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Preventing Sudden Infant Death Syndrome 
 
by Mark Jessen October 11, 2005

Back Sleeping

In 1992, the American Association of Pediatricians issued their policies regarding infant sleeping positions. Their studies prompted a national campaign called “Back to Sleep” in 1994. Since that time, parents have been counseled to have their infants sleep on their backs in order to reduce the risk of SIDS.

The campaign seems to have worked. Four years after the campaign began, SIDS-related deaths dropped by nearly half (from 4,660 to about 2,800). That’s a great advance, but with infant deaths still totaling over the 2,000 mark, there is still room for improvement.

Despite this campaign, many parents still allow their infants to sleep on their stomach, and with understandable reasons. Betty McEntire, PhD and Executive Director of the American SIDS Institute, often faces the question of why it is not good to have an infant sleep on its stomach. According to McEntire, babies who sleep on their stomach have a tendency to cry less, require more stimuli to wake, and wake less. However, babies who sleep on their stomachs are actually at 12.9 the risk of SIDS compared to babies who sleep on their backs, explains McEntire. Stomach-sleeping babies are at an increased risk of apneas (pauses in breathing), rebreathing (breathing in exhaled breath, upping the carbon dioxide content of the blood), and overheating—all of which are considered factors leading to SIDS. Interestingly, stomach- and back-sleeping babies have the same risk of spitting up and/or choking.

But what about flat spots for back-sleeping babies? According to the National Institutes of Health, flat spots on a baby’s skull will generally disappear once they begin sitting up. Additionally, while you shouldn’t allow your baby to sleep on their stomach, you can allow “tummy-time”—time when the baby can be placed or allowed to stay on its stomach (such time should be given when the child is awake and monitored). To further prevent flat spots, alternate the position you place your child in to sleep. Alternate the sides of the head that a child sleeps on.

Side sleeping is another sleeping position that should be avoided with infants. The risk of the baby rolling to its stomach makes such a position dangerous.

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