 hrs after waking up. We finally realized she needed to sleep longer so we needed to go through the same process again.

    The first night she woke at 5 and we let her cry until 6. It was intermittent. I assume she either fell back to sleep or was playing in her crib. The next morning she slept until 6 am and we got her up. Since that still didn’t seem to be late enough for her, the next morning when she woke at 6, we let her cry again. And again, it was intermittent until about 7. The next morning, she slept until 8 am!!!

    Now she tends to wake somewhere between 6:30 and 8. If she wakes before 7, I have to listen carefully to determine if she will go back to sleep or if she really is ready to get up. Those cries do actually sound different.

    Another interesting thing that happened, she loves her crib! When she is awake and I go in to get her, she wants to play in the crib for a few more mins.

    One more thing we did. Since the chances of SIDS drops dramatically at 6 months, we put a small stuffed animal in her crib. We decided it was small enough that she was not going to suffocate her if she slept over it or it over her. I think some mornings she actually played quietly with the stuffed animal for awhile. This “quiet play” seems like a nice restful way to wake up. And now that she is beyond the SIDS statistics, we have put a couple more stuffed animals in her crib. And she seems to enjoy that. As a matter of fact, now that we seem to be moving away from the afternoon nap, sometimes she just sits in her crib and talks to her animals. Again, 30 min of quiet play is often great rest.

    You know your child, so you know if CIO may not work. But by 8 months, he probably knows you are there for him and he is feeling the need to assert some independence. Especially since he has started crawling. (Part of the reason he is waking up might be because he is excited about this new skill!) I suggest you give him the chance to learn how to comfort himself back to sleep.

  17. Lindie says:

    Hi Jesica,

    Thanks for your input. I understand that CIO has worked for many families to restore restful nights, but I’ve done my research on the topic and decided it’s not right for our family at the moment.

    My son hasn’t developed object permanence yet (I can test him simply by hiding a toy he’s playing with under a blanket and see if he tries to uncover it. which he doesn’t, he just gets confused and starts looking around), so maybe when he understands that once I’m out of the room I am still there to protect him, just not right next to him, then I might consider the controlled crying method.

    Anyway, the frequent waking last night turned out being nothing to do with the rolling/crawling. This morning I checked his gums and he has five, yes FIVE, top teeth cutting through. Today has been a mess of crying, snot, drool, fever and cuddles.

    I put him to sleep at 7:30pm and now it’s 10:30pm and he hasn’t stirred. I just went to check on him and he had rolled onto his stomach successfully.

    Here’s to a (hopefully) good night’s rest!

  18. Andrea says:

    Hello, this might be a bit late, but I wanted to comment about the earlier posts about SIDS. Being a new mother, I read everything and had everything given to me about SIDS. I think some of the info is a bit confusing at times. A lot of it seems to lump suffocation and SIDS into the same thing. So I can see why the one post, was very adamant about the fact that it is not the same. I think also because the way to prevent these two things are so similar, people have just assumed that SIDS is a form of suffocation. So hopefully with forums like this and the more we inform people of what SIDS really is, the more we can try our best to prevent it and all the confusion. Thanks

  19. Pam says:

    Andrea, It sure can be confusing for a new mother. Right now, it’s kind of a scary time. We almost know enough to start using the word “prevent” but we don’t know quite enough. SIDS and suffocation are not the same thing; however, all the tools that we use to reduce the risk of SIDS can 100% prevent an accidental suffocation. That’s how the terms become interchangeable.

    The good news for new parents is that you have more tools than ever to reduce the risk of SIDS. You get to chose which tools you use. We don’t yet know what the “tipping point” is, but we do know that of the babies that are dying, 95% of them have at least one risk factor and 87% have two or more risk factors present.

    Also, remember, most babies live!

  20. ugh says:

    I don’t think it has anything to do with sleeping position. I think something else causes SIDS that is still not understood. Too many generations of healthy babies have been sleeping on their tummies for this to REALLY make that much sense. Some babies aren’t comfortable on their backs. I say, do what works for you and your baby and discuss things with your doctor. The.. IF you have a healthy baby they should sleep on their backs thing just doesn’t make sense. If you have a healthy baby they should be able to sleep however. And wouldn’t placing unhealthy babies on their tummy just quadruple their odds of dying? We need more research… I’m not buyin this thing. Basically, for the most part, people who have no children do these studies and write books about what’s best for them.

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